Source:Photodiagnosis and Photodynamic Therapy
Author(s): Dong Xue, Lu Tang, Yuhao Bai, Qian Ding, Pengcheng Wang, Ying Zhao
PurposeTo evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on the up-to-date evidence.MethodsMEDLINE and the Cochrane Library were systematically searched to identify eligible random controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I2 test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed.ResultsEleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD=0.13, CI:0.02-0.24, p=0.02) and marginal significant improvement in CAL gain (MD=0.18, CI:-0.005-0.363, p=0.056) were observed in favor of SRP+PDT at 3 months. When evaluated at 6 months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD=0.40, CI:0.05-0.74, p=0.03), but not in CAL gain (MD=0.37, CI:-0.18-0.93, p=0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3 months nor 6 months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies.ConclusionsPooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6 months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration.
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