Comparative analysis of the antimicrobial effect of Low Level Light Therapy versus Systemic Antimicrobials as an adjunct in the non surgical treatment of Stage 3 & 4 Periodontitis A Procalcitonin guided randomised controlled trial

Periodontitis is a chronic infectious disease, in which the microbial biofilm plays a significant role, resulting in inflammation within the supporting tissues of the teeth and if left untreated, will ultimately lead to tooth loss. The management centers on the mechanical disruption of the biofilm and systemic antimicrobials. However, there are significant limitations to antimicrobial therapy, especially multidrug resistance, patient compliance, overt use of antimicrobials and poor efficacy against the biofilm. The objectives of this study is to determine the CRP and PCT levels in Periodontitis Stage 3 and Stage 4 patients. To evaluate the reduction in CRP and PCT levels after Non Surgical Periodontal Therapy (NSPT), NSPT + adjunctive antimicrobials, NSPT + adjunctive LLLT and to compare the reduction in CRP and PCT levels among the three groups. Participants will be grouped into two groups- Group 1- Periodontally Healthy Group (Control) (n=16) and Group 2- Periodontitis Stage 3 and 4 Group (Test) (n=48).  Standardized serum samples will be collected from both groups to determine the values of CRP and PCT. Only Group 2, treatment group participants whose PCT values >0.25ng/mL will be included in the interventional randomized control trial. Standardized sub-gingival plaque samples from Group 2 participants will be collected for microbial analysis. Group 2 participants will be further sub grouped into three subgroups based on the interventions- A) NSPT (n=16), B) NSPT along with systemic antimicrobials (n=16), C) NSPT along with Low Level Light Therapy (n=16). A 400-500nm blue light source with power outputs ranging from 50-500mW, equipped with a probe tip will be used. It will be placed at the depth of the pocket and moved circumferentially around the tooth.