How effective is adjunctive antimicrobial photodynamic therapy in treating deep periodontal pockets in periodontal disease? A systematic review

Abstract

The aim of the present systematic review was to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) that is used as an adjunctive therapy with scaling and root planing (SRP) in deep periodontal pockets (≥5 mm). The addressed Patients, Intervention, Comparators, Outcomes, and Study design question was: In patients with advanced periodontitis (population), what is the effect of aPDT as adjunct to SRP (intervention) in comparison to SRP alone (comparison) on deep probing depths (outcome)? Electronic and manual literature searches were conducted using the following databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, up to and including February 2018. Six randomized trials were included. All studies used the combined approach aPDT+SRP and SRP in the test and control groups, respectively. The follow-up period ranged from 12 to 48 weeks. Wavelengths, power density, and duration of irradiation used were 670 nm, 500 mW cm , and 60 seconds, respectively. All studies showed significant reduction of probing depth (PD) ≥5 mm with aPDT at follow up. Considering the effects of adjunctive aPDT compared to SRP, only two studies showed additional benefit of adjunctive aPDT in reducing PD ≥5 mm compared to SRP alone at follow up. The overall mean difference for PD reduction (weighted mean difference = 0.31, 95% confidence interval [CI] = -0.03 to -0.66, P = .08) was also not significant between the aPDT and SRP groups at follow up. Whether aPDT as an adjunct to SRP is efficacious in the reduction of PD ≥5 mm compared to SRP alone in periodontal disease remains debatable, given that the available scientific evidence is weak.

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

“…The use of aPDT is well documented for many diseases and conditions such as infected leg ulcers, 20 diabetic foot, 21 and chronic skin ulcers. 22 With specific regard to the oral environment, its action includes the treatment of leukoplakia, 17 lichen planus, 23 periodontal pockets, 24 peri-implantitis, 25 and oral decontamination as well. 26,27 In the specific case of palatal ulcers during orthodontic therapy, this is the first case report to use this approach to solve this type of injury.…”

How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2?

“…Different systematic reviews and meta-analysis have assessed the role of aPDT as an adjunct to surgical and non-surgical mechanical therapy in the treatment of periodontal diseases [ 178 , 182 , [185] , [186] , [187] , [188] , [189] ]. A total of 26 randomized clinical trials using as test group (aPDT + surgical/non-surgical mechanical therapy) and usually as control group (surgical/non-surgical mechanical therapy alone or in combination with antibiotic therapy) were reviewed.…”

LASER in periodontal treatment: is it an effective treatment or science fiction?

“…125 Systematic reviews and meta-analysis studies have shown controversial results on APDT in periodontics, and the level of certainty of these reviews varies from very low to moderate. 12,[126][127][128][129][130][131][132][133][134] Regarding the initial treatment of aggressive or chronic periodontitis, some reviews showed encouraging results with several applications, including in the short term, [126][127][128][129] while others did not confirm superior effectiveness to conventional treatment or that its effect is limited. 12,[130][131][132] Regarding the use of APDT in diabetics 133 or smokers, 134 there is still a lack of studies.…”

“…12,[126][127][128][129][130][131][132][133][134] Regarding the initial treatment of aggressive or chronic periodontitis, some reviews showed encouraging results with several applications, including in the short term, [126][127][128][129] while others did not confirm superior effectiveness to conventional treatment or that its effect is limited. 12,[130][131][132] Regarding the use of APDT in diabetics 133 or smokers, 134 there is still a lack of studies. A meta-analysis of our team compared APDT to systemic antibiotic therapy with amoxicillin plus metronidazole on the non-surgical treatment of periodontitis.…”