Objective: This meta-analysis aims to evaluate the comparative clinical efficacy of photodynamic therapy (PDT) versus other non-surgical treatments in managing peri-implantitis.
Methods: Computer searches were conducted in databases including PubMed, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang for randomized controlled trials (RCTs) on the clinical efficacy of Photodynamic Therapy (PDT) compared to other non-surgical methods in the treatment of peri-implantitis. The search period spanned from May 2000 to May 2023. Based on inclusion and exclusion criteria, literature was screened, data extracted, and the quality of the studies was assessed. Included studies were publicly published randomized controlled experiments focusing on the combination of photodynamic therapy and non-surgical methods compared to non-surgical methods alone in the treatment of peri-implantitis. Articles with insufficient or unclear definitions of peri-implantitis cases were excluded from the selected studies. Statistical analysis was performed using RevMan 5.3 software.
Results: Nine RCTs were included for Meta-analysis. Meta-analysis showed that patients in the PDT trial group had reduced peri-implant probing depth (PD) during the follow-up period compared with the control group [WMD=-0.40, 95%CI(-0.62,-0.17), P = .0005], and bleeding on probing (BOP) was reduced [WMD=-9.20, 95%CI(-13.69,-4.71), P < .0001] more significantly, and the difference between the two groups was statistically significant (P < .05); while for Modified plaque index (mPI) decreased [MD=-0.07, 95%CI (-0.16, 0.01), P = .09], clinical attachment loss (CAL) gained [WMD=-0.66, 95%CI:(-1.46, 0.14), P = .11]. Plaque index (PI%) decreased [WMD=-1.66, 95%CI:(-3.43, 0.11), P = .07] insignificantly, and the difference between the two groups was not statistically significant (P > .05).Photodynamic Therapy (PDT) has been significantly effective in reducing periodontal pocket depth and gingival bleeding in the treatment of periodontal diseases. However, its efficacy in improving plaque control and promoting tooth attachment is limited, which may be attributed to its primary antibacterial action rather than promoting tissue repair.
Conclusion: Compared to other non-surgical treatments, PDT treatment has significant advantages in reducing peri-implant probing depth and bleeding in patients with peri-implantitis. These results suggest that PDT may be a more effective non-surgical option for reducing probing depth and bleeding in patients with peri-implantitis. Of course, future studies with larger sample sizes and longer follow-up periods are needed to confirm these findings.