Photodynamic therapy adjuvant to non-surgical periodontal therapy: Systematic review of randomized clinical trials.
| Title: | Photodynamic therapy adjuvant to non-surgical periodontal therapy: Systematic review of randomized clinical trials. |
|---|---|
| Authors: | Souza DAS; Federal University of Bahia, Stricto Sensu Graduate Program in Dentistry, Salvador, Bahia, Brazil.; Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil.; de Lima Dantas JB; Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil.; Federal University of Bahia, Institute of Health Sciences, Stricto Sensu Graduate Program in Interactive Process of Organs and Systems, Salvador, Bahia, Brazil.; School of Medicine and Public Health, Salvador, Bahia, Brazil.; Souto CS; Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil.; Mendonça DM; Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil.; Oliveira TJS; Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil.; São Leopoldo Mandic Dental Research Center, Stricto Sensu Graduate Program in Dental Sciences (Implantology), São Paulo, Brazil.; Dos Santos Vianna Néri J; Federal University of Bahia, Stricto Sensu Graduate Program in Dentistry, Salvador, Bahia, Brazil.; Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil. |
| Source: | International journal of dental hygiene [Int J Dent Hyg] 2024 Feb; Vol. 22 (1), pp. 45-55. Date of Electronic Publication: 2023 Sep 26. |
| Publication Type: | Systematic Review; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Blackwell Pub Country of Publication: England NLM ID: 101168070 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1601-5037 (Electronic) Linking ISSN: 16015029 NLM ISO Abbreviation: Int J Dent Hyg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford [Eng.] : Blackwell Pub., c2003- |
| MeSH Terms: | Photochemotherapy*/methods ; Chronic Periodontitis*/drug therapy ; Periodontitis* ; Anti-Infective Agents*; Dental Scaling/methods ; Humans ; Periodontal Pocket ; Root Planing ; Randomized Controlled Trials as Topic ; Combined Modality Therapy |
| Abstract: | Objectives: To systematically evaluate randomised controlled trials (RCTs) on whether adjuvant application of antimicrobial photodynamic therapy (aPDT) through the technique of irradiation in the external region of the periodontal pocket with optic-fibre tip offers benefits to scaling and root planning (SRP).; Methods: Five databases were searched by two independent reviewers according to pre-specified eligibility criteria up to April 2023. No restrictions regarding date of publication, language and minimum follow-up period were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and Grading of Recommendations, Assessment, Development and Evaluation for assessing the certainty of evidence.; Results: A total of 1388 publications were identified and reviewed for eligibility. Four of them fulfilled the inclusion criteria. The sample consisted of a total of 83 patients with periodontitis. In these, 330 periodontal sites were evaluated. The clinical findings of the majority of the included studies demonstrated that patients who received the association of aPDT + RAR with the protocol evaluated here, obtained clinical results similar to patients who received only the SRP alone. In none of the evaluated RCTs, clinical advantages were observed that would categorise this aPDT protocol as superior to conventional treatment.; Conclusion: Applying aPDT after SRP with external irradiation of the periodontal pocket does not seem to result in any clinical benefit compared to the use of SRP alone in patients with periodontitis.; (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
| References: | Wigdor HA, Walsh JT, Featherstone JD, Visuri SR, Fried D, Waldvogel JL. Lasers in dentistry. Lasers Surg Med. 1995;16:103-133.; Pourzarandian A, Watanabe H, Ruwanpura SM, Aoki A, Ishikawa I. Effect of low-level Er:YAG laser irradiation on cultured human gingival fibroblasts. J Periodontol. 2005;76:187-193.; Zein R, Selting W, Benedicenti S. Effect of low-level laser therapy on bone regeneration during osseointegration and bone graft. Photomed Laser Surg. 2017;35(12):649-658.; Aoki A, Sasaki KM, Watanabe H, Ishikawa I. Lasers in nonsurgical periodontal therapy. Periodontology 2000. 2004;36:59-97.; Meisel P, Kocher T. Photodynamic therapy for periodontal diseases: state of the art. J Photochem Photobiol B, Biol. 2005;79:159-170.; Kim MM, Darafsheh A. Light sources and dosimetry techniques for photodynamic therapy. Photochem Photobiol. 2020;96(2):280-294.; Bhathi M, MacRobert A, Meghji S, Henderson B, Wilson M. A study of the uptake of toluidine blue O by Porphyromonas gingivalis and the mechanism of lethal photosensitization. Photochem Photobiol. 1998;68:370-376.; Maisch T. Anti-microbial photodynamic therapy: useful in the future? Lasers Med Sci. 2007;22:83-91.; Theodoro LH, Silva SP, Pires JR, et al. Clinical and microbiological effects of photodynamic therapy associated with nonsurgical periodontal treatment. A 6-month follow-up. Lasers Med Sci. 2012;27(4):687-693.; Usacheva MN, Teichert MC, Biel MA. Comparison of the methylene blue and toluidine blue photobactericidal efficacy against gram-positive and gram-negative microorganisms. Lasers Surg Med. 2001;29:165-173.; Malik Z, Hanania J, Nitzan Z. Bactericidal effects of photoactivated porphyrins - an alternative approach to antimicrobial drugs. J Photochem Photobiol. 1990;5:281-293.; Taubman MA, Valverde P, Han X, Kawai T. Immune response: the key to bone resorption in periodontal disease. J Periodontol. 2005;76:2033-2041.; Cobb CM. Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. J Clin Periodontol. 2002;29(Suppl 2):6-16.; Sena IAA, Silva DNA, Azevedo MLDS, et al. Antimicrobial photodynamic therapy using a Chloro-aluminum phthalocyanine adjuvant to nonsurgical periodontal treatment does not improve clinical parameters in patients with chronic periodontitis. Photobiomodul Photomed Laser Surg. 2019;37(11):729-735.; Eickholz P, Kim TS, Schacher B, Reitmeir P, Bürklin T, Ratka-Krüger P. Subgingival topical doxycycline versus mechanical debridement for supportive periodontal therapy: a single blind randomized controlled two-center study. Am J Dent. 2005;18:341-346.; McColl E, Patel K, Dahlen L, et al. Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12 month randomized, controlled, single masked pilot study. J Clin Periodontol. 2006;33:141-150.; Braun A, Dehn C, Krause F, Jepsen S. Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol. 2008;35:877-884.; Mizutani K, Aoki A, Coluzzi D, et al. Lasers in minimally invasive periodontal and peri-implant therapy. Periodontol 2000. 2016;71(1):185-212.; Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Ver. 2021;10(1):89.; Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.; Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5:210.; Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.; Schünemann H, Brożek J, Guyatt G, Oxman A. GRADE handbook for grading quality of evidence and strength of recommendations. 2013.; Silva NTD, Silva DNA, Azevedo MLDS, et al. The effectiveness of photodynamic therapy as a complementary therapy to mechanical instrumentation on residual periodontal pocket clinical parameters: a clinical split-mouth test. Photodiagnosis Photodyn Ther. 2020;29:101565.; Silva DNA, Silva NTD, Sena IAA, et al. Efficacy of antimicrobial photodynamic therapy with chloro-aluminum phthalocyanine on periodontal clinical parameters and salivary GSH and MDA levels in patients with periodontitis. Photodiagnosis Photodyn Ther. 2020;31:101843.; Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1-6.; Steffens JP, Marcantonio RAC. 2018 classification of periodontal and Periimplantar diseases and conditions: a practical guide and key points. Rev Odontol UNESP. 2018;47(4):189-197.; Lorentz TC, Cota LO, Cortelli JR, Vargas AM, Costa FO. Prospective study of complier individuals under periodontal maintenance therapy: analysis of clinical periodontal parameters, risk predictors and the progression of periodontitis. J Clin Periodontol. 2009;36:58-67.; Moreira AL, Novaes AB Jr, Grisi MF Jr, et al. Antimicrobial photodynamic therapy as an adjunct to non-surgical treatment of aggressive periodontitis: a split-mouth randomized controlled trial. J Periodontol. 2015;86(3):376-386.; Wang H, Li W, Zhang D, Li W, Wang Z. Adjunctive photodynamic therapy improves the outcomes of peri-implantitis: a randomized controlled trial. Aust Dent J. 2019;64(3):256-262.; Cadore UB, Reis MBL, Martins SHL, et al. Multiple sessions of antimicrobial photodynamic therapy associated with surgical periodontal treatment in patients with chronic periodontitis. J Periodontol. 2019;90(4):339-349.; George R, Walsh LJ. Performance assessment of novel side firing flexible optical fibers for dental applications. Lasers Surg Med. 2009;41(3):214-221.; Campos GN, Pimentel SP, Ribeiro FV, et al. The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: a randomized controlled clinical trial. Lasers Med Sci. 2013;28(1):317-324.; Kolbe MF, Ribeiro FV, Luchesi VH, et al. Photodynamic therapy during supportive periodontal care: clinical, microbiologic, immunoinflammatory, and patient-centered performance in a split-mouth randomized clinical trial. J Periodontol. 2014;85(8):e277-e286.; Prates RA, Yamada AM Jr, Suzuki LC, et al. Histomorphometric and microbiological assessment of photodynamic therapy as an adjuvant treatment for periodontitis: a short-term evaluation of inflamatory periodontal conditions and bacterial reduction in a rat model. Photomed Laser Surg. 2011;29:835-844.; Carvalho VF, Andrade PV, Rodrigues MF, et al. Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial. J Clin Periodontol. 2015;42:440-447.; de Moraes M, de Vasconcelos RC, Longo JPF, et al. Effects of photodynamic therapy mediated by nanoemulsion containing chloro-aluminum phthalocyanine: a histologic and immunohistochemical study in human gingiva. Photodiagnosis PhotodynTher. 2015;12(4):592-597.; de Moraes M, de Vasconcelos RC, Longo JPF, et al. Photodynamic therapy using chloro-aluminum phthalocyanine decreases inflammatory response in an experimental rat periodontal disease model. J Photochem Photobiol B, Biol. 2017;167:208-215.; Ribeiro APD, Andrade MC, Bagnato VS, et al. Antimicrobial photodynamic therapy against pathogenic bacterial suspensions and biofilms using chloro-aluminum phthalocyanine encapsulated in nanoemulsions. Lasers Med Sci. 2013;30(2):549-559.; Carvalho AS, Napimoga MH, Coelho-Campos J, Silva-Filho VJ, Thedei G. Photodynamic therapy reduces bone resorption and decreases inflammatory response in an experimental rat periodontal disease model. Photomed Laser Surg. 2011;29(11):735-740.; Bechara Andere NMR, Dos Santos NCC, Araujo CF, et al. Evaluation of the local effect of nonsurgical periodontal treatment with and without systemic antibiotic and photodynamic therapy in generalized aggressive periodontitis. A randomized clinical trial. Photodiagnosis Photodyn Ther. 2018;24:115-120.; Arweiler NB, Pietruska M, Pietruski J, et al. Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole. Clin Oral Investig. 2014;18(9):2129-2135. |
| Contributed Indexing: | Keywords: low-level light therapy; periodontal debridement; periodontal diseases; photochemotherapy; systematic review |
| Substance Nomenclature: | 0 (Anti-Infective Agents) |
| Entry Date(s): | Date Created: 20230927 Date Completed: 20240202 Latest Revision: 20250626 |
| Update Code: | 20260130 |
| DOI: | 10.1111/idh.12759 |
| PMID: | 37752814 |
| Database: | MEDLINE |
Systematic Review; Journal Article