研究目的
To systematically review the literature regarding the antimicrobial effects of photodynamic therapy (PDT) on the multi-bacterial species and the possible surface alterations of the dental implants as a result of PDT.
研究成果
The systematic review demonstrated that photodynamic therapy (PDT) significantly reduces bacterial load on dental implant surfaces, as all included in-vitro studies showed this effect. However, findings regarding structural alterations on titanium surfaces were inconclusive, with only two studies reporting no significant changes. The results are preliminary, and future in-vitro studies with standardized laser parameters are required to draw stronger conclusions and better understand the potential surface effects of PDT.
研究不足
The main limitations include the small number of included studies (only 7), significant methodological heterogeneity among studies (e.g., variations in laser parameters, photosensitizers, and outcomes), incomplete reporting of laser and photosensitizer parameters (e.g., energy fluence, number of laser sessions), inability to perform meta-analysis due to heterogeneity, inconclusive findings on surface alterations, and the in-vitro nature of the studies limiting generalizability to in-vivo conditions. Further studies with standardized parameters are needed.
1：Experimental Design and Method Selection:
A systematic review was conducted following the PRISMA guidelines. The focused question was: 'Does PDT show antimicrobial efficacy against multi-bacterial species colonization and result in surface alteration on dental implants?' The review included in-vitro studies only, with interventions involving antimicrobial PDT, population of dental implants, comparisons with laser therapy, chemical detoxification or no treatment, and outcomes of bacterial load and surface alterations.
2：Sample Selection and Data Sources:
Electronic databases including MEDLINE and EMBASE were searched up to December 2018 using MeSH and text words related to photodynamic therapy, bacteria, infection, dental implants, and surface. Manual searches of specific journals were also performed. Studies were screened based on titles and abstracts, and data were extracted from included studies.
3：List of Experimental Equipment and Materials:
The review analyzed studies that used various dental implants (titanium and zirconia), titanium discs, titanium plates with germanium prisms, diode lasers with wavelengths from 625 nm to 810 nm, photosensitizers such as methylene blue, toluidine blue, phenothiazine chloride, and indocyanin green, and control treatments like chlorhexidine, laser therapy, and saline solution. Laboratory analyses included scanning electron microscopy, microbial culture analysis in colony forming units, multiple attenuated internal reflection infrared spectroscopy, fluorescence analysis, LPS inactivation, and attachment assays.
4：Experimental Procedures and Operational Workflow:
The search identified 70 studies initially, with duplicates removed and abstracts screened, resulting in 7 included studies. Data extraction covered author/country, study sample and groups, bacterial species, laboratory analysis, outcomes, and laser parameters. No meta-analysis was performed due to heterogeneity.
5：Data Analysis Methods:
Outcomes were reported narratively due to methodological heterogeneity. Data included reduction in bacterial load and surface alterations, analyzed qualitatively from the included studies.
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