Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (11): 752-760.doi: 10.12016/j.issn.2096-1456.2021.11.005

• Clinical Study • Previous Articles     Next Articles

Effect of the antimicrobial photodynamic therapy in the treatment of periodontitis in type 2 diabetes mellitus: a systematic review and meta-analysis

XU Tengfei1(),CHEN Bin1,AO Huizhi1,SUN Weibin1,WU WenLei2()   

  1. 1. Department of Periodontal, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
    2. Department of Senior Expert Diagnosis and Treatment, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2021-03-09 Revised:2021-04-25 Online:2021-11-20 Published:2021-07-20
  • Contact: WenLei WU E-mail:87719270@qq.com;wlwu@nju.edu.cn
  • Supported by:
    National Natural Science Foundation of China(51972167)

Abstract:

Objective This systematic review and meta-analysis was undertaken to evaluate the efficacy of antibacterial photodynamic therapy (aPDT) in the treatment of periodontitis in type-2 diabetes mellitus (T2DM) patients and to provide better treatment for patients with T2DM complicated with periodontitis.Methods The PubMed, Cochrane, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched for relevant randomized controlled trials (RCTs). RevMan 5.3 was applied for the meta-analysis, and a systematic evaluation was conducted. Results A total of 8 RCTs were included. The results showed that compared to simple subgingival scaling and root planing (SRP), aPDT assisted SRP had a better effect on improving the probing depth (PD) at 3 months after treatment, The difference was statistically significant [WMD=-0.32,95%CI(-0.45, -0.2), P < 0.05], but 6 months after treatment, there was no significant difference in the two groups [ WMD=-0.15,95%CI(-0.40, 0.10),P=0.23]. During the 6-month follow-up period, there were no significant differences in the clinical attachment level (CAL), bleeding on probing (BOP) or hemoglobin A1c (HbA1c) between the two groups (P> 0.05).Conclusion aPDT-assisted periodontal nonsurgical treatment in T2DM patients can improve PD in the short term but has no significant effect on the improvement of CAL, BOP and HbA1c.

Key words: antibacterial photodynamic therapy, 2 diabetes mellitus, periodontitis, subgingival scaling, root planning, periodontal therapy, meta-analysis, randomized controlled trail, blood sugar control

CLC Number: 

  • R78

Figure 1

Flow chart of literature screening"

Table 1

Characteristics of the included studies"

Study Year Design Sample
size(T/C)
Age(years) Intervention
(T/C)
Photosensitizer Types and parameters
of laser
Follow-up(months) Clinical parameters
Elsadek, et al[8]

2020

RCT

20/20

48.6 ± 6.5

T: SRP+aPDT
C: SRP
Methylene blue with
a concentration of
0.005%
670 nm diode laser,
150 mW power,60 s/
site
3

PD, BOP, CAL,
GR
Mirza, et al[9]

2019

RCT

15/15

T: 51.45
C: 52.93
T: SRP+aPDT
C: SRP
Methylene blue with
a concentration of
0.005%
670 nm diode laser,
150 mW power,60 s
6

PD, CAL, BOP,
P I, HbA1c,
AGEs, GCF
Ivanaga, et al[10]

2019

RCT

25/25

55 ± 10.2

T:SRP+aPDT
C:SRP
Curcumin with a
concentration of
100 mg/L
465-485 nm LED,
60 s
6

PD, CAL, BOP,
GR, PI
Barbosa, et al[11]

2018

RCT

6/6

35-65

T: SRP+aPDT
C: SRP
Methylene blue with
a concentration of
10 mg/mL
Diode laser, 40 mW
power, 120 s /tooth
6

PD, CAL, BOP,
PI, HbA1c
Castro Dos
Santo, et al[12]

2016

RCT

20/20

51.60 ± 10.05

T: SRP+aPDT
C: SRP
Methylene blue with
a concentration of
0.005%
660 nm diode laser,
60 s/tooth

6

PD, CAL, GR,
PI

Ramos, et al[15]

2016

RCT

15/15

T:48.9 ± 9.5
C:49.3 ± 7.4
T: SRP+aPDT
C: SRP
Phenothiazine chloride with a concentration of 10 mg/mL Red laser, 70 mW
power, 60 s/tooth
3

PD, CAL, BOP,
GR, HbA1c,
IL1-β
Hou, et al[14]

2016

RCT

24/24

55.62 ± 11.9

T: SRP+aPDT
C: SRP
Methylene blue with
a concentration of
0.1 g/L
660 nm laser, type
unknown, 60 s
3

PD, CAL, BI,
PLI, HbA1c
Al-Zahrani,
et al[13]

2009

RCT

15/15

52.21 ± 8.35

T: SRP+aPDT
C: SRP
Methylene blue with
a concentration of
0.001%
670 nm diode laser,
60 s/tooth
3

PD, CAL, BI,
HbA1c

Figure 2

Risk of bias graph T: test group; C: control group; RCT: randomized controlled trial; SRP: subgingival scaling and root planing; aPDT: antimicrobial photodynamic therapy; LED: light emitting diode; PD: probing depth; CAL: clinical attachment level; HbA1c: glycosylated hemoglobin; BOP: bleeding on probing; GR: gingival recession; PI: periodontal index; PLI: plaque index; BI: bleeding index; GCF: gingival crevicular fluid; AGEs: advanced glycation end products; IL1-β: interleukin1-β"

Figure 3

Meta-analysis changes in probing depth values of patients with diabetes after 3 months of treatment assisted by antibacterial photodynamic therapy"

Figure 4

Meta-analysis changes in probing depth values of patients with diabetes after 6 months of treatment assisted by antibacterial photodynamic therapy"

Figure 5

Meta-analysis changes in the clinical attachment level values of patients with diabetes after 3 months of treatment assisted by antibacterial photodynamic therapy"

Figure 6

Meta-analysis changes in the clinical attachment level values of patients with diabetes after 6 months of treatment assisted by antibacterial photodynamic therapy"

"

Figure 8

Meta-analysis changes in the bleeding on probing values of patients with diabetes after 6 months of treatment assisted by antibacterial photodynamic therapy"

Figure 9

Meta-analysis changes in the glycosylated hemoglobin values of patients with diabetes after treatment assisted by antibacterial photodynamic therapy"

Figure 10

Publish offset funnel plots"

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