Indocyanine Green-Mediated Antimicrobial Photodynamic Therapy Adjunctive to Scaling and Root Planing on Periodontal and Microbiological Outcomes in Periodontitis: A Systematic Review and Meta-Analysis Publisher Pubmed

Summary: Can ICG-aPDT improve periodontitis treatment? A study found it resulted in modest reductions in pocket depth and improved clinical measures. More research needed! #Periodontics #OralHealth

Hassani A ; Younespour S ; Taziki FZ ; Afrasiabi S ; Heidari M
Source: Photodiagnosis and Photodynamic Therapy Published:2026

Abstract

Objective: This systematic review and meta-analysis examined the adjunctive effect of indocyanine green-mediated antimicrobial photodynamic therapy (ICG-aPDT) with scaling and root planing (SRP) in periodontitis to address limited and inconsistent evidence regarding its clinical and microbiological efficacy. Data Sources: Electronic searches were conducted in MEDLINE (via PubMed), Scopus, Web of Science, Embase, Cochrane Library, ProQuest, and Google Scholar up to March 2025. Study Selection: Controlled clinical trials comparing SRP+ICG-aPDT with SRP alone were included. Primary outcomes were PPD and CAL; secondary outcomes were plaque, gingival, and bleeding indices, and subgingival microbial load. Risk of bias followed the Cochrane Handbook, and random-effects meta-analyses with subgroup analyses were performed. Results: Sixteen studies involving 541 participants were included. Adjunctive ICG-aPDT led to additional mean reductions in PPD (-1.05, -0.86, and -0.84 mm at 1, 3, and 6 months; all p < 0.001) and gains in CAL (-0.59 and -0.80 at 3, and 6 months; both p < 0.001) compared with SRP alone. Plaque and gingival indices improved significantly at 3 months (SMD = -0.83 and -1.05; both p < 0.001), and 6 months (SMD = -1.13 and -1.07; p < 0.001 and p = 0.02, respectively). Bleeding index showed marked reductions at both 3 and 6 months (SMD = -1.32 and -1.76; both p < 0.001). The subgingival P. gingivalis load also decreased significantly (SMD = -0.33; p = 0.04). Subgroup analyses showed no significant differences by irradiation type or session number (all p > 0.05). Conclusions: Adjunctive ICG-aPDT showed statistically significant but clinically modest improvements in periodontal outcomes, with PPD effects close to a 1-mm interpretive benchmark; however, high heterogeneity and methodological limitations warrant cautious interpretation and further standardized trials. © 2026 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/