Clinical and radiographic outcomes of adjunctive photodynamic therapy for treating peri-implantitis among diabetics and cigarette smokers: a systematic review of randomized controlled trials

Lasers Med Sci. 2023 Jun 19;38(1):142. doi: 10.1007/s10103-023-03807-0.

Abstract

Photodynamic therapy (PDT) has been suggested as an adjunctive therapeutic approach for peri-implantitis. This systematic review aimed to assess the clinical and radiographic outcomes of adjunctive PDT (aPDT) for the treatment of peri-implantitis among diabetics and cigarette smokers. Randomized controlled trials (RCTs), which assessed the clinical and radiographic outcomes of aPDT versus other intervention(s) and/or MD alone among diabetics and smokers with peri-implantitis, were considered eligible for the review. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the modified Jadad quality scale. The meta-analysis revealed no significant differences between the influence of aPDT and other intervention/MD alone on the peri-implant PI among diabetics at the final follow-up. However, statistically significant improvements in the peri-implant PD, BOP, and CBL were observed after the application of aPDT among diabetics. Similarly, no significant differences were found between the influence of aPDT and other interventions/MD alone on the peri-implant PD among smokers with peri-implant diseases at the final follow-up. However, statistically significant improvements in the peri-implant PI, BOP, and CBL were observed after the application of aPDT among smokers. Significant improvements in the peri-implant PD, BOP, and CBL among diabetics and the peri-implant PI, BOP, and CBL among smokers after the application of aPDT at the final follow-up. However, large-scale, well-designed, and long-term RCTs are recommended in this domain.

Keywords: Cigarette smoking; Diabetes Mellitus; Peri-implant mucositis; Peri-implantitis; Photochemotherapy.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Diabetes Mellitus*
  • Humans
  • Peri-Implantitis* / drug therapy
  • Photochemotherapy*
  • Randomized Controlled Trials as Topic
  • Smokers
  • Tobacco Products*