Novel Approaches of Indocyanine Green and aPDT in the Treatment of Periodontitis: A Narrative Review

In recent years, increasing attention has been given to adjunctive therapies aimed at improving clinical outcomes in periodontal treatment. Among these, antimicrobial photodynamic therapy (aPDT) using the photosensitizer indocyanine green (ICG) has shown great promise. Objective: This narrative review seeks to summarize the existing evidence from randomized controlled trials, systematic reviews, and in vitro and in vivo studies on the use of antimicrobial photodynamic therapy with indocyanine green (ICG) as a photosensitizer, as well as the emerging approach of double-light aPDT with ICG, in the treatment of periodontitis. Materials and Methods: PubMed, Web of Science, and Cochrane Library databases were searched to find relevant articles regarding the topic. The articles were published in English between the years 2015 and 2025. The search used keywords such as (“indocyanine green” AND “antimicrobial photodynamic therapy” AND (“efficiency” OR “efficacy” OR “effect”) AND (“periodont*” OR “gingivitis” OR “gingival” OR “gum”). The articles chosen were required to evaluate the treatment outcomes of periodontitis with ICG-aPDT. Conclusions: ICG-aPDT represents an effective adjunct treatment in periodontal therapy. It can non-invasively target biofilms and minimize systemic action. It makes this technique an attractive adjunct in modern periodontology practice. This narrative review shows that ICG-aPDT can be integrated into comprehensive periodontal care as an adjunct measure promoting tissue healing. However, more high-quality clinical trials are needed to develop standardized protocols and demonstrate long-lasting benefits.