Faculty of Dentistry, Department of Craniofacial Biology, University of the Western Cape, Tygerberg, South Africa.
Faculty of Dentistry, Department of Oral Medicine & Periodontology, University of the Western Cape, Tygerberg, South Africa.
Clin Exp Dent Res. 2021 Jun;7(3):354-364. doi: 10.1002/cre2.408. Epub 2021 Apr 2.
This systematic review evaluated the evidence for the effectiveness of Photodynamic therapy (PDT) in treating oral fungal infections, as an alternative to conventional antifungal medications.
Five randomized control trials (168 participants) comparing the treatment of oral fungal infections using met with our inclusion criteria. Clinical and microbiological improvement was assessed by random-effects meta-analysis. Methodological quality assessment and heterogeneity were performed using peer-reviewed criteria. PROSPERO registration: CRD42017076.
PDT showed statistically non-significant increased clinical efficacy (risk ratio (RR) = 1.47 [95% confidence interval (CI), 0.68; 3.17]; three studies, n = 108 participants, I = 50%) and mycological efficacy (mean difference (MD) = 0.54 [95%CI, -0.71; 1.79]; three studies, n = 100; I = 39%) at 30 days, as compared with conventional antifungal therapy. Lack of standardization of treatment parameters and variability in the assessment of outcomes was observed across the studies. All included studies had a moderate to low risk of bias.
PDT showed comparable effectiveness at treating oral fungal infections, particularly denture stomatitis. The small number of studies in this review, small sample size and variability of methods and outcome measures across studies, highlight the need for more standardized studies with longer follow-up periods to enable recommendation of PDT as an alternative to conventional antifungal therapy.
本系统评价评估了光动力疗法（PDT）治疗口腔真菌感染的有效性证据，作为替代传统抗真菌药物的方法。
五项随机对照试验（168 名参与者）符合我们的纳入标准，比较了使用 PDT 治疗口腔真菌感染的效果。通过随机效应荟萃分析评估临床和微生物学改善情况。使用同行评议标准进行方法学质量评估和异质性分析。PROSPERO 注册号：CRD42017076。
PDT 在 30 天时显示出统计学上无显著增加的临床疗效（风险比（RR）= 1.47 [95%置信区间（CI），0.68; 3.17]；三项研究，n = 108 名参与者，I = 50%）和真菌学疗效（MD = 0.54 [95%CI，-0.71; 1.79]；三项研究，n = 100；I = 39%），与传统抗真菌治疗相比。研究之间观察到治疗参数的标准化不足和结果评估的变异性。所有纳入的研究都存在中度至低度偏倚风险。
PDT 在治疗口腔真菌感染方面具有相当的有效性，特别是义齿性口炎。本综述中的研究数量较少，样本量小，研究方法和结果测量的变异性较大，这突显了需要进行更多标准化的研究，随访时间更长，以便推荐 PDT 作为传统抗真菌治疗的替代方法。
