Abstract
Periodontal disease can be treated in several ways. This paper reviewed whether antimicrobial photodynamic therapy (aPDT) in addition to scaling and root planing (SRP) produces improved clinical results over systemic antibiotics (ABs) in conjunction with SRP in adults with periodontitis. Studies were searched using the following electronic databases: MEDLINE, the Cochrane Database of Systematic Reviews, and the Web of Science Core Collection up to and including November 2018. Four randomized controlled trials (RCTs) were reviewed to maximise the reliability of the evidence. All participants suffered from either chronic or aggressive periodontitis and each study contained SRP as an adjunct to ABs or aPDT. To determine whether groups showed improvement after treatment, the outcome parameters chosen were probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Despite finding significant improvements in all groups, the differences among groups were not consistently statistically significant. The lack of homogeneity in the results among these studies indicates that it was not possible to determine a conclusion about whether aPDT or AB as an adjunct to SRP provides better improvements in periodontitis as measured by PD, CAL, and BOP. Further studies with more similar study designs are required before firm conclusions can be deduced.
Highlights
Periodontal disease is the inflammatory process that occurs in response to chronic infection or a build-up of dental plaque around the tooth tissue
Significant results were found in probing depth (PD), clinical attachment level, and bleeding on probing (BOP) among all intervention groups compared to the baseline
At 6 months, all intervention groups exhibited reduced PD compared to the C group
Summary
Periodontal disease is the inflammatory process that occurs in response to chronic infection or a build-up of dental plaque around the tooth tissue. Anaerobic bacteria including primarily Porphyromonas gingivalis, Tannerella forsythus, and Treponema denticola cause periodontal tissue destruction, alveolar bone loss, and eventually the loss of the tooth [1]. The most widespread treatment for periodontitis involves the physical removal of plaque through debridement and/or using antimicrobial agents [2]. It is difficult to determine the effectiveness of the debridement, especially where there has been extensive tissue loss and the periodontal pockets are deep and where root furcations are difficult to access [4]. Small amounts of bacteria are likely to be left residing in the pocket with the significant effect of continual breakdown of tissue [5]
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