Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis: A systematic review and meta-analysis

Zohaib Akram, Syed Saad Shafqat, Muhammad Omar Niaz, Anam Raza, Mustafa Naseem

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. Methods: Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. Results: Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = −0.61, 95% CI = −1.22 to −0.016, P =.044) and PD reduction (WMD = −1.79, 95% CI = −3.44 to −0.14, P =.034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95% CI = −0.75 to 0.79, P =.95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95% CI = −0.09 to 0.55, P =.159, Figure 3A), PD reduction (WMD = 0.31, 95% CI = −0.67 to 1.31, P =.52, Figure 3B) and GR depth (WMD = −0.34, 95% CI = −2.47 to 1.78, P =.74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. Conclusion: With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.

Original languageEnglish
Pages (from-to)3-13
JournalPhotodermatology Photoimmunology and Photomedicine
Volume36
Issue number1
DOIs
Publication statusPublished - Jan 2020

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Chronic Periodontitis
Photochemotherapy
Debridement
Meta-Analysis
Lasers
Confidence Intervals
Gingival Recession
Randomized Controlled Trials
Therapeutics
Databases
Oral Health
Laser Therapy
MEDLINE
Placebos

Cite this

@article{0eec13590f1444e3b69910f7430f2e89,
title = "Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis: A systematic review and meta-analysis",
abstract = "Background: The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. Methods: Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95{\%} confidence intervals (CI) for each variable were calculated using random effect model. Results: Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = −0.61, 95{\%} CI = −1.22 to −0.016, P =.044) and PD reduction (WMD = −1.79, 95{\%} CI = −3.44 to −0.14, P =.034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95{\%} CI = −0.75 to 0.79, P =.95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95{\%} CI = −0.09 to 0.55, P =.159, Figure 3A), PD reduction (WMD = 0.31, 95{\%} CI = −0.67 to 1.31, P =.52, Figure 3B) and GR depth (WMD = −0.34, 95{\%} CI = −2.47 to 1.78, P =.74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. Conclusion: With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.",
keywords = "chronic periodontitis, lasers, meta-analyses, Photochemotherapy, surgical treatment",
author = "Zohaib Akram and Shafqat, {Syed Saad} and Niaz, {Muhammad Omar} and Anam Raza and Mustafa Naseem",
year = "2020",
month = "1",
doi = "10.1111/phpp.12499",
language = "English",
volume = "36",
pages = "3--13",
journal = "Photodermatology Photoimmunology and Photomedicine",
issn = "0905-4383",
publisher = "Blackwell",
number = "1",

}

Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis : A systematic review and meta-analysis. / Akram, Zohaib; Shafqat, Syed Saad; Niaz, Muhammad Omar; Raza, Anam; Naseem, Mustafa.

In: Photodermatology Photoimmunology and Photomedicine, Vol. 36, No. 1, 01.2020, p. 3-13.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis

T2 - A systematic review and meta-analysis

AU - Akram, Zohaib

AU - Shafqat, Syed Saad

AU - Niaz, Muhammad Omar

AU - Raza, Anam

AU - Naseem, Mustafa

PY - 2020/1

Y1 - 2020/1

N2 - Background: The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. Methods: Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. Results: Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = −0.61, 95% CI = −1.22 to −0.016, P =.044) and PD reduction (WMD = −1.79, 95% CI = −3.44 to −0.14, P =.034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95% CI = −0.75 to 0.79, P =.95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95% CI = −0.09 to 0.55, P =.159, Figure 3A), PD reduction (WMD = 0.31, 95% CI = −0.67 to 1.31, P =.52, Figure 3B) and GR depth (WMD = −0.34, 95% CI = −2.47 to 1.78, P =.74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. Conclusion: With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.

AB - Background: The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. Methods: Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. Results: Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = −0.61, 95% CI = −1.22 to −0.016, P =.044) and PD reduction (WMD = −1.79, 95% CI = −3.44 to −0.14, P =.034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95% CI = −0.75 to 0.79, P =.95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95% CI = −0.09 to 0.55, P =.159, Figure 3A), PD reduction (WMD = 0.31, 95% CI = −0.67 to 1.31, P =.52, Figure 3B) and GR depth (WMD = −0.34, 95% CI = −2.47 to 1.78, P =.74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. Conclusion: With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.

KW - chronic periodontitis

KW - lasers

KW - meta-analyses

KW - Photochemotherapy

KW - surgical treatment

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U2 - 10.1111/phpp.12499

DO - 10.1111/phpp.12499

M3 - Review article

VL - 36

SP - 3

EP - 13

JO - Photodermatology Photoimmunology and Photomedicine

JF - Photodermatology Photoimmunology and Photomedicine

SN - 0905-4383

IS - 1

ER -