Antimicrobial photodynamic therapy versus antibiotics as an adjunct in the treatment of periodontitis and peri-implantitis: A systematic review and meta-analysis

Zhao, Yuxin; Pu, Rui; Qian, Yinjie; Shi, Jianzhong; Si, Misi

doi:10.1016/j.pdpdt.2021.102231

Cited by 44 publications

(25 citation statements)

References 59 publications

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“…Concomitant improvement in clinical and microbiological parameters when aPDT was used as adjunct to SD was reported in several studies [ 115 , 116 , 117 , 118 ]. This was consistent with the results from a current systematic review and meta-analysis that have shown positive effects on the clinical outcomes of using aPDT together with laser, with a high impact on key periodontal pathogens, particularly the red complex [ 119 ]. However, other trials showed only a reduction of periodontal pathogens without significant difference in clinical parameters when compared to SD only [ 120 , 121 ].…”

Section: Novel Antibacterial Agents and Strategies To Overcome Bacterial Resistance In Dental Biofilm: Pros And Conssupporting

confidence: 91%

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

et al. 2021

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Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.

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Section: Novel Antibacterial Agents and Strategies To Overcome Bacterial Resistance In Dental Biofilm: Pros And Conssupporting

confidence: 91%

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

et al. 2021

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“…This difficulty could discourage clinicians from adopting local/topical antibiotics. To achieve a high concentration of local/topical antibiotics, clinicians are required to increase the total amount of local/topical antibiotics, consequently increasing the risk of antimicrobial resistance and adverse effects [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, adjunct methods involving chemical methods, such as hydrogen peroxide, tetracycline, saline-soaked cotton pellets, citric acid, and chlorhexidine, have been proven fundamental in the treatment of peri-implantitis [ 15 ], together with other adjuvant methods including phototherapy and laser therapy, such as a continuous carbon dioxide laser [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Local/Topical Antibiotics for Peri-Implantitis Treatment: A Systematic Review

et al. 2021

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Most studies indicate that the mechanical removal of the bacterial biofilm from the implant surface is the central goal of peri-implantitis therapy. However, controversial results in the treatment of peri-implantitis have led to the consideration of additional strategies that include surgical approaches and chemical adjuvants. Local/topical antibiotics, such as minocycline, azithromycin, tetracycline, amoxicillin, doxycycline, and metronidazole, may improve the efficacy of the definitive treatment of the disease, but the lack of conclusive findings prevents their use in clinical practice. This systematic review aimed to evaluate the effect of local/topical antibiotics for peri-implantitis treatment. Randomised controlled studies (RCT) on patients with peri-implantitis and comparing the efficacy of local/topical antibiotics vs. placebo or mechanical debridement were included. A systematic search strategy was carried out using three registered databases (PubMed, Web of Science, and Scopus). RoB2 was used to assess risk of bias. Five RCTs were identified (n = 250 patients and 333 implants). Contrast results emerged among the included studies, and a high heterogeneity level was observed. Risk of bias revealed some concerns for three studies out of five, while one study was judged at high risk. Only one study analysed the limitations of its findings. Overall, local antibiotic use can be considered a valid approach in the treatment of peri-implantitis. Therefore, future long-term clinical trials with standardised protocols and antibiotics with similar biological activity profiles should be tested to achieve a valid and definitive conclusion.

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“…Também o uso de antibióticos sistêmicos ou locais associados ao tratamento periodontal convencional é de grande valia, porém possui desvantagens devido a sua resistência, promovendo assim o desenvolvimento de infecções oportunistas, possuindo efeitos colaterais sistêmicos e discordância em relação à sua prescrição. Por apresentar essas desvantagens, foi necessário buscar mecanismos alternativos para controlar o biofilme e tratar as doenças periodontais (Zhao et al, 2021).…”

Section: Revisão De Literaturaunclassified

Conceitos e aplicabilidade da terapia fotodinâmica na periodontia: revisão de literatura

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2021

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O Introdução: A Terapia Fotodinâmica é uma reação fotoquímica dependente de oxigênio iniciada por laser de baixa potência com comprimento de onda apropriado. E tem sido amplamente utilizada na periodontia por permitir a redução de periodontopatógenos com ausência de efeitos sistêmicos colaterais e mínimas possibilidades de resistência bacteriana. Objetivo: Realizar uma revisão de literatura sobre a terapia fotodinâmica e a sua importância no tratamento de doenças do periodonto. Metodologia: Foi realizada uma pesquisa bibliográfica nas bases de dados Pubmed, Scielo e Lilacs, com o auxílio dos seguintes descritores em saúde: “Terapia Fotodinâmica” (Photodynamic Therapy); “Fotoquimioterapia” (Photochemotherapy); “Terapia a Laser de Baixa Potência” (Low Powe Laser Therapy) compreendidos entre os anos de 1991 e 2021. Resultados: Atentando para os fatos, viu-se que a escolha de um de um fotossensibilizador e a aplicação com um comprimento de onda correto e específico leva ao sucesso desta terapia. Conclusão: É necessário a realização de mais estudos voltados para a sua utilização no tratamento de doenças periodontais. Sendo definidos protocolos terapêuticos específicos que permitam sua execução baseada na ciência.

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Antimicrobial photodynamic therapy versus antibiotics as an adjunct in the treatment of periodontitis and peri-implantitis: A systematic review and meta-analysis

Cited by 44 publications

References 59 publications

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

Local/Topical Antibiotics for Peri-Implantitis Treatment: A Systematic Review

Conceitos e aplicabilidade da terapia fotodinâmica na periodontia: revisão de literatura

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