Efficacy of adjunctive photodynamic therapy for chronic periodontitis undergoing scaling and root Planing: A Meta-analysis of randomized controlled trials

Studies evaluating the efficacy of adjunctive photodynamic therapy (PDT) for chronic periodontitis have reported conflicting results. The Web of Science, Cochrane Library, Pubmed, Embase, China National Knowledge Internet, Wanfang Data, VIP, and Chinese Biomedical Literature Database were searched for randomized controlled trials that compared scaling and root planing (SRP) with and without PDT for chronic periodontitis. Studies published before November 4, 2020 were included in the pooled analyses performed using the Review Manager 5.3 and Stata 12.0 software. A total of 18 RCTs involving 750 patients with periodontitis were identified. The pooled analysis showed that SRP with PDT had significantly different probing depth (PD) at third month [standardized mean difference (SMD), 0.22 mm; 95% CI, 0.07-0.37; P = 0.004]. However, there was no significant difference in the PD at sixth month (SMD, 0.12; 95% CI, 0-.10-0.33; P = 0.280). In addition, we found a significant difference in the clinical attachment level at third month (SMD, 0.24; 95% CI, 0.08-0.39; P = 0.003), whereas no significant difference was found in the clinical attachment level at sixth month (SMD, 0.18; 95% CI, -0.03-0.40; P = 0.090). In terms of the bleeding on probing, SRP with PDT revealed to be significantly better compared to SRP along at third month of follow-up (SMD, 0.77; 95% CI, 0.42-1.13; P < 0.001), but not at sixth month (SMD, 5.11; 95% CI, -2.50-12.72; P = 0.190). Adjunctive PDT improved the clinical efficacy in terms of the PD, clinical attachment level, and bleeding on probing at third month of follow-up, but not at sixth month.