title: Clinical efficacy of photodynamic therapy adjunctive to scaling and root planing in the treatment of chronic periodontitis: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on up-to-date evidence.
  
  
  METHODS
  MEDLINE and the Cochrane Library were systematically searched to identify eligible randomized controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I2test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed.
  
  
  RESULTS
  Eleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD=0.13, CI:0.02-0.24, p=0.02) and marginal significant improvement in CAL gain (MD=0.18, CI:-0.005-0.363, p=0.056) were observed in favor of SRP+PDT at 3months. When evaluated at 6months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD=0.40, CI:0.05-0.74, p=0.03), but not in CAL gain (MD=0.37, CI:-0.18-0.93, p=0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3months nor 6months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies.
  
  
  CONCLUSIONS
  Pooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration.
authors.affiliation: Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Xue
authors.affiliation: Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
authors.forename: Yuhao
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Ding
authors.affiliation: Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China. Electronic address: xw_dent@163.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000706:statistics & numerical data*; D012534:Dental Scaling / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D015995:Prevalence; D012307:Risk Factors; D016745:Root Planing / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents
keywords: Chronic periodontitis; Meta-analysis; Periodontal therapy; Photodynamic therapy; Scaling and root planing