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Efficacy of photodynamic therapy as adjunct treatment of chronic periodontitis: a systematic review and meta-analysis

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Abstract

Meta-analysis of treatment effects of antimicrobial photodynamic therapy (aPDT) adjunct to non-surgical scaling and root planing (SRP) in comparison to SRP alone on patients with chronic periodontitis. The meta-analysis was performed according to PRISMA statement and Cochrane Collaboration guidelines. Electronic search complemented by hand search assured a high yield of randomized controlled trials (RCTs) of aPDT as adjunct modality to SRP. Differences in probing depth (PD) and clinical attachment level (CAL) were calculated with 95% confidence intervals and pooled in a random effects model. Analysis for intra- and inter-study heterogeneity was provided by χ 2 and I 2 tests, and publication bias was checked by funnel plots. Pooled overall effects of 26 RCTs attested significant benefits of aPDT adjunct to SRP with respect to PD reduction (MD 0.37; 95% CI 0.12–0.53; P < 0.0001) and CAL gain (MD 0.33; 95% CI 0.19–0.48; P < 0.00001) after 3 and 6 months. Sensitivity analysis minimized heterogeneity of PD reduction (MD 0.21; 95% CI 0.13–0.30; P < 0.00001) and CAL gain (MD 0.36; 95% CI 0.27–0.46). aPDT adjunct to SRP provides significant PD reduction and CAL gain in treatment of chronic periodontitis. This moderate effect was found after 3 and 6 months which is short from a clinical perspective.

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Funding

No funding from sources other than the Department of Operative Dentistry and Periodontology of the University Medical Center Mainz has to be reported.

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Authors and Affiliations

  1. Department of Operative Dentistry and Periodontology, University Medical Center of the Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany

    Adriano Azaripour, Sebastian Dittrich & Brita Willershausen

  2. Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Cornelis J. F. Van Noorden

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  1. Adriano Azaripour
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  2. Sebastian Dittrich
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  3. Cornelis J. F. Van Noorden
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  4. Brita Willershausen
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Correspondence to Adriano Azaripour.

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Electronic supplementary material

Appendix Fig. 1

Forest plot of PD reduction and CAL gain after 3 month (JPEG 2366 kb)

Appendix Fig. 2

Forest plot of PD reduction and CAL gain after 6 month (JPEG 1857 kb)

Appendix Fig. 3

Forest plot of PD reduction and CAL gain after 12 month (JPEG 1817 kb)

Appendix Fig. 4

Forest plot of PD reduction and CAL gain after various incubation periods with photosensitizer (JPEG 2356 kb)

Appendix Fig. 5

Forest plot of PD reduction and CAL gain after various periods of activation time of photosensitizer (JPEG 2377 kb)

Appendix Fig. 6

Forest plot of PD reduction and CAL gain in studies with low bias risk (JPEG 1932 kb)

Appendix Fig. 7

Forest plot of PD reduction and CAL gain in studies with high bias risk (JPEG 2187 kb)

Appendix Fig. 8

Funnel plot of overall PD reduction (JPEG 1415 kb)

Appendix 1

Search strategy (DOCX 15 kb)

Appendix 2

Flow diagram according to the PRISMA Statement (JPEG 2187 kb)

Appendix 3

Modified quality assessment according to the Cochrane Handbook for Systematic Reviews of Interventions (DOCX 43 kb)

Appendix 4

Excluded studies from systematic review with reasons for exclusion (DOCX 57 kb)

ESM 1

Appendix list of references (DOCX 20 kb)

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Azaripour, A., Dittrich, S., Van Noorden, C.J.F. et al. Efficacy of photodynamic therapy as adjunct treatment of chronic periodontitis: a systematic review and meta-analysis. Lasers Med Sci 33, 407–423 (2018). https://doi.org/10.1007/s10103-017-2383-7

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  • DOI: https://doi.org/10.1007/s10103-017-2383-7

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