EFFICACY OF ANTIMICROBIAL PHOTODYNAMIC THERAPY AS AN ADJUNCT TO SCALING AND ROOT PLANING IN THE TREATMENT OF PERIODONTITIS: A LITERATURE REVIEW

Abstract

Periodontitis is a chronic inflammatory disease associated with subgingival biofilm dysbiosis, whose first-choice non-surgical treatment is scaling and root planing (SRP). Since periodontal pathogens may persist after instrumentation, especially in deep pockets, antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunct. The aim of this study was to analyze the efficacy of aPDT combined with SRP on the clinical parameters of periodontitis. A qualitative and descriptive literature review was carried out through a search in the PubMed/MEDLINE database for studies published between January 2020 and October 2026. Of the 129 records identified, 12 studies comprised the final sample, including eight systematic reviews with meta-analysis and four randomized clinical trials. Probing depth, clinical attachment level, bleeding on probing and microbiological outcomes were evaluated. Most studies reported an additional benefit of aPDT, with probing depth reductions generally below 1.4 mm and more evident effects in smokers, diabetic patients, people living with HIV and in multiple-session protocols. However, the Cochrane review rated the certainty of the evidence as very low and considered the differences of limited clinical relevance, and the heterogeneity of protocols limited comparisons. It was concluded that aPDT is a safe adjunctive therapy with a modest clinical benefit, which does not replace SRP and may be considered mainly in patients with risk factors; standardized clinical trials with longer follow-up are needed.