Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, USA.
Department of Prosthodontics, Department of Dentistry, Aga Khan University, Karachi, Pakistan.
Photodiagnosis Photodyn Ther. 2017 Dec;20:55-61. doi: 10.1016/j.pdpdt.2017.08.012. Epub 2017 Aug 25.
The aim of the present systematic review and meta-analysis was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) as a therapeutic protocol for oral decontamination.
In order to address the focused question: Is aPDT a useful therapeutic protocol for oral decontamination?, an electronic search without time or language restrictions was conducted up to July 2017 in indexed databases using the combination of different key words including photochemotherapy, lasers, photodynamic therapy, disinfection, mouth, saliva and oral. The exclusion criteria included reviews, case-reports, case-series, commentaries, letters to the editor, interviews, and updates. Four randomized control trials were included and processed for data extraction.
All studies reported that aPDT was effective in reducing the overall oral microbial load in saliva. Considering the effects of aPDT+photosensitizer (PS) compared with PS alone, there was no heterogeneity noticed for aPDT+PS (Q value=0.15, P=0.69, I=0%). The overall mean difference for bacterial count in CFU/ml between aPDT+PS and PS alone was also not significant (weighted mean difference=-0.41, 95% CI=-1.12 to 0.29, p=0.24) at follow-up.
The efficacy of aPDT for oral decontamination remains unclear. Further well-designed randomized clinical trials assessing the efficacy of aPDT reducing the oral microbial load are need.
本系统评价和荟萃分析的目的是评估抗菌光动力疗法（aPDT）作为口腔去污的治疗方案的疗效。
为了解决这个问题：aPDT 是一种用于口腔去污的有效治疗方案吗？我们进行了一项无时间和语言限制的电子搜索，截至 2017 年 7 月，在索引数据库中使用了不同关键词的组合，包括光化学疗法、激光、光动力疗法、消毒、口腔、唾液和口腔。排除标准包括综述、病例报告、病例系列、评论、给编辑的信、访谈和更新。共纳入 4 项随机对照试验，并进行了数据提取。
所有研究均报道 aPDT 可有效降低唾液中的整体口腔微生物负荷。考虑到 aPDT+光敏剂（PS）与 PS 单独使用的效果，aPDT+PS 之间没有异质性（Q 值=0.15，P=0.69，I=0%）。在随访时，aPDT+PS 和 PS 单独使用之间 CFU/ml 细菌计数的总体平均差异也无显著意义（加权平均差异=-0.41，95%CI=-1.12 至 0.29，p=0.24）。
aPDT 用于口腔去污的疗效仍不清楚。需要进一步设计良好的随机临床试验来评估 aPDT 降低口腔微生物负荷的疗效。
