Evaluation of the Adjunctive Effect of Photodynamic Therapy for the Treatment of Residual Periodontal Pockets: A Systematic Review.

Abstract

Purpose: Adjunctive use of photodynamic therapy in combination with scaling and root planing for periodontal maintenance offers an alternative to antibiotic therapy, potentially mitigating the risk of antibiotic resistance and its genotoxic or mutagenic effects. This systematic review analyzed studies, as of January 2023, that included the effects of a single application of photodynamic therapy in residual periodontal pockets with the probing depth and clinical attachment level as the primary and secondary outcomes, respectively.

Methods: PubMed, Scopus, and Web of Science databases, as well as the US National Institutes of Health and WHO Clinical Trials Registry, were searched for eligible studies on January 14, 2023.

Results: Excluding non-English language articles, a total of nine studies examining 286 subjects were considered. Six of the nine studies resulted in decreased probing depth levels. Likewise, six of the nine studies exhibited a positive trend in terms of clinical attachment levels with photodynamic therapy. A limited number of studies revealed significant probing depth levels and clinical attachment levels after photodynamic therapy. The overall risk of bias was high in four studies, four studies showed some concerns regarding the study limitations, and one study had a low risk of bias.

Conclusions: Photodynamic therapy in combination with scaling and root planing may result in modest reductions in residual periodontal pocket depth levels and improvements in clinical attachment levels. The use of PDT in periodontal maintenance can reduce or eliminate the need for periodontal surgery, which may be more invasive and lead to a longer recovery time.