Clinical efficacy of photodynamic therapy as an adjunct to scaling and root planing in the treatment of chronic periodontitis among cigarette smokers: A systematic review and meta-analysis.

Abstract

The aim of the study was to evaluate the clinical efficacy of adjunctive photodynamic therapy (PDT) as compared to scaling and root planing (SRP) alone in the treatment of chronic periodontitis among cigarette smokers. Electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register and Cochrane Central Register of Controlled Trials were searched up to January 2019. Randomized clinical trials (RCTs) with data on comparison between adjunctive PDT compared to SRP in each group were included. Primary outcomes included clinical attachment level (CAL) gain, while secondary outcomes was probing depth (PD) reduction. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random and fixed effect models. A total of 5 RCTs were included. Two clinical trials were classified as having a low risk of bias and 3 clinical trials as high risk of bias. The overall effect for CAL gain (WMD= -0.088, 95% CI= -0.40 to 0.23, p = 0.58) and PD reduction (WMD= -0.35, 95% CI= -0.87 to -0.17, p = 0.18) was not statistically significant between PDT and SRP groups at follow-up, respectively. Within the limitations of this study, it remains debatable whether PDT as an adjunct to SRP is more effective in clinical attachment level gain as compared to SRP alone in cigarette smokers given that the available scientific evidence is weak.