Efficacy of adjunctive photodynamic therapy and lasers in the non-surgical periodontal treatment: A Bayesian network meta-analysis

Background: Photodynamic therapy (PDT) and lasers have been widely applied in non-surgical treatments in recent decades; however, their efficacy is not known. The objective of this study was to compare adjunctive PDT, different lasers, and scaling and root planning (SRP) in the management of chronic periodontitis.

Methods: Randomized clinical trials (RCTs) assessing adjunctive PDT, different lasers, and SRP were identified. Relevant data were extracted, and the quality and risk of bias were evaluated. Network meta-analyses were performed to analyze clinical attachment level (CAL) outcomes.

Results: Forty-four studies, including 10 types of adjuncts, were included. PDT + SRP and PDT + diode laser (DL)+SRP were significantly more efficient than SRP at the 3-month and 6-month follow-up. Adjunctive potassium-titanyl-phosphate (KTP) laser showed significantly more CAL gains than SRP at 6 months. The most effective adjunctive treatment at 3 months was PDT + DL (60 %) and at 6 months was KTP laser (71 %).

Conclusions: PDT + DL + SRP and PDT + SRP were found to be preferentially recommended methods. KTP + SRP was significantly superior to SRP at the 6-month follow-up. However, further investigations are necessary.