A multicenter, controlled, randomized trial of home‐applied dual‐light photodynamic therapy in stage I to III periodontitis (LumoNorth2022 study)

BACKGROUND: Periodontitis is a widespread, chronic infection-triggered inflammatory condition in which professional supportive periodontal care (SPC) and daily oral hygiene form the backbone to reduce the disease activity. Light-based treatments have shown promising antibacterial effects, but their potential for routine home use has not been thoroughly studied METHODS: Stage I-III periodontitis patients in three dental clinics were randomized to receive either SPC (n = 20), or SPC + daily Dual-light aPDT (n = 20). The primary outcome was bleeding on probing (BOP). Secondary outcomes were visual plaque index (VPI), probing pocket depth (PPD), and clinical attachment level (CAL). Clinical examinations were conducted at the baseline, at 3 months, and at 6 months. Student's t‑test and ANOVA were used for analysis. RESULTS: The SPC + Dual-light aPDT group exhibited greater BOP reductions at 3 and 6 months compared with the SPC group (p = 0.03 and p = 0.04, respectively). The VPI% was reduced in the SPC + dual-light aPDT group at 6 months (p = 0.04). The number of sites with PPD ≥ 4 mm was reduced in the SPC + dual-light aPDT group at both follow-ups (p = 0.0019 and p = 0.0043, respectively) but not in the SPC group. A significant reduction in CAL values was observed in the SPC + dual-light aPDT group at both 3 and 6 month timepoints (p = 0.0065 and p = 0.0122, respectively), but not in the SPC group. CONCLUSION: Regular adjunctive use of dual-light aPDT during SPC may be an option for improved plaque (VPI) and gingivitis control (BOP) in periodontitis patients with a potential to modulate periodontal treatment results, measured by CAL and PPD ≥ 4 mm. GOV IDENTIFIER: NCT05425784, URL: https://clinicaltrials.gov/study/NCT05425784, registered on June 15, 2022. PLAIN LANGUAGE SUMMARY: Periodontitis is a common, long-lasting condition that causes inflammation in the gums surrounding the teeth. Periodontitis care needs professional oral healthcare and good daily oral hygiene. Sometimes, the existing home-care methods are not enough to stop the progression of periodontitis. Light-based treatments can eliminate bacteria very effectively, but their home use has not been studied. In this study, 41 patients with mild to moderate periodontitis were divided into two groups. One group (Group A) received normal treatment, which included good oral hygiene at home and cleaning and scaling by the dentist. The other group (Group B) received the normal treatment, and they also used a special antibacterial light-based treatment, which they could do daily at home. The oral health was thoroughly checked by the dentists at the start of the study, and then 3 and 6 months later. The results show that Group B had less plaque and inflammation in the gums, measured as less bleeding. The incidence of deepened gum pockets lowered in Group B during the follow-ups. The final point to note is that using this new type of light therapy might be an option to improve plaque control and gum inflammation in periodontitis patients, which can help to improve periodontal disease control.