Indocyanine green–mediated antimicrobial photodynamic therapy as an adjunct to periodontal therapy: a systematic review and meta-analysis

OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the efficacy of indocyanine green–mediated photodynamic therapy (ICG-PDT) as an adjunct to non-surgical periodontal therapy (NSPT), in the management of chronic periodontitis. MATERIALS AND METHODS: Four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Embase via OVID, Web of Science) were searched for randomised controlled trials comparing NSPT with ICG-PDT to NSPT without laser therapy. Primary outcome measures were changes in probing pocket depth (PPD) and clinical attachment level (CAL). Clinical outcomes were extracted and pooled from 7 eligible trials and meta-analyses conducted using mean difference with standard deviations. RESULTS: For PPD, adjunctive ICG-PDT resulted in a mean additional reduction of 1.17 mm (95% CI: 0.67–1.66 mm) at 3 months and a mean additional reduction of 1.06 mm (95% CI: 0.54–1.57 mm) at 6 months. For CAL, adjunctive ICG-PDT resulted in a mean additional gain of 0.70 mm (95% CI: 0.17–1.23 mm) at 3 months and a mean additional gain of 1.03 mm (95% CI: 0.83–1.24 mm) at 6 months. No adverse events were reported in any studies. CONCLUSIONS: The adjunctive use of ICG-PDT in NSPT results in improved treatment outcomes at 3 and 6 months post-therapy. Further investigation is needed to evaluate variables such as different photosensitiser concentrations and adjusting parameters associated with the light source. CLINICAL RELEVANCE: Indocyanine green–based photosensitisers may be a novel, clinically efficacious agent for use in the management of periodontitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00784-021-03871-2.