The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102231. doi: 10.1016/j.pdpdt.2021.102231. Epub 2021 Feb 20.
Clinical efficacy of antimicrobial photodynamic therapy (aPDT) as compared to antibiotics in periodontitis and peri-implantitis has been tested in several clinical trials. Yet controversial results were reported. The aim of the present study was to answer the question: "Will adjunctive antimicrobial photodynamic therapy be more effective than antibiotics agent in the treatment of periodontitis and peri-implantitis?".
Publications compared outcomes between aPDT and antibiotics in adult patients with periodontitis or peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. PubMed, EMBASE and Cochrane Central were searched until December of 2020. Clinical parameters including pocket probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated. The risk of bias was assessed by Cochrane Collaboration Tool. Weighted mean differences (WMD), 95 % confidence interval(CI) and heterogeneity were estimated by Review Manager software.
10 trials in periodontitis and 5 trials in peri-implantitis were included. Meta-analysis outcomes revealed equal clinical evidence for aPDT and antibiotics in periodontitis and peri-implantitis. In addition, aPDT significantly reduced the red complex in both diseases. However, owing to the heterogeneity of protocols in articles and the limited number of studies, the comparative conclusion remained unconfirmed.
aPDT can be considered as an alternative to antibiotics in the treatment of peri-implantitis and periodontitis. Given that high heterogeneity in outcome was found in this review, future long-term clinical trials with standard aPDT and antibiotic treatment should be tested to arrive at a firm conclusion.
抗菌光动力疗法（aPDT）在牙周炎和种植体周围炎中的临床疗效已在多项临床试验中得到检验。然而，报道的结果存在争议。本研究旨在回答以下问题：“辅助抗菌光动力疗法在牙周炎和种植体周围炎的治疗中是否比抗生素更有效？”。
本系统评价和荟萃分析纳入了比较 aPDT 与抗生素在牙周炎或种植体周围炎成人患者中疗效的出版物，这些文献均包含 3 个月以上的随访期。我们检索了 PubMed、EMBASE 和 Cochrane Central 数据库，检索时间截至 2020 年 12 月。评估的临床参数包括探诊深度（PPD）、临床附着水平（CAL）和探诊出血（BOP）。采用 Cochrane 协作工具评估偏倚风险。采用 Review Manager 软件评估加权均数差（WMD）、95%置信区间（CI）和异质性。
纳入了 10 项牙周炎研究和 5 项种植体周围炎研究。荟萃分析结果表明，aPDT 和抗生素在牙周炎和种植体周围炎中的临床疗效相当。此外，aPDT 可显著降低两种疾病中的红色复合体。然而，由于文章中方案的异质性和研究数量有限，该比较结论仍未得到证实。
aPDT 可被视为治疗种植体周围炎和牙周炎的抗生素替代方法。鉴于本综述中发现结局存在高度异质性，未来应进行具有标准 aPDT 和抗生素治疗的长期临床试验，以得出确定的结论。
