title: Adjunctive photodynamic therapy to non-surgical treatment of chronic periodontitis: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the efficacy of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling root planing (SRP) in patients with chronic periodontitis.
  
  
  METHODS
  A meta-analysis was conducted according to the PRISMA statement and Cochrane Collaboration recommendations. Two independent reviewers performed an extensive literature search and manual search on seven databases. Mean differences (MD) and 95% confidence intervals (CI) were calculated for clinical attachment level (CAL) gain and probing depth (PD) reduction. The I(2) test was used for inter-study heterogeneity. Publication bias was examined by Egger's regression test and the trim-and-fill method.
  
  
  RESULTS
  Sensitivity analysis of 14 randomized clinical trials (RCTs) revealed differences in PD reduction (MD 0.19, 95% CI 0.07-0.31, p = 0.002) and CAL gain (MD 0.37, 95% CI 0.26-0.47, p < 0.0001) in favour of SRP + aPDT, with no evidence of heterogeneity. Subgroup analysis revealed the absence of heterogeneity in RCTs, with high risk of bias for PD reduction and CAL gain. No evidence of publication bias was detected.
  
  
  CONCLUSIONS
  The use of adjunctive aPDT to conventional SRP provides short-term benefits. The evidence to support its clinical medium/long-term efficacy is insufficient. Further high-quality RCTs are needed to investigate the influence of potential confounders on the efficacy of adjunctive aPDT.
authors.affiliation: Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy. fabrizio.sgolastra@gmail.com
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sgolastra
authors.forename: Ambra
authors.initials: A
authors.lastname: Petrucci
authors.forename: Marco
authors.initials: M
authors.lastname: Severino
authors.forename: Filippo
authors.initials: F
authors.lastname: Graziani
authors.forename: Roberto
authors.initials: R
authors.lastname: Gatto
authors.forename: Annalisa
authors.initials: A
authors.lastname: Monaco
mesh_terms: D055113:Chronic Periodontitis / Q000188:drug therapy* / Q000628:therapy; D003131:Combined Modality Therapy; D012534:Dental Scaling / Q000379:methods*; D006801:Humans; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010778:Photochemotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016745:Root Planing / Q000379:methods*