{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:27:08Z","timestamp":1770812828511,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\/MCTES","award":["10.54499\/UIDB\/04585\/2020"],"award-info":[{"award-number":["10.54499\/UIDB\/04585\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Periodontitis is one of the most common inflammatory diseases and it is linked to the presence of a dysbiotic subgingival microbiome. The purpose of this review is to evaluate the impact of antimicrobial photodynamic therapy (aPDT) on the subgingival microbiome. Herein, based on an extensive evaluation of randomized controlled trials (RCTs), the effects of aPDT as a supplement to non-surgical periodontal therapy (NSPT) were found to be the main focus of these works. Studies that focused on analyzing microbiological results were selected, yielding contradictory results. The observed microbiological changes were variable, even though some studies showed notable improvements in clinical indicators such as bleeding on probing (BOP), clinical attachment level (CAL), and probing depth (PD). Several studies found that aPDT did not significantly reduce important periodontal pathogens such Tannerella forsythia, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans. Nevertheless, after multiple aPDT sessions, other studies reported positive changes in the subgingival microbiome, with a rise in beneficial bacteria and a decrease in periodontopathogens. While aPDT seems to be a safe and well-tolerated adjuvant to non-surgical periodontal therapy, there is still conflicting evidence regarding how well it modulates the subgingival microbiota. Additional long-term research with larger sample sizes is required to evaluate the microbiological and clinical advantages of aPDT.<\/jats:p>","DOI":"10.3390\/pharmaceutics17081070","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T10:59:01Z","timestamp":1755601141000},"page":"1070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Microbiological Impact of Antimicrobial Photodynamic Therapy in Non-Surgical Periodontal Treatment"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8377-7680","authenticated-orcid":false,"given":"Filipa Passos","family":"Sousa","sequence":"first","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3012-5274","authenticated-orcid":false,"given":"Mariana Anselmo","family":"Assun\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8339-1964","authenticated-orcid":false,"given":"Lucinda J.","family":"Bessa","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7184-5965","authenticated-orcid":false,"given":"Ricardo Castro","family":"Alves","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Di Stefano, M., Polizzi, A., Santonocito, S., Romano, A., Lombardi, T., and Isola, G. (2022). Impact of Oral Microbiome in Periodontal Health and Periodontitis: A Critical Review on Prevention and Treatment. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23095142"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/idj.12630","article-title":"Current Concepts in the Management of Periodontitis","volume":"71","author":"Kwon","year":"2021","journal-title":"Int. Dent. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/jre.13269","article-title":"Microbiome of Periodontitis and Peri-implantitis before and after Therapy: Long-read 16S rRNA Gene Amplicon Sequencing","volume":"59","author":"Yu","year":"2024","journal-title":"J. Periodontal Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1177\/0022034519845001","article-title":"The Role of Exopolysaccharides in Oral Biofilms","volume":"98","author":"Cugini","year":"2019","journal-title":"J. Dent. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1177\/15353702231187645","article-title":"Oral Microbiota in Human Health and Disease: A Perspective","volume":"248","author":"Santacroce","year":"2023","journal-title":"Exp. Biol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/prd.12362","article-title":"Microbial Signatures of Health, Gingivitis, and Periodontitis","volume":"86","author":"Abusleme","year":"2021","journal-title":"Periodontol. 2000"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1600-051X.1998.tb02419.x","article-title":"Microbial Complexes in Subgingival Plaque","volume":"25","author":"Socransky","year":"1998","journal-title":"J. Clin. Periodontol."},{"key":"ref_8","first-page":"5775","article-title":"Relationship between Oral Microbiota and Periodontal Disease: A Systematic Review","volume":"22","author":"Patini","year":"2018","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1111\/jcpe.13793","article-title":"Subgingival Microbiome in Periodontal Health, Gingivitis and Different Stages of Periodontitis","volume":"50","author":"Iniesta","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Seredin, P., Goloshchapov, D., and Litvinova, T. (2024). Biomaterials and Agents: Pharmaceutical and Biomedical Applications in Dental Research. Pharmaceutics, 16.","DOI":"10.3390\/pharmaceutics16070894"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1002\/JPER.20-0839","article-title":"A Re-evaluation of Scaling and Root Planing","volume":"92","author":"Cobb","year":"2021","journal-title":"J. Periodontol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1080\/1040841X.2022.2133594","article-title":"Community Dynamics of Subgingival Microbiome in Periodontitis and Targets for Microbiome Modulation Therapy","volume":"49","author":"Balan","year":"2023","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.1590\/1807-3107bor-2022.vol36.0104","article-title":"Application of Lasers in Dentistry: A Bibliometric Study of the Top 100 Most-Cited Papers","volume":"36","author":"Paschoal","year":"2022","journal-title":"Braz. Oral Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.adaj.2015.01.028","article-title":"Systematic Review and Meta-Analysis on the Nonsurgical Treatment of Chronic Periodontitis by Means of Scaling and Root Planing with or without Adjuncts","volume":"146","author":"Smiley","year":"2015","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1007\/s00784-019-03045-1","article-title":"The Application of Antimicrobial Photodynamic Therapy (aPDT, 670 Nm) and Diode Laser (940 Nm) as Adjunctive Approach in the Conventional Cause-Related Treatment of Chronic Periodontal Disease: A Randomized Controlled Split-Mouth Clinical Trial","volume":"24","author":"Katsikanis","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/1040841X.2018.1467876","article-title":"Antimicrobial Photodynamic Therapy\u2014What We Know and What We Don\u2019t","volume":"44","author":"Cieplik","year":"2018","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1016\/S1473-3099(16)30268-7","article-title":"Photoantimicrobials\u2014Are We Afraid of the Light?","volume":"17","author":"Wainwright","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1016\/j.biopha.2018.07.049","article-title":"Photodynamic Therapy\u2014Mechanisms, Photosensitizers and Combinations","volume":"106","author":"Kwiatkowski","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1002\/lsm.21080","article-title":"Photodynamic Therapy for Infections: Clinical Applications: Photodynamic Therapy For Infections","volume":"43","author":"Kharkwal","year":"2011","journal-title":"Lasers Surg. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1007\/s43630-024-00666-8","article-title":"Potentiation of Antimicrobial Photodynamic Therapy with Potassium Iodide and Methylene Blue: Targeting Oral Biofilm Viability","volume":"23","author":"Groppo","year":"2024","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bueno-Silva, B., Parma-Garcia, J., Frigo, L., Su\u00e1rez, L.J., Macedo, T.T., Uyeda, F.H., Melo, M.A.R.D.C., Sacco, R., Mour\u00e3o, C.F., and Feres, M. (2024). Antimicrobial Activity of Methylene Blue Associated with Photodynamic Therapy: In Vitro Study in Multi-Species Oral Biofilm. Pathogens, 13.","DOI":"10.3390\/pathogens13040342"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102330","DOI":"10.1016\/j.pdpdt.2021.102330","article-title":"Antimicrobial Photodynamic Therapy Effectively Reduces Porphyromonas gingivalis Infection in Gingival Fibroblasts and Keratinocytes: An In Vitro Study","volume":"34","author":"Oruba","year":"2021","journal-title":"Photodiagn. Photodyn. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107","DOI":"10.15171\/jlms.2018.21","article-title":"Photodynamic Inactivation of Porphyromonas gingivalis Utilizing Radachlorin and Toluidine Blue O as Photosensitizers: An In Vitro Study","volume":"9","author":"Moslemi","year":"2018","journal-title":"J. Lasers Med. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s10103-020-03067-2","article-title":"Antimicrobial Effect of Photodynamic Therapy Using Sinoporphyrin Sodium and 390\u2013400 Nm Light-Emitting Diode on Porphyromonas gingivalis In Vitro","volume":"36","author":"Song","year":"2021","journal-title":"Lasers Med. Sci."},{"key":"ref_25","first-page":"e55","article-title":"In Vitro Efficacy of Antimicrobial Photodynamic Therapy With Phycocyanin and Diode Laser for the Reduction of Porphyromonas gingivalis","volume":"13","author":"Etemadi","year":"2022","journal-title":"J. Lasers Med. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103825","DOI":"10.1016\/j.pdpdt.2023.103825","article-title":"Antimicrobial Photodynamic Therapy with Dendrosomal Curcumin and Blue Laser against Porphyromonas gingivalis","volume":"44","author":"Shahmoradi","year":"2023","journal-title":"Photodiagn. Photodyn. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Sales, L.S., Miranda, M.L., De Oliveira, A.B., Ferrisse, T.M., Fontana, C.R., Milward, M., and Brighenti, F.L. (2022). Effect of the Technique of Photodynamic Therapy against the Main Microorganisms Responsible for Periodontitis: A Systematic Review of In-Vitro Studies. Arch. Oral Biol., 138.","DOI":"10.1016\/j.archoralbio.2022.105425"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"21","DOI":"10.15171\/jlms.2016.05","article-title":"An In Vitro Comparison of Antimicrobial Effects of Curcumin-Based Photodynamic Therapy and Chlorhexidine, on Aggregatibacter actinomycetemcomitans","volume":"7","author":"Najafi","year":"2016","journal-title":"J. Lasers Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s10103-021-03267-4","article-title":"In Vitro Evaluation of Physical and Chemical Parameters Involved in aPDT of Aggregatibacter actinomycetemcomitans","volume":"37","author":"Soares","year":"2022","journal-title":"Lasers Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.pdpdt.2016.04.003","article-title":"Comparison of Antibacterial Effect of Photodynamic Therapy Using Indocyanine Green (Emundo) with 2% Metronidazole and 2% Chlorhexidine Gel on Porphyromonas Gingivalis (an In-Vitro Study)","volume":"15","author":"Fekrazad","year":"2016","journal-title":"Photodiagnosis Photodyn. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/adj.12409","article-title":"Effect of Photodynamic Therapy Adjunct to Scaling and Root Planing in Periodontitis Patients: A Randomized Clinical Trial","volume":"61","author":"Pulikkotil","year":"2016","journal-title":"Aust. Dent. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1902\/jop.2008.070652","article-title":"Photodynamic Therapy as an Adjunct to Non-Surgical Periodontal Treatment: A Randomized, Controlled Clinical Trial","volume":"79","author":"Christodoulides","year":"2008","journal-title":"J. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jphotobiol.2014.10.017","article-title":"Antimicrobial Photodynamic Therapy Associated to Nonsurgical Periodontal Treatment in Smokers: Microbiological Results","volume":"141","author":"Queiroz","year":"2014","journal-title":"J. Photochem. Photobiol. B"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1002\/lsm.23010","article-title":"Efficacy of Adjunctive Photodynamic Therapy in the Treatment of Generalized Aggressive Periodontitis: A Randomized Controlled Clinical Trial","volume":"51","author":"Borekci","year":"2019","journal-title":"Lasers Surg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s10103-009-0671-6","article-title":"Capacity of Photodynamic Therapy for Microbial Reduction in Periodontal Pockets","volume":"25","author":"Pinheiro","year":"2010","journal-title":"Lasers Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1002\/JPER.23-0195","article-title":"Efficacy of Photodynamic Therapy as an Adjunct to Scaling and Root Planing on Clinical Parameters and Microbial Composition in Subgingival Plaque of Periodontitis Patients: A Split-mouth Randomized Clinical Trial","volume":"95","author":"Nie","year":"2024","journal-title":"J. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s10103-011-0901-6","article-title":"Antimicrobial Photodynamic Therapy in the Non-Surgical Treatment of Aggressive Periodontitis: Microbiological Profile","volume":"27","author":"Novaes","year":"2012","journal-title":"Lasers Med. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1902\/jop.2014.140392","article-title":"Antimicrobial Photodynamic Therapy as an Adjunct to Non-Surgical Treatment of Aggressive Periodontitis: A Split-Mouth Randomized Controlled Trial","volume":"86","author":"Moreira","year":"2015","journal-title":"J. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1007\/s00784-016-2018-6","article-title":"Antimicrobial Photodynamic Therapy vs. Local Minocycline in Addition to Non-Surgical Therapy of Deep Periodontal Pockets: A Controlled Randomized Clinical Trial","volume":"21","author":"Tabenski","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.1902\/jop.2014.130559","article-title":"Photodynamic Therapy During Supportive Periodontal Care: Clinical, Microbiologic, Immunoinflammatory, and Patient-Centered Performance in a Split-Mouth Randomized Clinical Trial","volume":"85","author":"Kolbe","year":"2014","journal-title":"J. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1002\/lsm.22449","article-title":"Short-term Microbiological Effects of Photodynamic Therapy in Non-Surgical Periodontal Treatment of Residual Pockets: A Split-mouth RCT","volume":"48","author":"Oliveira","year":"2016","journal-title":"Lasers Surg. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s10103-008-0565-z","article-title":"Photodynamic Therapy as Adjunct to Non-Surgical Periodontal Treatment in Patients on Periodontal Maintenance: A Randomized Controlled Clinical Trial","volume":"24","author":"Chondros","year":"2009","journal-title":"Lasers Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1002\/JPER.22-0672","article-title":"Adjunctive Effects of Photodynamic Therapy Using Indocyanine Green in Residual Pockets during Periodontal Maintenance Therapy: A Split-mouth Randomized Controlled Trial","volume":"94","author":"Costa","year":"2023","journal-title":"J. Periodontol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.pdpdt.2019.05.028","article-title":"Clinical and Microbiological Effects of Multiple Applications of Antibacterial Photodynamic Therapy in Periodontal Maintenance Patients. A Randomized Controlled Clinical Study","volume":"27","author":"Gaspirc","year":"2019","journal-title":"Photodiagn. Photodyn. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/jcpe.12393","article-title":"Antimicrobial Photodynamic Effect to Treat Residual Pockets in Periodontal Patients: A Randomized Controlled Clinical Trial","volume":"42","author":"Carvalho","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"949","DOI":"10.12688\/f1000research.133230.2","article-title":"Indocyanine Green Based Antimicrobial Photodynamic Therapy as an Adjunct to Non-Surgical Periodontal Treatment in Periodontal Maintenance Patients: A Clinico-Microbiological Study","volume":"12","author":"Chowdhury","year":"2024","journal-title":"F1000Research"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1042\/BJ20150942","article-title":"New Photosensitizers for Photodynamic Therapy","volume":"473","author":"Abrahamse","year":"2016","journal-title":"Biochem. J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1039\/c4pp00309h","article-title":"A Novel Set of Symmetric Methylene Blue Derivatives Exhibits Effective Bacteria Photokilling\u2014A Structure\u2014Response Study","volume":"14","author":"Gollmer","year":"2015","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"293","DOI":"10.5978\/islsm.27_18-RA-01","article-title":"Photosensitizers in Antibacterial Photodynamic Therapy: An Overview","volume":"27","author":"Ghorbani","year":"2018","journal-title":"Laser Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1038\/ismej.2011.191","article-title":"Distinct and Complex Bacterial Profiles in Human Periodontitis and Health Revealed by 16S Pyrosequencing","volume":"6","author":"Griffen","year":"2012","journal-title":"ISME J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"394","DOI":"10.5051\/jpis.2200680034","article-title":"Comparison of the Oral Microbial Composition between Healthy Individuals and Periodontitis Patients in Different Oral Sampling Sites Using 16S Metagenome Profiling","volume":"52","author":"Kim","year":"2022","journal-title":"J. Periodontal Implant Sci."}],"container-title":["Pharmaceutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4923\/17\/8\/1070\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:30:46Z","timestamp":1760034646000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4923\/17\/8\/1070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":51,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["pharmaceutics17081070"],"URL":"https:\/\/doi.org\/10.3390\/pharmaceutics17081070","relation":{},"ISSN":["1999-4923"],"issn-type":[{"value":"1999-4923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]}}}