Wiench Rafał, Fiegler-Rudol Jakub, Zięba Natalia, Misiołek Maciej
Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland.
Pharmaceutics. 2025 Aug 12;17(8):1046. doi: 10.3390/pharmaceutics17081046.
: This systematic review evaluated the efficacy of laser therapies and antimicrobial photodynamic therapy (aPDT) for the treatment of intraoral halitosis by synthesizing randomized controlled trials. : A comprehensive search of the PubMed, Embase, Scopus, and Cochrane Library databases identified 14 eligible RCTs. : Laser-based interventions, including diode lasers and Er,Cr:YSGG lasers, and aPDT using photosensitizers such as methylene blue, toluidine blue, and (annatto), effectively reduced volatile sulfur compound levels and associated bacterial populations compared to traditional methods like tongue scraping and antiseptic rinses. Combination treatments consistently demonstrated superior short-term efficacy, although treatment outcomes often declined after 7-14 days, indicating the necessity for repeated sessions or adjunctive oral hygiene measures. : Methodological heterogeneity across studies regarding laser parameters, photosensitizer types, and outcome measurements highlighted the need for standardized protocols. Future research should focus on multicenter trials with extended follow-up and standardized microbiological evaluations to further validate these promising treatments and integrate them effectively into clinical practice.
本系统评价通过综合随机对照试验评估了激光疗法和抗菌光动力疗法(aPDT)治疗口腔内口臭的疗效。对PubMed、Embase、Scopus和Cochrane图书馆数据库进行全面检索,确定了14项符合条件的随机对照试验。与舌刮术和抗菌漱口水等传统方法相比,基于激光的干预措施,包括二极管激光和铒铬:钇钪镓石榴石激光,以及使用亚甲蓝、甲苯胺蓝和(胭脂树)等光敏剂的aPDT,能有效降低挥发性硫化合物水平和相关细菌数量。联合治疗在短期内始终显示出更好的疗效,尽管治疗效果在7-14天后往往会下降,这表明需要重复治疗或采取辅助口腔卫生措施。各研究在激光参数、光敏剂类型和结果测量方面存在方法学异质性,凸显了标准化方案的必要性。未来的研究应侧重于多中心试验,延长随访时间并进行标准化的微生物学评估,以进一步验证这些有前景的治疗方法,并将其有效纳入临床实践。