Sousa Filipa Passos, Assunção Mariana Anselmo, Bessa Lucinda J, Alves Ricardo Castro
Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal.
Pharmaceutics. 2025 Aug 19;17(8):1070. doi: 10.3390/pharmaceutics17081070.
Periodontitis is one of the most common inflammatory diseases and it is linked to the presence of a dysbiotic subgingival microbiome. The purpose of this review is to evaluate the impact of antimicrobial photodynamic therapy (aPDT) on the subgingival microbiome. Herein, based on an extensive evaluation of randomized controlled trials (RCTs), the effects of aPDT as a supplement to non-surgical periodontal therapy (NSPT) were found to be the main focus of these works. Studies that focused on analyzing microbiological results were selected, yielding contradictory results. The observed microbiological changes were variable, even though some studies showed notable improvements in clinical indicators such as bleeding on probing (BOP), clinical attachment level (CAL), and probing depth (PD). Several studies found that aPDT did not significantly reduce important periodontal pathogens such , , and . Nevertheless, after multiple aPDT sessions, other studies reported positive changes in the subgingival microbiome, with a rise in beneficial bacteria and a decrease in periodontopathogens. While aPDT seems to be a safe and well-tolerated adjuvant to non-surgical periodontal therapy, there is still conflicting evidence regarding how well it modulates the subgingival microbiota. Additional long-term research with larger sample sizes is required to evaluate the microbiological and clinical advantages of aPDT.
牙周炎是最常见的炎症性疾病之一，它与龈下微生物群落失调有关。本综述的目的是评估抗菌光动力疗法（aPDT）对龈下微生物群落的影响。在此，基于对随机对照试验（RCT）的广泛评估，发现aPDT作为非手术牙周治疗（NSPT）补充手段的效果是这些研究的主要焦点。选取了专注于分析微生物学结果的研究，结果相互矛盾。尽管一些研究显示在探诊出血（BOP）、临床附着水平（CAL）和探诊深度（PD）等临床指标上有显著改善，但观察到的微生物学变化是多样的。几项研究发现，aPDT并没有显著减少重要的牙周病原体，如 、 和 。然而，在多次进行aPDT治疗后，其他研究报告了龈下微生物群落的积极变化，有益细菌增加，牙周病原体减少。虽然aPDT似乎是一种安全且耐受性良好的非手术牙周治疗辅助手段，但关于它对龈下微生物群的调节效果仍存在相互矛盾的证据。需要进行更多样本量更大的长期研究，以评估aPDT的微生物学和临床优势。
