Soft and hard tissue changes after photodynamic therapy in aggressive periodontitis: A systematic review and meta-analysis

In the nonsurgical therapy of periodontal disease, scaling and root planing (SRP) is the gold standard. Bacterial recolonization occurs from the residual subgingival plaque or from other oral contaminants. To avoid bacterial recolonization, regular periodontal care is essential, as well as the inclusion of coadjutants and active debridement, including such antibiotic therapy and photodynamic therapy. Therefore, the aim of this systematic review and meta-analysis is to evaluate periodontal tissue changes after photodynamic therapy in aggressive periodontitis. An electronic search was conducted on PubMed/ MEDLINE, GOOGLE SCHOLAR, and HAND SEARCH of a reference list of archived articles published from January 2015 to August 2018. After thorough scrutiny, five studies assessing clinical attachment level (CAL) and probing pocket depth (PPD) were considered for the meta-analysis. Using fixed and random effect models, the standardized mean differences (SMDs) were calculated. Results of the fixed and random-effect models had slightly distinct estimates of SMD of CAL, both models resulted in positive and significant treatment effects. The fixed effect was slightly different and positive for PPD (SMD = 0.843, 95 percent CI = 0.510 to 1.176, P = 0.001, significant), while random effects were somewhat different and positive for PPD (SMD = 1.227, 95 percent CI = -0.129 to 2.582, P = 0.076, not significant). Because of heterogeneity, one model indicated substantial treatment effects for PPD, whereas another model showed non-significant treatment effects. Hence, the results concluded the beneficial effects of photodynamic therapy in aggressive periodontitis.