The Antimicrobial Effect Of Laser Or Photodynamic Therapy Adjunctive To Scailing And Root Planning:a Systematic Review

ObjectivesTo compare the antimicrobial effects of using laser or photodynamic thera-py(aPDT)adjunctive to scailing and root planning(SRP)with using SRP alone,in clinical treatment of periodontitis.MethodsWith free-word retrieval and Boolean operation,a systematic electronic search of Web of science,Pubmed,Cocrane Central Register of Controlled Trials,Embase,CNKI,Sinomed and Wanfang databases was conducted for studies about the antimicrobial effect of laser or aPDT adjunctive to SRP up to 16th December 2020.The retrieval results was screened firstly through abstract analysis and secondly through full-text analysis.The eligibility assessment was performed independently by 2 reviewers following the predetermined inclusion criteria,and any disagreement was resolved by discussion.By operating the RevMan 5.4,quality assessments were performed accourding to Cochrane risk-of-bias tool for randomized trials,and meta-analyses were performed using random effet methods and outcomes of standard mean difference(SMD),along with their 95%confidence interval(CI).ResultsOut of 741 records,5 articles for adjunctive using laser and 4 for aPDT were included.Outcomes about laser adjunctive to SRP showed no difference of abundance reduction of Porphyromonas gingivalis(Pg),Tannerella forsythia(Tf)and Treponema denticola(Td),compared with the outcomes of SRP alone.A meta-analysis including two articles,on the abundance of Pg at 3 months after treatment,indicated no favour of adjunctive using laser after SRP(SMD=-0.39;95%CI:-1.43/0.66;P=0.47).Researches about aPDT.adjunctive to SRP identified a statistically significant difference(SMD=-1.60;95%CI:-2.52/-0.67;P=0.0007)in favour of adjunctive using aPDT,accourding to the meta-analysis on the abundance of Pg at 3 months after treatment.Still,the outcomes about reduction of Tf and Td showed contradictions between articles,and requied more researches to have a harmonious result about the antimicrobial effect of adjunctive using aPDT after SRP.ConclusionsAvailable evidence,about the antimicrobial effect of adjunctive using laser or aPDT,is limited by the low number of random controlled studies and the heterogeneity of study designs.To identify the advantages,comparable microbiological methods and outcome indexes are necessary in further investigations.