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<p>To systematically evaluate the efficacy of photodynamic therapy in treating peri-implantitis and compare the effectiveness of various photosensitizers based on randomized clinical trials.&#xa0;A systematic review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, incorporating data from PubMed/MEDLINE, Embase, Web of Science, and CNKI up to December 31, 2024. Randomized clinical trials that assessed the efficacy of photodynamic therapy with various photosensitizers for peri-implantitis were included. Primary outcomes included bleeding on probing, probing depth, plaque index, clinical attachment level, crestal bone loss, and bleeding index. Standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated for each outcome to quantify the effect size. Risk of bias was assessed using the Cochrane risk-of-bias tool.&#xa0;13 randomized clinical trials involving 678 participants were included in the analysis. Photodynamic therapy significantly improved several clinical outcomes compared to controls: bleeding on probing (SMD = -0.49, 95% CI: -0.89 to -0.09), probing depth (SMD = -1.49, 95% CI: -2.31 to -0.66), plaque index (SMD = -1.11, 95% CI: -1.98 to -0.25), and crestal bone loss (SMD = -0.53, 95% CI: -0.89 to -0.17). Subgroup analyses revealed that Toluidine Blue was the most effective photosensitizer, showing superior improvements across multiple outcomes.&#xa0;Photodynamic therapy is an effective treatment for peri-implantitis, particularly when using Toluidine Blue, which consistently outperformed other photosensitizers in improving clinical outcomes. These findings provide strong evidence for integrating photodynamic therapy into peri-implantitis management protocols, offering a promising, minimally invasive alternative to conventional treatments. Future studies should focus on optimizing photodynamic therapy protocols, assessing long-term outcomes, and evaluating its effectiveness in diverse patient populations.</p><p>Clinical trial number:&#xa0;PROSPERO (CRD42024600326).</p>

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Efficacy of photodynamic therapy with various photosensitizers for peri-implantitis treatment: a systematic review and meta-analysis of randomized clinical trials

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月16日

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  • Xin Li,
  • Hang Liu,
  • Lian Yang,
  • Yiming Ji,
  • Dingli Feng,
  • Ruiqi Shao,
  • Guanhua Zhang,
  • Shichen Lin,
  • Shaoyu Duan,
  • Xue Wu

摘要

To systematically evaluate the efficacy of photodynamic therapy in treating peri-implantitis and compare the effectiveness of various photosensitizers based on randomized clinical trials. A systematic review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, incorporating data from PubMed/MEDLINE, Embase, Web of Science, and CNKI up to December 31, 2024. Randomized clinical trials that assessed the efficacy of photodynamic therapy with various photosensitizers for peri-implantitis were included. Primary outcomes included bleeding on probing, probing depth, plaque index, clinical attachment level, crestal bone loss, and bleeding index. Standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated for each outcome to quantify the effect size. Risk of bias was assessed using the Cochrane risk-of-bias tool. 13 randomized clinical trials involving 678 participants were included in the analysis. Photodynamic therapy significantly improved several clinical outcomes compared to controls: bleeding on probing (SMD = -0.49, 95% CI: -0.89 to -0.09), probing depth (SMD = -1.49, 95% CI: -2.31 to -0.66), plaque index (SMD = -1.11, 95% CI: -1.98 to -0.25), and crestal bone loss (SMD = -0.53, 95% CI: -0.89 to -0.17). Subgroup analyses revealed that Toluidine Blue was the most effective photosensitizer, showing superior improvements across multiple outcomes. Photodynamic therapy is an effective treatment for peri-implantitis, particularly when using Toluidine Blue, which consistently outperformed other photosensitizers in improving clinical outcomes. These findings provide strong evidence for integrating photodynamic therapy into peri-implantitis management protocols, offering a promising, minimally invasive alternative to conventional treatments. Future studies should focus on optimizing photodynamic therapy protocols, assessing long-term outcomes, and evaluating its effectiveness in diverse patient populations.

Clinical trial number: PROSPERO (CRD42024600326).