Some evidence to support antimicrobial photodynamic therapy in patients with chronic periodontitis

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The aim of this review was to assess the efficacy and safety of antimicrobial photodynamic therapy (aPDT) used alone or adjunctive to scaling root planing  (SRP) in patients with chronic periodontitis.

The authors searched seven databases and conducted a manual search for randomised controlled trials conducted on humans  diagnosed with chronic periodontal disease comparing (aPDT) alone or SRP+aPDT and scaling root planing alone or in combination with placebo; Primary outcomes of interest were changes in clinical attachment level (CAL) gain (mm) and probing depth (PD) reduction. Weighted mean differences and 95% confidence intervals were calculated for CAL, PD and and gingival recession.  Heterogeneity was assessed with the I2 test. A funnel plot together with Egger’s regression test and the trim and fill method were used to assess publication bias.

They found

  • At 3 months, significant differences in clinical attachment level (p = 0.006) and probing depth reduction (p = 0.02) for scaling root planing with antimicrobial photodynamic therapy, while no significant differences were retrieved for antimicrobial photodynamic therapy used alone;
  • At 6 months no significant differences were observed for any investigated outcome.
  • No heterogeneity nor publication bias was detected.

They concluded:-

The results of this meta-analysis support the clinical short term efficacy of adjunctive aPDT and its safety, there is insufficient evidence to support the efficacy of aPDT as alternative to SRP. However, since only modest clinical improvement of chronic periodontitis was found for adjunctive aPDT and no significant microbiological changes were shown, more well-designed, long-term, randomized clinical trials are needed before adjunctive aPDT can be considered a reliable, routine and predictable treatment.

 

Sgolastra F, Petrucci A, Gatto R, Marzo G, Monaco A. Photodynamic therapy in the treatment of chronic periodontitis: a systematic review and meta-analysis.Lasers Med Sci. 2011 Oct 16. [Epub ahead of print] PubMed PMID: 22002328.

Related review

Atieh MA. Photodynamic therapy as an adjunctive treatment for chronic periodontitis: a meta-analysis. Lasers Med Sci. 2010 Jul;25(4):605-13. Epub 2009 Dec 19. PubMed PMID: 20024665.

 

 

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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