Use of photosensitizers in photodynamic therapy combined with scaling and root planing for the treatment of periodontitis: a systematic and qualitative review

Objectives: To review and analyze the effectiveness of photosensitizers used in photodynamic therapy when combined with scaling and root planing for the treatment of periodontitis. Methods: An electronic and manual search was conducted in the PubMed, VHL, Embase, Google Scholar, and Capes Periodicals databases, with no restrictions on publication year or language. Clinical trials assessing the efficacy of photodynamic therapy with photosensitizers in combination with scaling and root planing for periodontitis treatment were selected. Study quality was evaluated using the CONSORT guidelines, considering criteria such as sample size, randomization, allocation concealment, blinding, and loss to follow-up. Studies were classified into three levels of evidence based on their ratings. Results: The initial search identified 2,016 studies, of which 13 met the inclusion criteria: level I (5 studies), level II (3 studies), and level III (5 studies). Three level I studies demonstrated that photodynamic therapy with photosensitizers was more effective than scaling and root planing alone in improving clinical parameters. Another level I study showed improvements from baseline to follow-up but found no additional benefits between groups. The findings from the remaining studies should be interpreted with caution due to a higher risk of bias. Conclusion: photosensitizers used in antimicrobial photodynamic therapy appear to enhance short-term clinical outcomes, demonstrating effectiveness when combined with scaling and root planing in the treatment of periodontitis.