Int J Stomatol

Int J Stomatol ›› 2024, Vol. 51 ›› Issue (4): 406-415.doi: 10.7518/gjkq.2024074

• Periodontitis • Previous Articles     Next Articles

Meta-analysis of the efficacy of antimicrobial photodynamic therapy and systemic antimicrobial drug as an adjunct treatment for periodontitis

Yu Ma1(),Yu Zuo2,Jianhua Liu1()   

  1. 1.Dept. of Oral Emergency, Suzhou Stomatological Hospital, Suzhou 215000, China
    2.Dept. of Prosthodontics, the Affi-liated Stomatological Hospital of Guilin Medical College, Guilin 541004, China
  • Received:2023-12-29 Revised:2024-04-15 Online:2024-07-01 Published:2024-06-24
  • Contact: Jianhua Liu E-mail:mayu_1109@sina.com;dentist_liujh@sina.com

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Abstract:

Objective This study aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) and systemic antimicrobial drug as an adjunct treatment for periodontitis. Methods 　Seven databases, namely, Embase, PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP, were searched from inception until November 2023. The language of the searched literature is Chinese or English. Studies were screened out according to inclusion and exclusion criteria, and their quality was evaluated using the Cochrane tool. Meta-analysis and publication bias detection of the included studies were performed using RevMan 5.4 and Stata 14.0 software. Results Eight studies were included. Meta-analysis showed that 3 months after treatment using methylene blue (MB) as the photosensitizer (PS), the improvement effect of scaling and root planning (SRP)+aPDT on probing depth (PD) was better than that of SRP+systemic antimicrobial drug. When phenothiazine chloride was the PS, the improvement effect of SRP+systemic antimicrobial drug on PD was better than that of SRP+aPDT (P<0.05). No significant difference was observed in the improvement effect of SRP+aPDT/SRP+systemic antimicrobial drug on clinical attachment level (CAL) and probing bleeding (BOP) at 3 months after treatment (P>0.05) and the improvement effect of SRP+aPDT/SRP+systemic antimicrobial drug on PD, CAL, and BOP at 6 months after treatment (P>0.05). Compared with those at baseline, SRP+aPDT improved PD, CAL, and BOP by (0.80±0.19) mm, (0.94±0.29) mm, and 19.74%±1.91%, respectively, at 3 months after treatment (P<0.05). In addition, SRP+systemic antimicrobial drug improved PD, CAL, and BOP by (1.02±0.27) mm, (0.95±0.25) mm, and 19.39%±11.83%, respectively (P<0.05). At 6 months after treatment, SRP+aPDT improved PD, CAL, and BOP by (1.37±0.47) mm, (1.29±0.52) mm, and 28.97%±2.43%, respectively (P<0.05). In addition, SRP+systemic antimicrobial drug improved PD, CAL, and BOP by (1.55±0.53) mm, (1.34±0.49) mm, and 29.34%±10.47%, respectively (P<0.05). Conclusion For PD, the improvement effect is in the order of SRP+MB-aPDT>SRP+systemic antimicrobial drug> SRP+phenothiazine chloride-aPDT. MB-aPDT may be an alternative to systemic antimicrobial drug as an adjunct treatment for periodontitis. The type of periodontitis, type 2 diabetes mellitus, smoking, number of aPDT, type of systemic antimicrobial drug, and treatment time of systemic antimicrobial drug have a similar influence on the treatment effect of SRP+aPDT/SRP+systemic antimicrobial drug.

Key words: antimicrobial photodynamic therapy, antimicrobial drug, scaling and root planning, periodontitis, Meta analysis

CLC Number: 

  • R781.4

TrendMD: 

Fig 1

Flow chart of literature searching and screening"

Tab 1

Relevant informations of the literature"

研究发表年份纳入人数

SRP+aPDT组

（年龄/岁）

SRP+全身抗菌药物组（年龄/岁）

牙周炎

类型

有/无

T2DM

是否

吸烟

PS种类aPDT次数全身抗菌药物治疗时间/d

全身抗菌

药物的种类

Al-Khureif等[13]20201729.61±3.231.44±2.4AP无否吩噻嗪氯47AMX+MTZ
Al-Zahrani等[14]20093051.92±7.2851.42±6.24CP有是MB114Dox
Arweiler等[15]20133537.4±8.034.7±9.1AP无否吩噻嗪氯27AMX+MTZ
Arweiler等[16]20143537.3±8.034.7±9.0AP无否吩噻嗪氯17AMX+MTZ
Ramos等[17]20163048.9±9.549.3±7.4CP有否吩噻嗪氯414Dox
Skaleri?等[10]202320未描述未描述AP无否吩噻嗪氯27AMX+MTZ
Theodoro等[18]20172748.8±8.346.3±6.8CP无否MB37AMX+MTZ
Theodoro等[19]20182948.8±3.948.9±5.1CP无是MB37AMX+MTZ

Tab 2

Quality evaluation results of the literature"

研究随机分配方法分配方案隐藏

研究者或患者的

盲法

检查者

盲法

文献数据完整性

选择性报告

研究结果

其他偏

倚来源

Al-Khureif等[13]随机比例块

按顺序编号的密封不透明信封来确保对

随机化的盲法

研究者和患者盲法盲法完整无选择性报告未描述
Al-Zahrani等[14]

计算机生成的

随机数字表

未描述患者盲法盲法完整无选择性报告未描述
Arweiler等[15]未描述未描述未描述盲法完整无选择性报告未描述
Arweiler等[16]未描述未描述未描述盲法完整无选择性报告未描述
Ramos等[17]

计算机生成的

随机数字表

按顺序编号的密封不透明信封来确保对

随机化的盲法

未描述未描述完整无选择性报告未描述
Skaleri?等[10]

计算机生成的

随机数字表

按顺序编号的密封不透明信封来确保对

随机化的盲法

未描述未描述完整无选择性报告未描述
Theodoro等[18]

计算机生成的

随机数字表

按顺序编号的密封不透明信封来确保对

随机化的盲法

研究者盲法盲法完整无选择性报告未描述
Theodoro等[19]未描述未描述未描述未描述完整无选择性报告未描述

Tab 3

Meta analysis results of intergroup comparison between the test group and control group at different follow-up time points after treatment"

结局指标随访时间/月

纳入

人数

SMD95% CIP值
PD/mm31880.14-0.21~0.490.43
61060.25-0.31~0.820.38
CAL/mm31880.05-0.15~0.260.61
61060.21-0.52~0.950.57
BOP/%3138-1.20-3.98~1.590.40
6810.07-12.07~12.210.99

Tab 4

Meta analysis results of the comparison of intra-group differences between the test group and control group at different follow-up time points after treatment compared with baseline"

结局指标随访时间/月试验组（SRP+aPDT）对照组（SRP+全身抗菌药物）
纳入人数Mean±SDP值纳入人数Mean±SDP值
PD/mm393-（0.80±0.19）<0.0195-（1.02±0.27）<0.01
653-（1.37±0.47）<0.0153-（1.55±0.53）<0.01
CAL/mm393-（0.94±0.29）<0.0195-（0.95±0.25）<0.01
653-（1.29±0.52）0.0153-（1.34±0.49）<0.01
BOP/%368-（19.74±1.91）<0.0170-（19.39±11.83）<0.01
640-（28.97±2.43）<0.0141-（29.34±10.47）<0.01

Fig 2

Results of subgroup analysis of the type of photosensitizer"

Fig 3

PD publication bias plot at 3 months after treatment"

Fig 4

CAL publication bias plot at 3 month after treatment"

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