Yarlagadda Sayisree, Selvakumar Rene Jochebed, Parashar Saumya Rajesh, Arockiam Selva, Natanasabapathy Velmurugan
Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India.
J Conserv Dent Endod. 2023 Sep-Oct;26(5):502-513. doi: 10.4103/jcd.jcd_305_23. Epub 2023 Sep 16.
The aim of this systematic review was to assess the antimicrobial activity of nanoparticle-mediated photodynamic therapy (N-PDT) on biofilms in the presence of dentin substrate when compared to photodynamic therapy (PDT) and conventional disinfection protocols.
This systematic review was registered in Open Science Framework (10.17605/OSF.IO/GBR3F). Six databases, namely PubMed, Embase, Web of Science, Scopus, Medline, and Google Scholar, were searched for English language articles until June 2022. Laboratory studies assessing the antimicrobial activity of N-PDT against biofilm in human or bovine teeth were included. The risk of bias (RoB) was evaluated using the Joanna Briggs Institute tool for quasi-experimental studies. Meta-analysis was performed using the random-effects maximum likelihood model.
The search revealed 2804 articles, out of which 9 studies were included in the final review. Seven articles had low RoB and two had moderate RoB. Chitosan and diode laser at 810 nm were the most commonly used nanoparticle and light source, respectively. The meta-analysis of bacterial reduction log and percentage reduction revealed that N-PDT had better antimicrobial efficacy than the control group. When the bacterial reduction log of N-PDT was compared with PDT, PDT performed better N-PDT, and for percentage reduction, there was no difference.
The currently available evidence is low and inconclusive with regard to the superior efficacy of N-PDT. The type of nanoparticle, incubation time, light source, and exposure time were found to be covariates that influence the antimicrobial efficacy of N-PDT.
本系统评价的目的是评估纳米颗粒介导的光动力疗法（N-PDT）与光动力疗法（PDT）和传统消毒方案相比，在存在牙本质基质的情况下对生物膜的抗菌活性。
本系统评价已在开放科学框架（10.17605/OSF.IO/GBR3F）中注册。检索了六个数据库，即PubMed、Embase、Web of Science、Scopus、Medline和谷歌学术，以查找截至2022年6月的英文文章。纳入评估N-PDT对人牙或牛牙生物膜抗菌活性的实验室研究。使用乔安娜·布里格斯研究所的准实验研究工具评估偏倚风险（RoB）。采用随机效应最大似然模型进行荟萃分析。
检索共发现2804篇文章，其中9项研究纳入最终评价。7篇文章的RoB较低，2篇文章的RoB中等。壳聚糖和810nm二极管激光分别是最常用的纳米颗粒和光源。细菌减少对数和减少百分比的荟萃分析表明，N-PDT的抗菌效果优于对照组。将N-PDT的细菌减少对数与PDT进行比较时，PDT的表现优于N-PDT，而在减少百分比方面，两者没有差异。
关于N-PDT的卓越疗效，目前可得的证据较少且尚无定论。发现纳米颗粒类型、孵育时间、光源和照射时间是影响N-PDT抗菌效果的协变量。
