Indocyanine green-based adjunctive antimicrobial photodynamic therapy for treating chronic periodontitis: A randomized clinical trial

Hill, Greta; Dehn, Claudia; Hinze, Annette Viktoria; Frentzen, Matthias; Meister, Jörg

doi:10.1016/j.pdpdt.2019.02.019

Cited by 34 publications

(39 citation statements)

References 46 publications

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“…In total, 21/38 of the articles (55.3%) showed a low risk of bias, with two articles [ 6 , 31 ] scoring 10/10, eleven [ 24 , 26 , 28 , 29 , 38 , 43 , 44 , 49 , 51 , 52 , 55 ] scoring 9/10, and eight [ 23 , 25 , 34 , 35 , 37 , 46 , 48 , 50 ] scoring 8/10.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, for each dental research field, studies were allocated as: 8/17 in periodontitis [ 22 , 24 , 26 , 28 , 29 , 31 , 36 , 38 ]; 2/4 in peri-implantitis [ 39 , 41 ]; 4/5 in endodontics [ 43 , 44 , 46 , 47 ]; 5/5 in caries disinfection [ 48 , 49 , 50 , 51 , 52 ]; 0/2 in candida disinfection; 1/1 in halitosis [ 55 ]; 2/3 in OLP [ 56 , 58 ]; 0/1 in healing pericoronitis. …”

Section: Resultsmentioning

confidence: 99%

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Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review

et al. 2020

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Background: Antimicrobial photodynamic therapy (aPDT) has been proposed as an effective alternative method for the adjunctive treatment of all classes of oral infections. The multifactorial nature of its mechanism of action correlates with various influencing factors, involving parameters concerning both the photosensitizer and the light delivery system. This study aims to critically evaluate the recorded parameters of aPDT applications that use lasers as the light source in randomized clinical trials in dentistry. Methods: PubMed and Cochrane search engines were used to identify human clinical trials of aPDT therapy in dentistry. After applying specific keywords, additional filters, inclusion and exclusion criteria, the initial number of 7744 articles was reduced to 38. Results: Almost one-half of the articles presented incomplete parameters, whilst the others had different protocols, even with the same photosensitizer and for the same field of application. Conclusions: No safe recommendation for aPDT protocols can be extrapolated for clinical use. Further research investigations should be performed with clear protocols, so that standardization for their potential dental applications can be achieved.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review

et al. 2020

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“…Three studies were multi-arm trials [ 48 , 52 , 53 ]. The adjuncts included were: (1) antimicrobial photodynamic therapy (aPDT) indocyanine green (ICG) [ 54 , 55 ], (2) aPDT methylene blue (MB) 0.005% [ 56 , 57 ], (3) aPDT MB 1% [ 47 , 58 , 59 , 60 ], (4) aPDT phenothiazine chloride (PC) [ 61 , 62 ], (5) aPDT toluidine blue O (TBO) [ 53 ], (6) chlorhexidine (CHX) chip [ 52 , 63 , 64 ], (7) CHX xanthan gel [ 65 , 66 ], (8) doxycycline hyclate (DH) gel [ 50 , 67 ], (9) metronidazole (MET) gel [ 68 , 69 ], (10) minocycline (MINO) gel [ 49 , 70 ], (11) MINO microspheres [ 48 , 71 , 72 ], (12) povidone iodine (PI) 10% irrigating solution [ 73 ], (13) sulfonic/sulfuric acid (SA) gel [ 51 ], and (14) tetracycline (TC) fibers [ 52 ]. SMD alone was used as the reference comparator arm.…”

Section: Resultsmentioning

confidence: 99%

Clinical Efficacy of Single Application Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review and Network Meta-Analysis

2020

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This review aimed to rank the clinical efficacy of commercially available single-application local drug delivery and adjunctive agents (LDAs) compared with subgingival mechanical debridement (SMD) in nonsurgical periodontal therapy (NSPT). Randomized controlled clinical trials that compared LDAs against SMD alone or with placebo in adults (aged at least 18 years) diagnosed with periodontitis with a minimum of 6 months follow-up were included. A frequentist approach to random-effects network meta-analysis was implemented. The efficacies of the LDAs measured by probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were reported as mean difference (MD) with 95% confidence intervals (CIs). The treatments were ranked according to their P-score. Four network meta-analyses suggested that sulfonic/sulfuric acid gel (PPD MD −1.13 mm, 95% CI −1.74 to −0.53, P-score 0.91; CAL MD −1.09 mm, 95% CI −1.58 to −0.61, P-score 0.95) and doxycycline hyclate gel (PPD MD −0.90 mm, 95% CI −1.50 to −0.30, P-score 0.93; CAL MD −0.84 mm, 95% CI −1.40 to −0.28, P-score 0.92) were the most effective in reducing PPD and gaining CAL in split-mouth and parallel studies, respectively (moderate certainty of evidence). LDAs have differing efficacies, but they present with possible clinical significance over SMD alone in NSPT.

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“…However, other trials showed only a reduction of periodontal pathogens without significant difference in clinical parameters when compared to SD only [ 120 , 121 ]. In addition, results from other studies indicated that neither microbiological nor clinical parameters were improved following the application of laser or aPDT [ 122 , 123 , 124 , 125 , 126 , 127 , 128 ] ( Table 4 ). Overall, the results of the current review were consistent with guidelines issued by the European Federation of Periodontology (EFP), which suggested that there is no clear evidence supporting the use of lasers or PDT as adjuncts to SD [ 29 ].…”

Section: Novel Antibacterial Agents and Strategies To Overcome Bacterial Resistance In Dental Biofilm: Pros And Consmentioning

confidence: 99%

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

et al. 2021

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Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.

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Indocyanine green-based adjunctive antimicrobial photodynamic therapy for treating chronic periodontitis: A randomized clinical trial

Cited by 34 publications

References 46 publications

Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review

Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review

Clinical Efficacy of Single Application Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review and Network Meta-Analysis

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

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