Effect of photodynamic therapy and laser alone as adjunct to scaling and root planing on gingival crevicular fluid inflammatory proteins in periodontal disease: A systematic review.
BACKGROUND
To assess the efficacy of antimicrobial photodynamic therapy (aPDT) or laser therapy (LT) alone as an adjunct to scaling and root planing (SRP) on the gingival crevicular fluid (GCF) inflammatory proteins in periodontal disease.


METHODS
Databases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched from 1980 up to and including July 2016. The addressed PICO question was: "What effect does aPDT and/or LT as an adjunct to SRP have on the GCF inflammatory proteins in periodontal disease patients?"


RESULTS
Eight studies used aPDT while 10 studies used laser alone. Eight cytokines including tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10, interferon gamma (IFN-γ), matrix metalloproteinase (MMP)-8 and granulocyte colony-stimulating factor (GM-CSF) were eligible for qualitative analysis for aPDT and LT studies. Four aPDT studies showed significant reduction in IL-1β while one study showed significant reduction in TNF-α levels after aPDT application at follow-up. One study showed significant reduction of IFN-γ, IL-8 and GM-CSF levels after aPDT at follow-up. IL-1β significantly reduced in 4 LT studies, while one study showed significant decrease for IL-6 and TIMP-1 levels. MMP-8 and TNF-α showed significant reduction in three and one study respectively.


CONCLUSIONS
It remains debatable whether adjunctive aPDT or LT is effective in the reduction of GCF inflammatory proteins in periodontal disease due to non-standard laser parameters and short follow up period. These findings should be considered preliminary and further studies with long-term follow up and standardized laser parameters are recommended.
Department of Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi 75600, Pakistan.
Zohaib
Z
Akram
Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Tariq
T
Abduljabbar
Dental Biomaterials, Preventive and Minimally Invasive Dentistry, Departamento de Odontologìa, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Alfara del Patriarca, 46115 Valencia, Spain.
Salvatore
S
Sauro
Faculty of Dentistry, Department of Dental Materials, International Medical University, Kuala Lumpur, Malaysia; Faculty of Dentistry, Department of Paediatric Dentistry and Orthodontics, 34 Hospital Road, Pokfulam, Prince Philip Dental Hospital, University of Hong Kong, Hong Kong SAR, China.
Umer
U
Daood
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods; D016207:Cytokines / Q000276:immunology*; D012534:Dental Scaling / Q000379:methods; D005883:Gingival Crevicular Fluid / Q000276:immunology*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D010518:Periodontitis / Q000276:immunology* / Q000628:therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D016745:Root Planing / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D016207:Cytokines; D017319:Photosensitizing Agents
Crevicular fluid; Cytokine; Laser; Periodontal disease; Photodynamic therapy