BACKGROUND: This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri‑implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri‑implant mucositis (pi-M). METHODS: For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1beta, tumor necrosis factor-alpha [TNF-alpha]) outcomes were assessed at baseline and 3-month follow-up. RESULTS: Mean changes between baseline and 3-month follow-up in peri‑implant clinico-radiographic parameters were significantly different between control (PI: 12.42+/-21.80%; BOP: 12.10+/-19.30%; PD: 0.45+/-0.41 mm; CBL: 1.10+/-1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55+/-25.80%; BOP: 28.77+/-29.24%; PD: 0.84+/-0.62 mm; CBL: 1.98+/-1.85 mm] and MB-mediated PDT [PI: 27.24+/-26.15%; BOP: 27.71+/-28.16%; PD: 0.85+/-0.63 mm; CBL: 1.95+/-1.80 mm]), however comparable differences were observed in peri‑implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 x 10(4) colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 x 10(4) CFU/mL) as compared to group-I (-4.40 x 10(3) CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210+/-108; group-II: 298+/-165; group-III: 277+/-121 pg/mL; p = 0.03), IL-1beta (group-I: 101+/-95; group-II: 84+/-98; group-III: 86+/-74 pg/mL; p = 0.02), and TNF-alpha (group-I: 336+/-121; group-II: 385+/-210; group-III: 366+/-198 pg/mL; p = 0.03) peri‑implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS: ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri‑implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri‑implant parameters.
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