Assessment of Spirulina Gel Prepared by Different Extraction Methods as an Adjunctive Therapy to Mechanical Debridement in the Treatment of Stage II Periodontitis: A Randomized Clinical Trial

Abstract

Objective: To evaluate the clinical and biochemical effects of locally delivered spirulina gels prepared by different extraction methods as adjuncts to mechanical debridement in stage II periodontitis.Materials and methods: Seventy-five participants were included: 15 periodontally healthy negative controls and 60 participants with periodontitis who were randomized in a 1:1:1:1 ratio to the positive control, phosphate-buffered saline (PBS), 2% calcium chloride (CaCl₂), or ethanol groups (n=15 each). The clinical outcomes were full-mouth plaque score (FMPS), bleeding on probing, probing depth, clinical attachment level, and gingival index; the biochemical outcome was GCF TNF-α. Outcomes were measured at baseline and three months and analysed according to distribution, with p≤0.05 considered statistically significant.Results: All four periodontitis groups improved significantly from baseline. After three months, the CaCl₂ group showed the lowest numerical FMPS, bleeding on probing, probing depth, clinical attachment level, and TNF-α values. Intergroup differences were significant for FMPS, bleeding on probing, probing depth, and clinical attachment level, but not for gingival index or TNF-α.Conclusion: Spirulina gel may enhance the clinical response to mechanical debridement. The CaCl₂-extracted formulation produced the most favourable three-month clinical pattern.