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: Comparative Efficacy of Ozonated Olive Oil Versus 810 nm Diode Laser Photobiomodulation as Adjuncts to Scaling and Root Planing in Diabetic Periodontitis: A Randomized Controlled Clinical Trial

Author(s) Prof. Dr. Dhirendra Kumar Singh, Prof. Dr. Mohammad Jalaluddin
Country India
Abstract Background: Type 2 diabetes mellitus and periodontitis have a bidirectional relationship, and adjunctive therapies to scaling and root planing (SRP) are often investigated to improve local healing and inflammatory control in this high-risk group.1,2 Photobiomodulation therapy (PBMT) at 808/810 nm has shown promising adjunctive effects on probing depth reduction, clinical attachment gain, and inflammatory markers in diabetic periodontitis, although currently available studies remain heterogeneous and largely short-term.^2 Ozone-based local therapies have also demonstrated antimicrobial and anti-inflammatory potential in periodontal treatment and may provide a biologically plausible adjunct to SRP.3,4
Aim: To compare the clinical, biochemical, microbial, and glycemic efficacy of subgingival ozonated olive oil versus 810 nm diode laser PBMT as adjuncts to SRP in patients with diabetic periodontitis.
Methods: In this randomized, controlled, single-blind, parallel-group trial, 60 patients with Stage III/IV Grade C periodontitis and controlled/moderately controlled type 2 diabetes mellitus were allocated equally into three groups: Group A, SRP plus saline irrigation; Group B, SRP plus subgingival ozonated olive oil; and Group C, SRP plus 810 nm diode laser PBMT. Clinical periodontal parameters, HbA1c, gingival crevicular fluid (GCF) biomarkers, and quantitative polymerase chain reaction (qPCR) counts of Porphyromonas gingivalis and Tannerella forsythia were assessed at baseline, 1 month, 3 months, and 6 months. Intra-group changes were analyzed using repeated measures ANOVA, and inter-group differences were evaluated using one-way ANOVA with Tukey’s post-hoc testing.
Results: All groups improved over time, but adjunctive therapy groups demonstrated greater reductions in probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), inflammatory mediators, and periodontal pathogen counts than SRP alone. At 6 months, mean PPD reduction was 1.48 ± 0.42 mm in Group A, 2.18 ± 0.49 mm in Group B, and 2.56 ± 0.51 mm in Group C. Mean CAL gain was 1.22 ± 0.39 mm, 1.91 ± 0.46 mm, and 2.29 ± 0.48 mm, respectively. HbA1c reduction was modest in all groups but was greatest in the PBMT group. Inter-group differences were statistically significant for most primary and secondary outcomes at 3 and 6 months.
Conclusion: Both ozonated olive oil and diode laser PBMT appear to be effective adjuncts to SRP in diabetic periodontitis, with PBMT showing the most consistent long-term improvement in periodontal, inflammatory, microbial, and glycemic parameters. These findings support the protocol hypothesis and justify future adequately powered clinical trials.
Keywords diabetic periodontitis; photobiomodulation; ozonated olive oil; scaling and root planing; diode laser; inflammatory biomarkers.
Field Medical / Pharmacy
Published In Volume 17, Issue 2, April-June 2026
Published On 2026-04-30
DOI https://doi.org/10.71097/IJSAT.v17.i2.10886
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