Is adjunctive photodynamic therapy more effective than scaling and root planing alone in the treatment of periodontal disease in hyperglycemic patients? A systematic review.

BACKGROUND: To assess the impact of scaling and root planing (SRP) with and without adjunct photodynamic therapy (PDT) in the treatment of periodontal disease (PD) in hyperglycemic patients.

METHODS: Databases (MEDLINE, EMBASE; and CENTRAL) were searched up to December 2017. The addressed PICO question was: "What is the effectiveness of adjunctive PDT to non-surgical periodontal treatment by means of clinical periodontal and glycemic parameters in hyperglycemic patients?"

RESULTS: Four clinical trials and 1 experimental study were included. Energy fluence, power output, power density and duration of irradiation were 2.79 J per square centimeters (J cm-2 ), 150 milliwatts (mW), 428 milliwatts per square centimeters (mW/cm2 ) and 133 s (s) respectively. All studies reporting clinical periodontal and metabolic parameters, showed that aPDT was effective in the treatment of periodontal inflammation in hyperglycemic patients at follow-up. When compared with SRP alone, none of the studies showed additional benefits of PDT as compared to SRP alone at follow up. Three studies showed no influence of SRP with or without aPDT on HbA1c levels. One study showed a significant reduction of HbA1c levels in adjunctive aPDT as compared to SRP alone at follow-up.

CONCLUSION: It remains debatable whether adjunctive PDT as compared to SRP is effective in the treatment of periodontal inflammation and reduction of HbA1c levels in hyperglycemic patients.