Photodynamic therapy for the treatment of peri-implant diseases: A network meta-analysis of randomized controlled trials.

BACKGROUND

Photodynamic therapy in peri-implantitis has been tested in randomized clinical trials. Though systematic review and meta-analysis on human and animal studies, identifies the utility of photodynamic therapy, a comparison of other interventions with photodynamic therapy for peri-implantitis does not exist. Hence the aim of this network meta-analysis is to identify the role of photodynamic therapy for peri-implantitis compared with other interventions tested in randomized human clinical trials.

METHOD

Randomized controlled trials comparing photodynamic therapy and other interventions in patients with peri- implantitis was searched for in electronic databases. The risk of bias was calculated using Cochrane risk of Bias tool. The heterogeneity between the studies in direct comparison was assessed using Chi-square and I tests. GRADE working group approach was used to assess the quality of evidence. Publication bias was assessed using Funnel plot and Trim and Fill method was used to identify the number of missing studies.

RESULTS

We observed a significant reduction in the level of attachment scores with the use of combined photodynamic therapy with mechanical debridement when compared with other interventions tested. For bleeding on probing, pocket depth and plaque scores no statistically significant results were obtained.

CONCLUSION

The use of photodynamic therapy with mechanical debridement will definitely bring about significant improvement in patients with peri-implantitis. Further trials on the use of photodynamic therapy with other treatment modalities need to be tested to arrive at the best possible treatment option for peri-implantitis.