Eficácia da aPDT como adjuvante ao tratamento da periodontite comparada à instrumentação subgengival isolada sobre a quantidade de sítios ≥ 5 mm: uma revisão sistemática

Abstract

Subgingival instrumentation (SI) is considered the gold standard in the treatment of periodontitis, but due to its limitations, it has been proposed the implementation of adjuvant therapies among them Antimicrobial Photodynamic Therapy (aPDT), which has a photochemical mechanism of action initiated by the presence of light, use of a photosensitizing agent and the presence of oxygen. The adjuvant use of aPDT to IS has shown positive effects on clinical and microbiological periodontal parameters. The randomized clinical trials that have evaluated its effect as an adjuvant, mostly present as an outcome the changes in periodontal clinical parameters as a mean, which may not demonstrate its real clinical benefit considering the inclusion of sites with shallow periodontal pockets. Thus, the aim of this study was to conduct a systematic review to compare the effect of aPDT adjuvant to IS versus IS alone with the primary endpoint being the amount of residual sites (absolute number or percentage) ≥ 5 mm in patients with untreated periodontitis. MEDLINE (PubMed), EMBASE, SCOPUS (Elsevier), and Web of Science databases were used for the search, and the search was performed in the corresponding period between July and August 2022. The electronic manual search resulted in 1.347 articles, and of the 61 potentially eligible articles, only 2 of these were included for the qualitative analysis. The present study showed that aPDT was effective in reducing the amount of residual sites with PS ≥ 5 mm in initially moderate and deep pockets. It is suggested that further well designed and methodologically homogeneous studies be conducted that have the amount of residual sites with PS ≥ 5 mm as the endpoint as well as other patient centered outcomes.