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Photodiagnosis and Photodynamic Therapy Apr 2024The application of photodynamic therapy (PDT) is pivotal in the management of diverse dermatologic conditions. Microneedling (MN) is a minimally invasive tool that is... (Review)
Review
BACKGROUND
The application of photodynamic therapy (PDT) is pivotal in the management of diverse dermatologic conditions. Microneedling (MN) is a minimally invasive tool that is capable of inducing transient pores on the skin to facilitate transdermal drug delivery. Several studies have reported augmentation of PDT combined with MN. This systematic review analyzes the current studies on the efficacy and safety of MN-assisted PDT for skin diseases.
METHODS
The literature search using the PRISMA standard was completed through PubMed, Embase, Web of Science and CENTRAL from the establishment of the databases to November 2023. Two independent researchers finished the procedure.
RESULTS
A total of 12 articles and 413 subjects met our study criteria. This systematic review suggests that MN-assisted PDT can decrease the incubation time required for the photosensitizer and reduce skin lesions of actinic keratosis (AK) . The common side effect is pain and no serious adverse events were reported.
CONCLUSIONS
MN is an effective method to increase the transdermal delivery rate of photosensitizers. For different photosensitizers and disease, MN may show different clinical effects.
Topics: Photochemotherapy; Humans; Photosensitizing Agents; Needles; Administration, Cutaneous; Keratosis, Actinic; Skin Diseases; Drug Delivery Systems; Percutaneous Collagen Induction
PubMed: 38367923
DOI: 10.1016/j.pdpdt.2024.104016 -
Photodiagnosis and Photodynamic Therapy Apr 2024This study aimed to assess the influence of methylene blue (MB)-mediated adjunctive antimicrobial photodynamic therapy (aPDT) when compared to conventional mechanical... (Meta-Analysis)
Meta-Analysis Review
Efficacy of methylene blue-mediated antimicrobial photodynamic therapy on clinical and radiographic outcomes among patients with periodontal diseases: A systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
This study aimed to assess the influence of methylene blue (MB)-mediated adjunctive antimicrobial photodynamic therapy (aPDT) when compared to conventional mechanical debridement (MD) alone on periodontal clinical and radiographic outcomes among periodontitis patients.
METHODS
Randomized clinical trials (RCTs) were incorporated by conducting an electronic search in Web of Science, Scopus, and PubMed for articles published in English up to August 2023 to address the following focused question based on the PICO format: "Whether the application of MB-mediated aPDT as an adjunctive to MD (Intervention) leads to improved periodontal clinical and/or radiographic outcomes (Outcome) among participants with and without periodontal diseases (Population) as compared to MD alone (Conparison)". The risk of bias (RoB) of the included studies was assessed using the modified Jadad scale. A meta-analysis was conducted, and it included the presentation of the standard mean difference (SMD) along with a 95 % confidence interval (CI).
RESULTS
In total, 11 studies were included in this systematic review and meta-analysis. The meta-analysis demonstrated statistically significant improvements in periodontal plaque index (SMD: -0.72 % [95 % CI: -0.99 % to -0.45 %]; p<0.00001), probing depth (SMD: -0.38 % [95 % CI: -0.57 % to -0.19 %; p<0.00001), and bleeding on probing (SMD: -0.44 % [95 % CI: -0.68 % to -0.20 %]; p = 0.0003) scores at the final follow-up visit after the application of MB-mediated aPDT in comparison with MD alone. Nevertheless, there was no statistically significant difference was observed in periodontal clinical attachment level values (SMD: -0.01 % [95 % CI: -0.21 % to 0.19 %]; p = 0.95) between the control group and the experimental group. Six studies achieved a low RoB, five were rated as having medium RoB, while no study received a high RoB.
CONCLUSION
MB-mediated aPDT, when used as an adjunct to conventional MD contributes to the improvement of periodontal clinical outcomes including PI, PD, and BOP in patients with periodontitis.
Topics: Methylene Blue; Humans; Photochemotherapy; Photosensitizing Agents; Randomized Controlled Trials as Topic; Periodontal Diseases
PubMed: 38316339
DOI: 10.1016/j.pdpdt.2024.104000 -
Journal of Cataract and Refractive... May 2024Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with... (Meta-Analysis)
Meta-Analysis Comparative Study
Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with prophylactic CXL. Therefore, we performed a meta-analysis comparing outcomes of refractive surgeries with vs without prophylactic CXL. We systematically searched databases for studies comparing refractive surgeries for myopic correction with vs without prophylactic corneal crosslinking. Review Manager 5.4.1 was used to perform statistical analysis. We included 2820 eyes from 28 studies. Compared with refractive surgery alone, surgery with prophylactic CXL resulted in decreased central corneal thickness, corrected distance visual acuity logMAR, and safety and efficacy indices. There were no significant differences in postoperative uncorrected distance visual acuity of 20/20 or better at ≥12 months and other visual outcomes among both groups. More randomized controlled trials with standard crosslinking protocols are needed to analyze the prophylactic use of crosslinking with refractive surgeries.
Topics: Humans; Cross-Linking Reagents; Photosensitizing Agents; Keratomileusis, Laser In Situ; Riboflavin; Collagen; Visual Acuity; Myopia; Photorefractive Keratectomy; Photochemotherapy; Lasers, Excimer; Corneal Stroma; Ultraviolet Rays; Keratoconus; Corneal Surgery, Laser; Refraction, Ocular
PubMed: 38288954
DOI: 10.1097/j.jcrs.0000000000001405 -
Lasers in Medical Science Jan 2024The objective of this systematic review was to evaluate the effectiveness of photobiomodulation therapy (PBM) in managing avulsed teeth. This systematic review was... (Review)
Review
The objective of this systematic review was to evaluate the effectiveness of photobiomodulation therapy (PBM) in managing avulsed teeth. This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (i.e., "PRISMA") statement 2020 and was registered in the International Prospective Register of Systematic Reviews (i.e., PROSPERO) with number CRD42022362198. The participants, intervention, comparison, outcomes, and study design (i.e., PICOS) for the present study considered the following question: "Does the use of laser PBM in the treatment of teeth with avulsion influence tissue repair performance?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest databases until January 2023. The SYRCLE's RoB tool (Systematic Review Center for Laboratory Animal Experimentation) for animal studies were used for quality assessment. A total of 7 in vivo studies published between 2011 and 2018 were included in this systematic review for qualitative analysis. All studies used Wistar rats, totaling 368 specimens that simulated tooth avulsion trauma. The effect of photodynamic therapy in the treatment of avulsed teeth was positive in 5 studies (significant increase in tissue repair) and negative in 2 studies, in which both studies with negative results kept teeth in saline solution before reimplantation and showed the longest time and power of laser application. PBM appears to be effective for tissue repair in the treatment of avulsed teeth, depending on the means of conservation of the avulsed tooth and the laser application protocol.
Topics: Animals; Rats; Low-Level Light Therapy; Photochemotherapy; Rats, Wistar; Tooth; Tooth Avulsion
PubMed: 38280099
DOI: 10.1007/s10103-024-03998-0 -
Photodiagnosis and Photodynamic Therapy Feb 2024The presence of peri‑implant inflammation including peri‑implant mucositis and peri‑implantitis, is a crucial factor that impacts the long-term stability and... (Review)
Review
BACKGROUND
The presence of peri‑implant inflammation including peri‑implant mucositis and peri‑implantitis, is a crucial factor that impacts the long-term stability and success of dental implants. This review aimed to evaluate the safety and effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjuvant therapy option for managing peri‑implant mucositis and peri‑implantitis.
METHODS
We systematically searched the PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar databases (no time limitation). The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the quality of the studies was assessed using the Cochrane Collaboration tool.
RESULTS
Of 322 eligible articles, 14 studies were included in this review. The heterogeneity and poor quality of the articles reviewed prevented a meta-analysis. The reviewed articles used a light source (60 s, 1 session) with a wavelength of 635 to 810 nm for optimal tissue penetration. These studies showed improved clinical parameters such as probing depth, bleeding on probing (BOP), and plaque index after aPDT treatment. However, in smokers, BOP increased after aPDT. Compared to conventional therapy, aPDT had a longer-term antimicrobial effect and reduced periopathogens like Porphyromonas gingivalis, as well as inflammatory factors such as Interleukin (IL)-1β, IL-6, and Tumor necrosis factor alpha (TNF-α). No undesired side effects were reported in the studies.
CONCLUSION
Although the reviewed articles had limitations, aPDT showed effectiveness in improving peri‑implant mucositis and peri‑implantitis. It is recommended as an adjunctive strategy for managing peri‑implant diseases, but further high-quality research is needed for efficacy and long-term outcomes.
Topics: Humans; Photochemotherapy; Peri-Implantitis; Mucositis; Photosensitizing Agents; Randomized Controlled Trials as Topic; Anti-Infective Agents
PubMed: 38278339
DOI: 10.1016/j.pdpdt.2024.103990 -
BMC Oral Health Jan 2024Photodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Photodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis investigated the current available evidence regarding the efficacy of PDT in the management of DS.
MATERIALS AND METHODS
PubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for the statistical analyses.
RESULTS
Elven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal therapy, while three studies assessed the adjunctive use of PDT (PDT + antifungal therapy) vs. topical antifungal therapy alone. The results revealed comparable efficacy of PDT and conventional antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13) and at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relatively better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy on the clinical outcomes.
CONCLUSIONS
PDT might be considered a viable option for DS either as an adjunct or as an alternative to the topical antifungal medications. Further studies with adequate sample sizes and standardized PDT parameters are warranted.
Topics: Humans; Antifungal Agents; Candida; Photochemotherapy; Stomatitis, Denture
PubMed: 38229054
DOI: 10.1186/s12903-023-03789-z -
Actas Dermo-sifiliograficas May 2024Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their...
BACKGROUND AND OBJECTIVE
Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS.
MATERIALS AND METHODS
We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (Study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, one adverse event. The search was conducted in the Cochrane Library, MEDLINE, and EMBASE databases; study selection was performed based on pre-defined criteria. The risk of bias was determined in each study.
RESULTS
We obtained a total of 11,363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n=25), with only five randomized clinical trials (RCTs) and one cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in three RCTs and high in two RCTs.
CONCLUSION
The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice.
Topics: Humans; Administration, Topical; Hidradenitis Suppurativa; Injections, Intralesional; Photochemotherapy; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 38159839
DOI: 10.1016/j.ad.2023.12.001 -
Photodiagnosis and Photodynamic Therapy Feb 2024This study provides an overview of the effectiveness and safety of PDT for the treatment of HPV-associated precancerous cervical conditions and contains recent findings...
Evaluation of the effectiveness and safety of photodynamic therapy in the treatment of precancerous diseases of the cervix (neoplasia) associated with the human papillomavirus: A systematic review.
This study provides an overview of the effectiveness and safety of PDT for the treatment of HPV-associated precancerous cervical conditions and contains recent findings from relevant research studies. A comprehensive literature search of MEDLINE/PubMed, Cochrane Central Library, and Google Scholar was conducted, including analytic epidemiological studies, and 11 papers were included. The narrative synthesis approach was used to summarize the results of the included studies. Studies were critically appraised using The Joanna Briggs Institute (JBI) tool for assessing the risk of bias. The results of the study demonstrate that CRR for HPV remission ranges from 66.7 % to 92.73 %, whereas for CIN1 it fluctuates from 57.1 % to 83.3 %. The frequency of recurrence of the disease ranged from 3.3 % to 8.9 % during the follow-up period of up to 2 years. Adverse events were observed in 8 (66 %) studies and the most common were cervical stenosis, abdominal pain, vaginal pain, and focal edema. Five types of topical and intravenous applications along with lasers of various wavelengths and intensities were mostly used. However, all studies demonstrated relatively similar results. According to the results, PDT has demonstrated favorable outcomes, but no impressive effect on the treatment of CIN. It should be emphasized, that the effectiveness of PDT for the treatment of HPV-associated CIN may vary depending on some variables, including the kind of PDT agent used, the dosage, duration and frequency of PDT administration, the severity and location of the lesions, and the host immunological response.
Topics: Female; Humans; Cervix Uteri; Human Papillomavirus Viruses; Papillomavirus Infections; Photochemotherapy; Photosensitizing Agents; Precancerous Conditions; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms
PubMed: 38070631
DOI: 10.1016/j.pdpdt.2023.103925 -
Photobiomodulation, Photomedicine, and... Feb 2024This systematic review aimed to evaluate the adhesive bond strength of restorative materials to caries-affected dentin (CAD) treated with antimicrobial photodynamic... (Meta-Analysis)
Meta-Analysis Review
This systematic review aimed to evaluate the adhesive bond strength of restorative materials to caries-affected dentin (CAD) treated with antimicrobial photodynamic therapy (aPDT) in comparison with conventional chemical disinfectants. Three databases, including the Web of Science, Scopus, and PubMed, were searched to address the focused question: "What is the effect of aPDT compared to conventional chemical disinfection techniques on the adhesive bond strength of restorative materials to CAD?." Search keywords included "dentin*" "adhes bond*" "caries-affected dentin" "photodynamic "photochemotherapy" "photosensitizing agent" "phototherapy" "photoradiation" "laser" "light activated" "photoactivated." A fixed-effects model was used in each meta-analysis and the inverse variance was used to calculate the standard mean difference (SMD). For evaluating the statistical heterogeneity, the Cochrane's test and the statistics were used. The risk of bias was evaluated based on the Cochrane Collaboration's tool. Fourteen studies were included in the qualitative as well as quantitative analysis. The results of the meta-analyses exhibited an SMD of 2.38% [95% confidence interval (CI): 2.03-2.73; < 0.00001], indicating a statistically significant difference in the shear bond strength scores between the tested group (samples treated with aPDT) and the control group (i.e., favoring the sound dentin and/or conventional chemical disinfectants). Contrarily, an SMD of -1.46% (95% CI: -2.04 to -0.88; < 0.00001) and -0.37% (95% CI: -0.70 to -0.03; = 0.03) was observed, indicating a statistically significant difference in the microtensile bond strength (μTBS), as well as microleakage scores between the tested group (favoring the samples treated with aPDT) and the control group (i.e., sound dentin and/or conventional chemical disinfectants). Adhesive bond strength of restorative materials to CAD treated with conventional chemical disinfectants showed superior outcomes compared to photodynamic therapy (aPDT).
Topics: Dental Caries Susceptibility; Dentin; Resin Cements; Anti-Infective Agents; Photochemotherapy; Disinfectants
PubMed: 38011333
DOI: 10.1089/photob.2023.0037 -
International Orthodontics Mar 2024We conducted this review to evaluate the safety and efficacy of antimicrobial photodynamic therapy (aPDT) for the management of gingivitis and white spot lesions (WSLs)...
AIM
We conducted this review to evaluate the safety and efficacy of antimicrobial photodynamic therapy (aPDT) for the management of gingivitis and white spot lesions (WSLs) in fixed orthodontic patients.
METHODS
The PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar databases were searched for randomized controlled trials and clinical trials assessing the clinical effectiveness of aPDT for the management of gingivitis and WSLs in fixed orthodontic patients without time limitation. Primary outcomes were the changes in clinical parameters such as DIAGNOdent, plaque index (PI), bleeding on probing (BOP), and gingival index (GI). Secondary outcomes included measurements of microbial and inflammatory factors, such as cytokine levels (tumor necrosis factor alpha [TNF-α], interleukin-1 beta [IL-1β], and interleukin-6 [IL-6]), and bacterial counts.
RESULTS
Our search yielded a total of 12 studies that met the inclusion criteria. Among the 11 studies that evaluated gingivitis, the majority employed a diode laser (670nm, 150 mW, 22J/cm, 60seconds) as the light source and methylene blue at a concentration of 0.0005% (applied for 3minutes) as the photosensitizer in a single treatment session. The included studies reported positive effects of aPDT on gingivitis management, with more improvements observed in PI, BOP, and GI following aPDT treatment. Additionally, aPDT was found to reduce the counts of periopathogens such as Porphyromonas gingivalis, as well as inflammatory factors (TNF-α, IL-1β, and IL-6). Two studies demonstrated that aPDT, particularly when administered in multiple sessions, effectively controlled the extent of WSLs during orthodontic treatment and yielded favorable outcomes that persisted for several months after treatment.
CONCLUSION
Based on the available evidence, aPDT appears to be a safe and effective treatment option for managing WSLs and gingivitis in patients with fixed orthodontic appliances. However, further high-quality RCTs are necessary to investigate the impact of potential confounding factors on the efficacy of aPDT.
Topics: Humans; Tumor Necrosis Factor-alpha; Interleukin-6; Photochemotherapy; Anti-Infective Agents; Gingivitis; Dental Caries
PubMed: 37992475
DOI: 10.1016/j.ortho.2023.100821