Is Antimicrobial Photodynamic Therapy Effective for Microbial Load Reduction in Peri‐implantitis Treatment? A Systematic Review and Meta‐Analysis

• Published in: Photochemistry and photobiology 2018-07, Vol.94 (4), p.752-759
• Main Authors: Fraga, Renato Silva, Antunes, Lívia Azeredo Alves, Fontes, Karla Bianca Fernandes da Costa, Küchler, Erika Calvano, Iorio, Natalia Lopes Pontes Póvoa, Antunes, Leonardo Santos
• Format: Article
• Language: English
• Subjects: Antiinfectives and antibacterials; Bibliographic data bases; Confidence intervals; Dental implants; Dental prosthetics; Dental restorative materials; Evidence-based medicine; Finite element method; Meta-analysis; Microorganisms; Photochemotherapy; Photodynamic therapy; Reduction; Surgical implants; Systematic review
• ISSN: 0031-8655; 1751-1097
• DOI: 10.1111/php.12901

The systematic review and meta‐analysis were undertaken to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) in the microbiological alteration beneficial to peri‐implantitis treatment. This study is registered with PROSPERO, number CRD42017064215. Bibliographic databases including Cochrane Library, Web of Science, Scopus and PubMed were searched from inception to 8 January 2017. The search strategy was assembled from the following MeSH Terms: “Photochemotherapy,” “Dental Implants” and “Peri‐Implantitis.” Unspecific free‐text words and related terms were also included. The Cochrane Collaboration's tool was used to evaluate the risk of bias of included studies. The random‐effect model was chosen, and heterogeneity was evaluated using the I2 test. Three studies met the inclusion criteria. Meta‐analysis demonstrated an association between aPDT and reduction in viable bacteria counts for: Aggregatibacter actinomycetemcomitans (OR = 1.31; confidence interval = 1.13, 1.49; P < 0.00001), Porphyromonas gingivalis (OR = 4.08; confidence interval = 3.22, 4.94; P < 0.00001) and Prevotella intermedia (OR = 1.66; confidence interval = 1.06, 2.26; P < 0.00001). A aPDT appears to be effective in bacterial load reduction in peri‐implantitis and has a positive potential as an alternative therapy for peri‐implantitis. Peri‐implantitis has been defined as an inflammatory process that affects the soft tissues surrounding an osseointegrated implant. Microorganisms like Prevotella intermedia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, Prevotella nigrescens, Peptostreptococcus spp and Fusobacterium nucleatum are commonly related to peri‐implantitis. The antimicrobial photodynamic therapy may be an effective clinic adjunct therapy, resulting in bacterial load reduction in peri‐implantitis.