Department of Dental Materials and Prosthodontics, School of Dentistry, Araraquara, São Paulo State University (Unesp), Rua Humaitá 1680, Araraquara 14801-903, Brazil.
Department of Morphology, School of Dentistry, Genetics, Orthodontics and Pediatric Dentistry São Paulo State University (Unesp), School of Dentistry, Araraquara, SP, Brazil.
Photodiagnosis Photodyn Ther. 2022 Sep;39:102876. doi: 10.1016/j.pdpdt.2022.102876. Epub 2022 Apr 23.
The presence of oral microorganisms resistant to traditional treatment is increasing, thus a search for new therapies is needed. In this context, antimicrobial photodynamic therapy (aPDT) is an approach for the treatment of antibiotic resistant andnon resistant microorganisms. Therefore, the aim of the present study was to conduct a systematic review and meta-analysis of randomized clinical trials of aPDT for oral antisepsis against oral polymicrobial biofilms.
PubMed, Science Direct, Scopus, SciELO, Lilacs, Cochrane Library and Embase databases were searched. In total, five articles were included for qualitative analysis and four articles were used for quantitative analyses. Bias assessment of the eligible articles was made using the RoB 2 criteria. Network meta-analysis was performed using the random-effect model. Subgroup's analysis was also conducted. The groups evaluated were aPDT, exposure to light only and no treatment at all (control group). The quality of evidence was assessed by CINeMA approach.
aPDT mediated by curcumin had significant results in the reducing bacterial load (0.31-0.49 log UFC/ I=0%) when compared with the control group. The included articles were classified as low risk of bias, despite biases detected by allocation and blinding. Moreover, quantitative analysis between aPDT and control group and between light and control group were classified with low risk of confidence rating, while the results from aPDT versus light were classified as moderate risk of confidence rating.
aPDT has significant efficacy for oral antisepsis, however more randomized clinical trials will be needed to validate the present results.
具有传统治疗耐药性的口腔微生物的存在正在增加,因此需要寻找新的治疗方法。在这种情况下,抗菌光动力疗法(aPDT)是治疗抗生素耐药和非耐药微生物的一种方法。因此,本研究旨在对口腔多微生物生物膜的口腔消毒的 aPDT 进行随机临床试验的系统评价和荟萃分析。
检索了 PubMed、Science Direct、Scopus、SciELO、Lilacs、Cochrane 图书馆和 Embase 数据库。共有 5 篇文章进行了定性分析,4 篇文章进行了定量分析。使用 RoB 2 标准评估合格文章的偏倚。使用随机效应模型进行网络荟萃分析。还进行了亚组分析。评估的组为 aPDT、仅暴露于光和不进行任何治疗(对照组)。使用 CINeMA 方法评估证据质量。
与对照组相比,姜黄素介导的 aPDT 在减少细菌负荷方面具有显著效果(0.31-0.49 log UFC/ I=0%)。尽管在分配和盲法方面存在偏倚,但纳入的文章被归类为低偏倚风险。此外,aPDT 与对照组之间以及光与对照组之间的定量分析被归类为低置信度评级,而 aPDT 与光之间的结果被归类为中置信度评级。
aPDT 对口腔消毒具有显著疗效,但需要更多的随机临床试验来验证目前的结果。