Photodynamic therapy as an adjunctive treatment for chronic periodontitis: a meta-analysis

Several antimicrobial strategies have been proposed in response to the alarming rise in antimicrobial resistance of periodontal pathogens. Antimicrobial photodynamic therapy (a-PDT) is a promising novel approach that has been used in several clinical applications including in the treatment of periodontal diseases. The aim of this review was to systematically investigate the effectiveness of a-PDT as an adjuvant treatment for chronic periodontitis. The guidelines of the Quality of Reporting of Meta-analyses (QUOROM) conference statement were followed in the preparation of this meta-analysis. An electronic search for randomized controlled trials (RCTs) that investigated the combined use of scaling and root planing (SRP) and a-PDT in comparison with SRP alone was performed without language restriction up to 1 October 2008. RevMan 5.0 software was used to analyze the data. A random effects model was chosen and standardized mean differences with 95% confidence intervals were calculated for continuous data. Four RCTs were included. The use of a-PDT in conjunction with SRP was associated with significantly greater attachment gain (mean difference 0.29, 95% confidence interval 0.08 to 0.50, p=0.007), and greater reduction in probing depth (mean difference 0.11, 95% confidence interval -0.12 to 0.35, p=0.35) at 12 weeks. However, the changes in gingival recession showed slight differences. This review and meta-analysis supported the potential improvements in clinical attachment level and probing depth provided by the combined approach (SRP with a-PDT). Nevertheless, the findings of this review should be interpreted with caution given the small number of included studies.