A Meta-analysis Of Clinical Effectiveness Of Photodynamic Therapy In The Adjuvant Treatment Of Chronic Periodontitis

Objective:Subgingival Scaling and root planing(SRP)are currently the main methods for the treatment of chronic periodontitis(CP).In recent years,photodynamic therapy(PDT)has been widely used in the oral diseases due to its highly effective antibacterial properties.In this study,the clinical efficacy of PDT combined with SRP and SRP alone in the treatment of chronic periodontitis was systematically evaluated through evidence-based medicine,so as to provide scientific basis and theoretical guidance for the clinical application of PDT in chronic periodontitis.Methods:Databases in both English and Chinese were serached for PDT adjunct to traditional SRP compared with traditional SRP alone,for the treatment of CP designed as clinical randomized controlled trials(RCTs),the databases including: The Web of Science,The Cochrane Library,Pubmed,Embase,CNKI(China National Knowledge Internet),Wanfang Data,VIP and CBM(Chinese Bio Medical Literature Database),published until November 4,2020.Two reviewers independently conducted literature screening according to the inclusion and exclusion criteria,extracted the data and assessed the literature quality.Then after cross-checking,meta analyses was performed by using Review Manager 5.3 software and Stata 12.0software.Results:A total of 18 RCTs involving 750 patients who with periodontitis were in cluded.The results of meta-analysis showed that compared with SRP groups S RP+PDT groups showed a statistically significant difference in the probing dept h(PD)at 3-month follow-up[SMD=0.22,95%CI(0.07,0.37),P=0.004],there was no statistically significant difference in the probing depth at 6-month follow-up[SMD=0.12,95%CI(-0.10,0.33),P=0.28],there was a statistically significant dif ference in the clinical attachment level(CAL)at 3-month follow-up[SMD=0.24,95%CI(0.08,0.39),P=0.003],and there was no statistically significant difference in the clinical attachment level at 6-month follow-up[SMD=0.18,95%CI(-0.03,0.40),P=0.09].The difference in the improvement of bleeding on probing during t he 3-month follow-up was statistically significant[SMD=0.77,95%CI(0.42,1.13),P<0.0001],and there was no statistically significant difference in the improve ment of bleeding on probing at 6-month follow-up[SMD=5.11,95%CI(-2.50,12.72),P=0.19].Conclusion:Compared with SRP alone,PDT adjunct to SRP in the treatment of chronic periodontitis can improve the clinical effectiveness to some extent,which is mainly manifested in the reduction of probing depth,the increase of clinical attachment level and the improvement of bleeding on probing during the 3-month follow-up.