대한치과의사협회지 (The Journal of the Korean dental association)

  • 제54권6호
  • /
  • Pages.429-437
  • /
  • 2016
  • /
  • 0376-4672(pISSN)
  • /
  • 2713-7961(eISSN)
대한치과의사협회 (The Korean Dental Association)
권호 표지

광역학요법을 이용한 치주염치료 - 체계적 문헌고찰 및 메타분석

Antimicrobial photodynamic therapy as an adjunct to nonsurgical periodontal treatment - Systematic review and Meta-analysis

  • 모진아 (한국보건의료연구원 신의료기술평가본부, 인하대학교)
  • Mo, Jin-A (National Evidence-Based Health Care Collaborating Agency, Inha University)
  • 투고 : 2016.01.26
  • 심사 : 2016.04.15
  • 발행 : 2016.06.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: Photodynamic therapy has been proven to promote additional clinical and microbiological benefits in the treatment of chronic periodontitis and aggressive periodontitis. The purpose of this study is to assess the effectiveness of the photodynamic therapy for patient with periodontitis. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 300 studies were searched and 13 studies were included in the final assessment. Each of the stages from literature search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The safety of the photodynamic therapy was assessed by bleeding. The effectiveness of the photodynamic therapy was assessed by the reduction of Probing pocket depth (PPD) and the gain of Clinical attachment level (CAL). The mean difference of PPD was 0.46(95% CI 0.09~0.82), (p=.01).). The mean difference of CAL was ?0.49(95% CI ?1.12~0.14), (p=.13). Conclusion: The additional use of $^{\circ}{\infty}$Antimicrobial Photodynamic Therapy for Periodontitis$^{\circ}{\pm}$ caused hemorrhage to similar extents to conventional treatment modalities, where scaling and root planing are solely performed, in patients with periodontitis who are expected to have a lower degree of treatment response to non-surgical or surgical periodontal therapies (implant or refractory periodontitis) and those where there is a concern for the possible occurrence of antimicrobial side effects or resistance. This indicates that there are no problems with its safety. But there were no consistent reports about the effects of the additional use of photodynamic therapy. This led to a decision that the safety and efficacy of the current technology deserve further studies (Recommendation rating of A, Classification of technology II-a).

키워드

과제정보

연구 과제 주관 기관 : 보건복지부

참고문헌

  1. Ali RW, Johannessen AC, Dahlen G, Socransky SS, Skaug N. Comparison of the subgingival microbiota of periodontally healthy and diseased adults in northern Cameroon. Journal of Clinical Periodontology.1997; 24: 830-835.
  2. Haffajee AD, Socransk SS. Microbial etiological agents of destructive periodontal disease. Periodontology 2000. 1994; 5:78-111. https://doi.org/10.1111/j.1600-0757.1994.tb00020.x
  3. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005; 366: 1809-1820. https://doi.org/10.1016/S0140-6736(05)67728-8
  4. Loomer PM. Microbiological diagnostic testing in the treatment of periodontal disease. Periodontology 2000. 2004; 34: 49-56. https://doi.org/10.1046/j.0906-6713.2002.003424.x
  5. Korean academy of periodontology. Available from URL from: http://www.kperio.org.
  6. Hoggins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration. www.cochrane-handbook.org.
  7. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and metaanalyses: The PRISMA statement. Ann Intern Med. 2009;151:264-269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  8. SIGN 50: a guideline developer's handbook. Scottish Intercollegiate Guidelines Network. http://www.sign.ac.uk/pdf/sign50.pdf, 2011
  9. Al-Zahrani MSA. Photodynamic therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis in smokers. Saudi Medical Journal 2011; 32: 1183-1188.
  10. Andersen RL. Treatment of periodontal disease by photodisinfection compared to scaling and root planing. Journal of Clinical Dentistry 2007; 18: 34-38.
  11. Betsy J, Prasanth CS, Baiju K. Efficacy of antimicrobial photodynamic therapy in the management of chronic periodontitis: a randomized controlled clinical trial. Journal of Clinical Periodontology 2014; 41: 573-581. https://doi.org/10.1111/jcpe.12249
  12. Braun AD. Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: A randomized clinical trial. Journal of Clinical Periodontology 2008; 35: 877-884. https://doi.org/10.1111/j.1600-051X.2008.01303.x
  13. Campos GNP. The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: A randomized controlled clinical trial. Lasers in Medical Science 2013; 28: 317-324. https://doi.org/10.1007/s10103-012-1159-3
  14. Cappuyns IC. Treatment of residual pockets with photodynamic therapy, diode laser, or deep scaling. A randomized, split-mouth controlled clinical trial. Lasers in Medical Science 2012; 27: 979-986. https://doi.org/10.1007/s10103-011-1027-6
  15. Chondros PN. Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: A randomized controlled clinical trial. Lasers in Medical Science 2009; 24: 681-688. https://doi.org/10.1007/s10103-008-0565-z
  16. Christodoulides NN. Photodynamic therapy as an adjunct to non-surgical periodontal treatment: A randomized, controlled clinical trial. Journal of Periodontology 2008; 79: 1638-1644. https://doi.org/10.1902/jop.2008.070652
  17. Lulic MLG, I. One-year outcomes of repeated adjunctive photodynamic therapy during periodontal maintenance: A proof-of-principle randomizedcontrolled clinical trial. Journal of Clinical Periodontology 2009; 36: 661-666. https://doi.org/10.1111/j.1600-051X.2009.01432.x
  18. Macedo GDO. Additional effects of aPDT on nonsurgical periodontal treatment with doxycycline in type II diabetes: A randomized, controlled clinical trial. Lasers in Medical Science 2014; 29: 881-886. https://doi.org/10.1007/s10103-013-1285-6
  19. Noro Filho GAC. PDT in non-surgical treatment of periodontitis in HIV patients: A split-mouth, randomized clinical trial. Lasers in Surgery and Medicine 2012; 44: 296-302. https://doi.org/10.1002/lsm.22016
  20. Polansky RH. Clinical effectiveness of photodynamic therapy in the treatment of periodontitis. Journal of Clinical Periodontology 2009; 36: 575-580. https://doi.org/10.1111/j.1600-051X.2009.01412.x
  21. Sigusch BWE. Full-mouth antimicrobial photodynamic therapy in Fusobacterium nucleatuminfected periodontitis patients. Journal of Periodontology 2010; 81: 975-981. https://doi.org/10.1902/jop.2010.090246
  22. Health Insurance Review Agency. A Study on the Construction and Management of Health Technology Assessment System. Seoul: Health Insurance Review Agency. 2005; 227-228.