Int J Stomatol

Int J Stomatol ›› 2022, Vol. 49 ›› Issue (3): 305-316.doi: 10.7518/gjkq.2022054

• Original Articles • Previous Articles     Next Articles

Photodynamic therapy as an adjunct to periodontitis: a meta-analysis

Ma Yu1(),Zuo Yu2,Zhang Xin1()   

  1. 1.Dept. of Ge-neral Dentistry, The Affiliated Stomatological Hospital of Soochow University, Suzhou 215000, China
    2.Dept. of Prostho-dontics, The Affiliated Stomatological Hospital of Guilin Medical College, Guilin 541004, China
  • Received:2021-06-10 Revised:2021-12-28 Online:2022-05-01 Published:2022-05-09
  • Contact: Xin Zhang E-mail:137874636@qq.com;909088887@qq.com

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Abstract: Objective

This study aimed to evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planning (SRP) in patients with chronic periodontitis.

Methods

Published literature on PubMed, Embase, Web of Science/SCI, Wanfang, CNKI, and VIP was searched by Boolean algorithm combined with medical subject words and free words. The time was also searched from their inception until December 2020, and the language type was Chinese or English. Then, a manual search was performed to obtain a randomized controlled trial of PDT adjunctive to SRP in the treatment of periodontitis. Literature was screened out on the basis of the inclusion and exclusion criteria. The Cochrane bias risk assessment tool was used to evaluate literature quality. Revman 5.3 software was used for meta-analysis. Outcome indicators included clinical attachment loss, probing depth, plaque index, and bleeding on probing.

Results

A total of 21 articles were included. Meta-analysis showed that at 1 month after SRP+PDT treatment, PD and BOP diffe-rences were statistically significant (PD: SMD=-0.81, 95%CI was -1.40 to -0.21, P=0.008; BOP: SMD=-0.61, 95%CI was -1.05 to -0.16, P=0.008). At 3 months after treatment, only PD difference was statistically significant (SMD=-0.57, 95%CI was -0.91 to -0.23, P=0.001). At 6 months after treatment, CAL and PD differences were statistically significant (CAL: SMD=-0.46, 95%CI was -0.88 to -0.03, P=0.04; PD: SMD=-0.57, 95%CI was -1.04 to -0.11, P=0.02). The experimental group was lower than the control group.

Conclusion

PDT adjunctive to SRP improved CAL and reduced PD in the short term (6 months), but no evidence that PDT adjunctive to SRP was superior to pure SRP in improving PI and BOP was found.

Key words: photodynamic therapy, scaling and root planning, periodontitis, meta-analysis

CLC Number: 

  • R 783

TrendMD: 

Tab 1

The basic features of the included study"

作者发表年国家

研究人数

（男/女）

样本量（试验组/对照组）年龄/岁

研究

设计

激光参数光敏剂参数
波长/nm额定功率/mWPDT次数种类质量浓度/g·L-1放置时间/s
Grzech-Le?niak等[6]2019波兰40（15/25）40（20/20）50.3±11.6FMD6355001甲苯胺蓝－－
Vohra等[11]2018沙特阿拉伯52（26/26）52（23/29）50.1±9.98FMD6701501亚甲基蓝10－
Segarra-Vidal等[12]2017西班牙40（12/28）40（20/20）55±2FMD6701501亚甲基蓝0.05－
Monzavi等[26]2016伊朗50（25/25）50（25/25）49.6±8.5FMD8102003吲哚菁绿5－
Betsy等[27]2014印度88（37/51）88（44/44）39.6±8.7FMD655601亚甲基蓝10180
Raut等[28]2018印度50（28/22）50（25/25）49.8±5.1FMD8108001吲哚菁绿560
Alwaeli等[29]2015马来西亚16（5/11）32（16/16）40.9±13.34SMD6601001吩噻嗪氯化物－60
Lui等[30]2011中国24（10/14）48（24/24）50SMD9401 5003亚甲基蓝100180
Raj等[31]2016印度20（8/12）40（20/20）35~50SMD6352003甲苯胺蓝160
Harmouche等[32]2019法国36（14/22）72（36/36）50.25±5.98SMD625~6352 0003甲苯胺蓝0.160
Theodoro等[33]2012巴西33（12/21）33（22/11）43.12±8.2FMD6604001甲苯胺蓝0.1－
Petelin等[34]2015斯洛文尼亚27（9/18）27（18/9）47±2.8FMD660603吩噻嗪氯化物－180
Corrêa等[35]2015巴西20（11/9）40（20/20）48.1±7.5SMD660601亚甲基蓝1060
Siva等[36]2020巴西19（8/11）38（19/19）34~66SMD6601001－－－
Chondros等[37]2009荷兰24（10/14）24（12/12）49.5±8.47FMD670751吩噻嗪氯化物－60
Polansky等[38]2009澳大利亚58（22/36）58（29/29）48.7FMD680751－－－
Birang等[39]2015伊朗20（7/13）40（20/20）37.2±8.6SMD8105003－－－
Rahman等[40]2020印度15（8/7）15（10/5）－FMD8105001吲哚菁绿5180
Shingnapurkar等[41]2016印度30（15/15）60（30/30）－SMD8102001吲哚菁绿5180
Bassir等[42]2013伊朗16（8/8）32（16/16）50.3±8.7SMD625~6352 0003甲苯胺蓝0.1180
Malgikar等[43]2016印度24（15/9）48（24/24）35.83±7.81SMD9801 5001亚甲基蓝10180

Tab 2

The quality evaluation results of the included literatures"

作者随机分配方法分配方案隐藏方式研究人员或患者的盲法结果评估者的盲法结果数据的完整性选择性报告研究结果其他偏倚来源
Grzech-Le?niak等[6]计算机生成的随机化表未描述未描述未描述完整未描述未描述
Vohra等[11]抛硬币按顺序编号的密封不透明信封未描述未描述完整未描述无
Segarra-Vidal等[12]计算机生成的随机化表按顺序编号的密封不透明信封未描述正确完整无选择性报告无
Monzavi等[26]区组随机化按顺序编号的密封不透明信封正确正确完整无选择性报告无
Betsy等[27]随机数字表按顺序编号的密封不透明信封未描述正确完整无选择性报告无
Raut等[28]抽签法未描述未描述正确完整未描述未描述
Alwaeli等[29]计算机生成的随机化表按顺序编号的密封不透明信封未描述正确完整无选择性报告无
Lui等[30]未描述未描述未描述正确完整未描述未描述
Raj等[31]抛硬币未描述未描述未描述完整未描述未描述
Harmouche等[32]计算机生成的随机化表按顺序编号的密封不透明信封正确正确完整无选择性报告无
Theodoro等[33]计算机生成的随机化表未描述未描述未描述完整未描述未描述
Petelin等[34]未描述未描述未描述未描述完整未描述未描述
Corrêa等[35]计算机生成的随机化表按顺序编号的密封不透明信封未描述正确完整未描述未描述
Siva等[36]未描述未描述未描述未描述完整未描述未描述
Chondros等[37]抛硬币未描述未描述正确完整未描述未描述
Polansky等[38]计算机生成的随机化表未描述未描述正确完整未描述未描述
Birang等[39]随机数字表未描述正确未描述完整无选择性报告未描述
Rahman等[40]区组随机化按顺序编号的密封不透明信封未描述正确完整无选择性报告无
Shingnapurkar等[41]抛硬币未描述未描述未描述完整未描述未描述
Bassir等[42]计算机生成的随机化表按顺序编号的密封不透明信封正确正确完整无选择性报告无
Malgikar等[43]计算机生成的随机化表按顺序编号的密封不透明信封未描述正确完整无选择性报告无

Tab　3

Meta analysis results of CAL, PD, PI and BOP"

指标时间/月SMD95%CIP值
CAL1-0.09-0.31~0.130.41
3-0.18-0.40~0.050.13
6-0.46-0.88~-0.030.04*
PD1-0.81-1.40~-0.210.008*
3-0.57-0.91~-0.230.001*
6-0.57-1.04~-0.110.02*
PI1-0.22-0.46~0.020.07
3-0.11-0.32~0.090.28
60.19-0.14~0.530.26
BOP1-0.61-1.05~-0.160.008*
3-0.11-0.70~0.490.72
6-0.26-1.47~0.950.67

Fig 2

Meta analysis results of CAL"

Fig 3

Meta analysis results of PD"

Tab　4

Results of subgroup analysis of photosensitizer types"

指标时间/月吩噻嗪染料组吲哚菁绿组
SMD95%CIP值SMD95%CIP值
PD1-0.49-1.08~0.100.100-1.52-2.24~-0.80<0.000 1*
3-0.41-0.71~-0.110.007-1.92-3.08~-0.770.001 0*

Tab　5

Results of subgroup analysis of photosensitizer deposition"

指标时间/月60 s组180 s组
SMD95%CIP值SMD95%CIP值
PD3-0.40-0.77~-0.030.03*-0.79-1.39~-0.180.01*
6-0.35-0.88~0.180.19-0.74-1.39~-0.090.03*
CAL6-0.31-0.77~0.140.18-0.90-1.98~0.190.11

Tab　6

Results of subgroup analysis of PDT times"

指标时间/月1次组3次组
SMD95%CIP值SMD95%CIP值
PD1-0.38-0.89~0.120.14-1.46-2.78~-0.140.03*
3-0.42-0.80~-0.050.03*-0.87-1.61~-0.130.02*
6-0.54-1.06~-0.010.05-0.80-2.45~0.850.34
CAL6-0.32-0.68~0.030.04*-1.28-3.90~1.340.08

Tab　7

Results of subgroup analysis of study design"

指标时间/月FMD组SMD组
SMD95%CIP值SMD95%CIP值
PD1-0.70-1.75~0.350.19-0.90-1.74~-0.060.03*
3-0.71-1.32~-0.100.02*-0.45-0.84~-0.070.02*
6-0.64-1.32~0.040.07-0.42-0.94~0.090.10
CAL6-0.58-1.25~0.090.09-0.24-0.61~0.130.20

Fig 4

The sensitivity analysis results of BOP at 6 months"

Fig 5

The publication bias test results of CAL at 6 months"

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