Effect of adjunctive photodynamic therapy on gingival crevicular fluid interleukin-1β in Stage III and IV periodontitis: A systematic review and meta-analysis.

Abstract

Interleukin-1β (IL-1β) is a main pro-inflammatory cytokine that is used for the assessment of treatment efficacy in periodontitis. This meta-analysis aimed to assess the effect of antimicrobial photodynamic therapy (aPDT) on Stage III-IV (severe) periodontitis-induced local IL-1β. This review study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and registered in PROSPERO (CRD42024522546). Electronic and manual search of the literature was conducted in four databases for English articles from the first record up until June 30, 2022 comparing the effects of aPDT versus conventional scaling and root planing on IL-1β levels at different follow-up times. The mean gingival crevicular fluid level of IL-1β with 95% confidence interval (CI) was pooled using the random effect model. The I ² statistics were applied to analyze the heterogeneity of the findings. The risk of bias (RoB) was analyzed using the revised Cochrane RoB. Analysis of 11 retrieved studies revealed that after the application of aPDT, a significant reduction in IL-1β level occurred at 1-2 (standardized mean difference [SMD]: 0.29, 95% CI: -0.57-1.15; P = 0.0002), 4-6 (SMD: 0.53; 95% CI: -0.36-1.42; P < 00001), and 12-13 (SMD: 1.04; 95% CI: -0.22-2.3; P < 0.00001) follow-up weeks. The application of aPDT can serve as an effective adjunctive therapy for the treatment of Stage III-IV periodontitis. Although the results of this meta-analysis showed that increasing the session frequency of aPDT had a higher effect size, further studies without the limitations of the existing studies are required to confirm the present results.