Antimicrobial effect of indocyanine green-mediated photodynamic therapy in patients with periodontal disease: A systematic review

Aim: This systematic review assessed the antimicrobial effect of indocyanine green-mediated photodynamic therapy (ICG-PDT) in patients with periodontal disease. Materials and Methods: Four electronic databases that is, MEDLINE, MEDLINE-In-Process, EMBASE, and Cochrane Library were systematically searched from their inception until December 22, 2022. Randomized controlled trials (RCTs) reporting the antimicrobial effect of ICG-PDT in patients with periodontal disease and published in English were included. The Cochrane risk of bias tool was used to assess the quality of the included RCTs. Two independent reviewers performed all the steps involved in a systematic review (primary and secondary screening, data extraction, and quality assessment). As the data extracted was not suitable for meta-analysis, the evidence was synthesized qualitatively. Results: Overall, seven RCTs from seven publications were included. All included studies had PDT, laser, or photothermal with ICG as the test group while the control group included low-level laser therapy, root surface debridement, and scaling and root planning. The bacterial species assessed across the included studies included Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Fusobacterium nucleatum, and Treponema denticola. With subtle exceptions, ICG-PDT in combination with root surface debridement and scaling and root planning significantly reduced the growth of periodontal pathogens from baseline. Conclusion: Based on the evidence from the limited studies, ICG-PDT seems to exhibit potent antimicrobial activity against an array of periodontal pathogens in patients with periodontal disease.