Photodynamic Therapy in Non-Surgical Treatment of Periodontitis: A Systematic Review and Meta-Analysis

Aim: to evaluate the adjunctive effects of photodynamic therapy (aPDT) on nonsurgical mechanical treatment in patients with periodontitis. Materials and methods: The search strategy was conducted according to the PRISMA guidelines to answer research questions regarding the effectiveness of aPDT in association with non-surgical periodontal therapy. The mean values and standard deviations were collected by data extraction. A descriptive comparison between aPDT in association with periodontal treatment and periodontal treatment alone was performed, and meta-analyses of PPD were also performed. Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. Results: Out of 2059 records, 14 articles on adjunctive photodynamic therapy were included because they met the eligibility criteria. A comparison between the aPDT data and the control group showed improved PPD for photodynamic therapy (SMD -0.76, p = 0.003; I-2 = 88%). Statistical analysis was then applied to the three PPD subgroups. The first group included studies that used indocyanine green in association with a wavelength of 810 nm (SMD -1.79, p < 0.00001, I-2 = 88%). The second group included studies that used phenothiazine chloride at a wavelength of 660 nm (SMD -0.03, p = 0.84, I-2 = 0%). The last group included studies that used methylene blue photosensitizers treated with a wavelength 628-670 nm were included (SMD -0.13, p = 0.38; I-2 = 0%). Conclusions: despite the limited number of RCTs and the great heterogeneity between them, it can be concluded that aPDT in association with nonsurgical periodontal treatment improved the clinical parameters at 3 months.