Int J Stomatol

Int J Stomatol ›› 2026, Vol. 53 ›› Issue (6): 850-858.doi: 10.7518/gjkq.2026648

• Original Article • Previous Articles    

Comparing the clinical efficacy of photodynamic therapy and systemic antimicrobial drug in the adjunct treatment of patients with stage Ⅲ or Ⅳ periodontitis complicated with type 2 diabetes mellitus

Xingru Ye1(),Yu Zuo2,Yu Ma3()   

  1. 1.Dept. of Periodontics, Suzhou Stomatological Hospital, Suzhou 215000, China
    2.Dept. of Prosthodontics, Affiliated Stomatological Hospital of Guilin Medical College, Guilin 541004, China
    3.Suzhou Yingbo Dental Clinic, Suzhou 215000, China
  • Received:2025-03-18 Revised:2026-09-18 Online:2026-11-01 Published:2026-10-29
  • Contact: Yu Ma E-mail:694337259@qq.com;mayu_1109@163.com

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Abstract:

Objective This study aimed to compare the clinical efficacy of photodynamic therapy (PDT) and systemic antimicrobial drug as adjuncts to scaling and root planing (SRP) in patients with stage Ⅲ or Ⅳ periodontitis complicated with type 2 diabetes (T2DM). Methods Fifty-one patients with stage Ⅲ or Ⅳ periodontitis complicated with T2DM were randomly divided into three groups by block randomization: SRP group, SRP+amoxicillin (AMX)+me-tronidazole (MTZ) group, SRP+PDT group. Correspon-ding treatments were administered according to group assignment. During the 6-month follow-up, glycosylated hemoglobin (HbA1c), probing depth (PD), clinical attachment loss (CAL), gingival index (GI), bone loss rate (BLR), and interleukin-6 (IL-6) were compared among the three groups. Results Of the 51 participants, four were lost to follow-up, and 47 were included in the statistical analysis. At baseline, there were no significant differences in age, sex and relevant observation indicators among the three groups (P>0.05). 1) The PD decreased at 1, 3, and 6 months after treatment in all three groups compared with baseline (P<0.05). At 1 and 3 months after treatment, PD in the SRP+AMX+MTZ group and SRP+PDT group was lower than that in the SRP group (P<0.05). At three months after treatment, PD in the SRP+PDT group was lower than that in the SRP+AMX+MTZ group (P<0.05). 2) The CAL of SRP group and SRP+AMX+MTZ group were lower than the baseline at 3 and 6 months after treatment (P<0.05). The CAL in the SRP+PDT group was also lower than the baseline at 1, 3 and 6 months after treatment (P<0.05). 3) The GI decreased at 1, 3, and 6 months after treatment in all three groups compared with baseline (P<0.05). The GI of SRP+PDT group was lower than that of SRP group and SRP+AMX+MTZ group at 1 month after treatment (P<0.05). The GI in the SRP+PDT group was lower than that of SRP group at 3 months after treatment (P<0.05). 4) The IL-6 decreased at 1, 3, and 6 months after treatment in all three groups compared with baseline (P<0.05). 5) HbA1c and BLR showed no significant pre-post or intergroup differences (P>0.05). Conclusion Adjunctive PDT can improve periodontal indicators in these patients, with short-term advantages in PD and GI, and may be serve as a potential alternative to systemic antimicrobial drug.

Key words: photodynamic therapy, amoxicillin, metronidazole, scaling and root planing, periodontitis, type 2 dia-betes mellitus

CLC Number: 

  • R781.4＋2

TrendMD: 

Tab 1

Basic information of three groups"

项目SRP组SRP+AMX+MTZ组SRP+PDT组F值P值
年龄/岁51.71±6.7648.94±9.1150.38±10.660.360.70
性别-0.81
男性7（50.00%）7（41.18%）6（37.50%）
女性7（50.00%）10（58.82%）10（62.50%）
FPG/（mmol/L）10.78±3.1110.24±2.6910.11±2.010.270.76
HbA1c/%11.10±2.2111.32±2.9310.77±2.040.210.81
PD/mm7.44±1.286.37±1.936.45±1.871.750.19
CAL/mm5.43±0.605.30±1.075.44±1.380.090.91
GI/分2.50±0.762.35±0.932.62±0.810.430.65
BLR/%64.21±13.0061.62±15.2063.66±13.290.150.86
IL-6/（pg/mL）15.97±3.6816.48±4.7717.16±1.800.410.67

Tab 2

Analysis of the difference of index before and after treatment in the three groups"

项目SRP组SRP+AMX+MTZ组SRP+PDT组F/P交互F/P时间F/P组别
HbA1c/%0.06/0.990.41/0.660.39/0.68
基线11.10±2.2111.32±2.9310.77±2.04
治疗后3个月10.90±1.7411.09±2.7610.47±1.64
治疗后6个月11.10±3.0511.17±2.8610.44±1.53
PD/mm1.75/0.14156.22/<0.01**8.75/<0.01**
基线7.44±1.286.37±1.936.45±1.87
治疗后1个月3.50±0.68①2.61±1.00a①2.10±0.97a①
治疗后3个月3.23±0.60①2.77±0.58a①1.95±0.72ab①
治疗后6个月2.74±0.73①3.03±1.06①2.63±1.05①
CAL/mm0.37/0.9012.98/<0.01**0.26/0.77
基线5.43±0.605.30±1.075.44±1.38
治疗后1个月4.74±1.534.46±1.104.13±1.40①
治疗后3个月4.06±1.65①3.71±1.32①3.83±1.64①
治疗后6个月3.93±1.53①4.21±1.43①4.02±0.84①
GI/分2.67/0.02*37.10/<0.01**1.96/0.15
基线2.50±0.762.35±0.932.62±0.81
治疗后1个月1.79±0.80①1.53±1.07①0.88±0.72ab①
治疗后3个月1.79±0.70①1.59±1.00①1.12±0.62a①
治疗后6个月1.64±0.93①1.47±0.80①1.19±0.75①
BLR/%0.01/0.993.65/0.060.17/0.84
基线64.21±13.0061.62±15.2063.66±13.29
治疗后6个月60.96±11.4358.85±13.9660.81±12.36
IL-6/（pg/mL）0.57/0.64257.11/<0.01**0.22/0.81
基线15.97±3.6816.48±4.7717.16±1.80
治疗后1个月6.28±0.78①5.56±1.58①5.48±1.63①
治疗后3个月5.93±1.09①5.39±1.60①5.57±0.79①
治疗后6个月6.53±2.14①6.38±1.51①6.31±1.28①

Fig 1

Variation trend of index before and after treatment in the three groups"

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