The mean age of patients in the studies included in this review ranged from 39.6 years to 62.8 years. Hence, the objective of the systematic review was to determine the effectiveness of aPDT as a primary mode or as an adjunct to non-surgical periodontal therapy. However, randomized controlled trials and systematic reviews have shown contrasting results regarding the efficacy of aPDT in chronic periodontitis. In the presence of various types of photosensitizers, such as toluidine blue O and methylene blue, several periodontal pathogens are found to be susceptible to red lasers, which points to the fact that aPDT could be could be advantageous in periodontal therapy. Because several studies had shown that killing both Gram-positive and Gram-negative bacteria is possible, Wilson’s group in London investigated different aspects of the application of aPDT in dentistry in vitro and in vivo. Įven though the effects of photodynamic action have been known for a long time, interest in its practical use has increased only in the last few years. The transfer of energy causes the formation of free radicals of singlet oxygen, which exert destructive action on bacteria and their products. This treatment modality is based on the principle that a photoactivatable substance, called a photosensitizer, is activated by the light of a particular wavelength. aPDT was introduced in 1904 as the light-induced inactivation of cells, microorganisms or molecules. ![]() Limitations of drug resistance associated with the use of local and systemic medications have led to the popularity of antimicrobial photodynamic therapy (aPDT) in the management of chronic periodontitis. To improve the results of mechanical debridement, antibiotics are widely used. Residual pockets during SRP present similar challenges and additional therapeutic approaches to achieving periodontal health are required. Although many studies have shown significant improvements following SRP, complete elimination of subgingival periodontal pathogens and irritants is not always possible. Scaling and root planing (SRP) are considered as the gold standard for the treatment of chronic periodontitis. The ultimate goal of periodontal therapy is to eliminate supragingival and subgingival plaque and arrest the progression of periodontal disease. ![]() Long-term, multicenter studies with larger sample sizes are needed before aPDT can be recommended as an effective treatment modality. Although there was a wide range of heterogeneity in the included studied, they all indicated that aPDT has the potential to be an effective adjunct in the treatment of chronic periodontitis. Basic study characteristics, photosensitizing agents and wavelengths used in aPDT, frequency of aPDT application, effect of aPDT on clinical parameters, antimicrobial effect of aPDT in chronic periodontitis, effect of immunological parameters following aPDT and patient-based outcome measures were collected from the studies. Twenty studies included in this systematic review were randomized clinical trials (RCTs) or quasi-RCTs of aPDT compared to placebo, no intervention, or non-surgical treatment in an adult population. The focused question was developed using the Patient, Intervention, Comparison, and Outcome (PICO) format, and two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies from January 2008 to December 2016. The aim of this systematic review was to investigate whether antimicrobial photodynamic therapy (aPDT) as either a primary mode of treatment or an adjunct to non-surgical treatment was more effective than scaling and root planing (SRP) alone in treating chronic periodontitis in terms of clinical attachment level (CAL) gain and probing depth (PD) reduction.
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