Efficacy of scaling and root planing with and without adjunct antimicrobial photodynamic therapy on the expression of cytokines in the gingival crevicular fluid of patients with periodontitis: A systematic review.
BACKGROUND
The aim of the present review was to study the efficacy of scaling and root planing (SRP) with and without adjunct antibacterial photodynamic therapy (aPDT) on the expression of cytokines in the gingival crevicular fluid (GCF) of patients with periodontitis.


METHODS
In order to address the focused question: "What is the efficacy of SRP with and without aPDT on the expression of cytokines in the GCF of patients with periodontitis" an electronic search without time or language restrictions was conducted up to and including July 2016 in indexed databases using various key words. The exclusion criteria included reviews, laboratory and experimental studies, case reports, commentaries, letters to the editor, interviews, updates, studies where intervention group received aPDT without previous SRP, and studies where local delivery of antibiotics was used as adjunctive therapy to aPDT.


RESULTS
Six randomized control trials were included in the present systematic review. All studies included a control group which received only SRP. Results from 34% of studies reported lower cytokine levels among individuals receiving adjunct aPDT to SPT compared to patients receiving SRP alone. Selective cytokines reduction in the GCF following SRP with adjunct aPDT compared with SRP alone was reported in 50% of the studies. In one study SRP with adjunct aPDT failed to reduce GCF cytokine concentration.


CONCLUSIONS
From the literature reviewed the efficacy aPDT as adjunct to SRP in downregulating GCF cytokines remains debatable. Further well-designed studies are needed in this regard.
Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA. Electronic address: sergio_kellesarian@urmc.rochester.edu.
Sergio Varela
SV
Kellesarian
Department of Dentistry, Universidad Santa Maria, Caracas, Venezuela.
Vanessa Ros
VR
Malignaggi
Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Tariq
T
Abduljabbar
Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Fahim
F
Vohra
Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
Hans
H
Malmstrom
Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe, University of Frankfurt, Frankfurt, Germany; Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
Georgios E
GE
Romanos
Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
Fawad
F
Javed
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000276:immunology* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D016207:Cytokines / Q000276:immunology*; D012534:Dental Scaling; D005883:Gingival Crevicular Fluid / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D010518:Periodontitis / Q000276:immunology* / Q000628:therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D016745:Root Planing; D016896:Treatment Outcome; D055815:Young Adult
D016207:Cytokines; D017319:Photosensitizing Agents
Cytokines; Periodontal debridement; Periodontal diseases; Periodontitis; Photochemotherapy