The Effectiveness of Photodynamic Therapy as an Adjunctive Treatment of Aggressive Periodontitis : A Systematic Review and Meta-analysis
Keywords:Aggressive periodontitis treatment, Photodynamic therapy, Aggressive periodontitis, Systematic review, Meta-analysis
Background: The treatment of aggressive periodontitis aims to eliminate dental plaque, following the same methods with treatment of chronic periodontitis. However, aggressive periodontitis does not response as effective as in chronic periodontitis in means of unpredictable outcome along with the ability of periodontal pathogens can penetrated into epithelial cell. Deep periodontal pocket depth and local factors such as furcation area, root concavity made it more difficult to completed eliminate. Adjunctive treatment with systemic antibiotics shows promising outcome. However, there are some limitations. From the disadvantages of conventional treatment and adjunctive treatment with systemic antibiotics, Photodynamic therapy as an adjuvant to scaling and root planing has emerged recently.Objective: The objective of this systematic review and meta-analysis was to find out whether does antimicrobial photodynamic therapy have an effectiveness as an adjunctive treatment of aggressive periodontitis.Methods: The following database were searched from 2000 to April 2020 from PubMed, The Cochrane Database of Systematic Review (CDSR), google scholar, hand search. Randomized controlled clinical trial studies which comparing adjunctive treatment with photodynamic therapy and conventional treatment which were published in Thai and English only.
Results: Total of 5 studies were included in this study. Standard mean difference with 95% confidence interval and random effect model was generated. The results showed adjunctive treatment with photodynamic therapy could reduce periodontal pocket (SMD=1.381 (95%CI (-0.032) – 3.095, p=0.114)), while the data had high heterogeneity (I2=96.0%) caused by limited number of studies, no standard protocol in using photodynamic therapy, short term follow up. In future studies, higher quality experimental design might need to be conduct along with clinical and microbiological parameter evaluation. Long-term follow up period was also need to be established.Conclusion: At present, evidence that support an effectiveness of photodynamic therapy as an adjunctive treatment of aggressive periodontitis is insufficient.
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