Laser treatments as an adjunct to non-surgical periodontal therapy in subjects with periodontitis and type 2 diabetes mellitus: a systematic review and meta-analysis

Abstract

Objectives Periodontal disease and diabetes have an extensively investigated bidirectional correlation. Non-surgical periodontal treatment (NSPT) was proven to contribute to glycemic control. Moreover, it may benefit from the association of adjunctive therapies. The aim of the present systematic review is to assess the clinical efficacy of NSPT in association with laser (LT) or photodynamic therapy (PDT) in controlled or uncontrolled diabetic patients, and to grade the level of evidence. Materials and methods Randomized controlled clinical trials with at least 3-month follow-up were searched in MEDLINE via OVID, EMBASE, and Cochrane Central, screened for inclusion, and grouped based on the performed treatments, follow-up time, type of diabetes, and level of glycemic control. Results Eleven RCTs with 504 total subjects were included. The adjunct of PDT showed a statistically significant 6-month difference in PD changes (with low certainty of evidence), but not in CAL changes, while a significant difference in 3-month PD and CAL changes was found with the adjunct of LT (low certainty of evidence). Patients treated with PDT registered a higher decrease in HbA1c levels at 3 months, but no significant difference was noted at 6 months; LT also led to better HbA1c changes at 3 months with a moderate certainty of evidence. Conclusion Despite the promising short-term HbA1c decrease, the results should be interpreted with caution due to the small effect sizes and the statistical heterogeneity, and further evidence from well-designed RCTs is needed to support the routine use of PDT or LT in adjunct to NSPT.

Emerging role of photodynamic therapy as an adjunct to nonsurgical periodontal therapy on periodontal status and glycemic control in patients with type 2 diabetes: A clinical study

“…Corbella et al . [ 24 ] in a systematic review and meta-analysis, has reported additional benefits of PDT in deep periodontal pockets as well as a higher decrease in HbA1c levels at 3 months, but no significant difference was noted at 6 months.…”

The effect of adjunctive LASER application on periodontal ligament stem cells

“…The LASER revolution in dentistry and the invention of ruby LASER by Theodore Maiman in 1960 has seen significant changes over the past few decades owing to advances and usability of LASERs in a multitude of dental and periodontal applications (Passanezi et al, 2015;Theodoro et al, 2021;Corbella et al, 2023). LASERs are clinically categorized into two types based on their wavelength: 1) a deeply penetrating type where the LASER light penetrates and scatters into the tissue deeply, such as the diode LASERs (810-980 nm) and neodymium-doped yttrium-aluminum-garnet (Nd:YAG) available for clinical application; and 2) a superficially absorbed type such are the erbium-doped yttrium-aluminum-garnet (Er:YAG) (2940 nm), carbon dioxide (CO 2 ) (10,600 nm) and erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr: YSGG) (2780 nm) LASERs (Ohsugi et al, 2020;Fu and Wo, 2021).…”