Comparative Study of Spirulina Gel and Spirulina Nanoparticles Gel in the Treatment of Stage II Grade B Periodontitis: Randomized Controlled Study with Radiological and Biochemical Assessment

Abstract Objectives Periodontitis stage II grade B represents moderate periodontal disease with a predictable, moderate rate of progression. It disrupts microbial-host balance, leading to attachment loss, deepened pockets, and gingival inflammation and bleeding. While scaling and root planing remain the gold standard, they face limitations in accessing deep periodontal pockets. Spirulina was recently introduced as a local delivery system for periodontal treatment therapy. The objectives of the present study were to evaluate the effects of locally delivered spirulina nanoparticle gel and spirulina gel with scaling and root planing (SRP) in treating periodontitis stage II, grade B. Materials and Methods In a randomized controlled trial, 60 patients with periodontitis stage II, grade B were enrolled. Each was assigned to one of three groups: Group I (spirulina nanogel + SRP), Group II (spirulina gel + SRP), or Group III (placebo gel + SRP). Clinical parameters (plaque index, gingival index, probing pocket depth, clinical attachment level) were recorded at baseline, 3, and 6 months. Gingival crevicular fluid samples were taken to assess superoxide dismutase (SOD) levels, and radiographic bone density was evaluated with ImageJ software. Results All groups showed significant improvements over time. The spirulina nanogel group had significantly greater reductions in periodontal parameters and a greater gain in clinical attachment level compared to the other groups (p < 0.05). SOD levels and radiographic bone density increased significantly across all groups, with the nanogel group showing the highest increase. Conclusion Combining spirulina nanogel with SRP resulted in better clinical, biochemical, and radiographic outcomes. Further long-term studies are needed to confirm these effects. Registration ClinicalTrials.gov with # ID NCT06699654 Date of registration: 16 th , November, 2024