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Aim: The aim of the present study was to assess the effectiveness of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of periodontal inflammation among patients with prediabetes., Methods: Demographic information was collected using a questionnaire. Hemoglobin A1c (HbA1c) levels were measured at baseline and at 3 and 6 months' follow-up., Treatment: Individuals were randomly divided into 2 groups as follows: (a) Group-1, participants underwent full-mouth MD; and Group-2: participants underwent full-mouth MD with adjunct aPDT. In groups 1 and 2, full-mouth plaque index (PI), bleeding on probing (BOP) and probing pocket depth (PPD) were measured at baseline and at 3 and 6 months' follow-up. In both groups, full-mouth digital intraoral radiographs were also taken. Sample-size was estimated and statistical analysis was performed with level of significance set as P<0.05., Results: In total, 70 prediabetic male individuals (35 patients in group-1 and 35 in group-2) were included. At baseline, PI, BOP, number of sites with PPD ≥4mm were comparable among individuals in groups 1 and 2. In groups 1 and 2, PI (P<0.05), BOP (P<0.05), number of sites with PPD ≥4mm (P<0.05) were significantly higher at baseline compared with 3 months' follow-up. There was no statistically significant difference in PI, BOP, number of sites with PPD ≥4mm at 3 and 6 months' follow-up. At 6 months' follow-up, PI, BOP, number of sites with PPD ≥4mm were comparable to their respective baseline values. There was no statistically significant difference in CBL in both groups at 3 and 6 months' follow-up. There was no statistically significant difference in HbA1c levels among individuals in groups 1 and 2 at all-time intervals., Conclusion: In the short-term, MD is effective in reducing periodontal inflammation among patients with prediabetes. The contribution of adjunct aPDT in this regard is insignificant., (Copyright © 2017. Published by Elsevier B.V.)

Background: The aim of the present systematic review and meta-analysis was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) as a therapeutic protocol for oral decontamination., Methods: In order to address the focused question: Is aPDT a useful therapeutic protocol for oral decontamination?, an electronic search without time or language restrictions was conducted up to July 2017 in indexed databases using the combination of different key words including photochemotherapy, lasers, photodynamic therapy, disinfection, mouth, saliva and oral. The exclusion criteria included reviews, case-reports, case-series, commentaries, letters to the editor, interviews, and updates. Four randomized control trials were included and processed for data extraction., Results: All studies reported that aPDT was effective in reducing the overall oral microbial load in saliva. Considering the effects of aPDT+photosensitizer (PS) compared with PS alone, there was no heterogeneity noticed for aPDT+PS (Q value=0.15, P=0.69, I 2 =0%). The overall mean difference for bacterial count in CFU/ml between aPDT+PS and PS alone was also not significant (weighted mean difference=-0.41, 95% CI=-1.12 to 0.29, p=0.24) at follow-up., Conclusion: The efficacy of aPDT for oral decontamination remains unclear. Further well-designed randomized clinical trials assessing the efficacy of aPDT reducing the oral microbial load are need., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with denture stomatitis (DS)., Methods: A questionnaire was used to gather demographic information. Clinical oral examination was performed to determine location of denture in the jaws and oral erythematous lesions. Presence of fungal hyphae in smokers and non-smokers was confirmed using exfoliative cytology. In both groups, aPDT was performed and colony forming units per milliliter (CFU/ml) were assessed im both groups at 3-months follow-up. Level of significance was et at P<0.05., Results: Twenty-two males with DS (12 smokers and 10 non-smokers) were included. The mean ages of smokers and non-smokers was 73.8±2.5 and 70.5±1.2years, respectively. The duration and daily frequency of cigarette smoking was 20.6±4.5years and 12.3±1.5 cigarettes daily, respectively. Smokers and non-smokers had been wearing complete dentures since 6.2±0.8 and 5.8±0.4years, respectively. At 3-months follow-up, there was a statistically significant decrease in the mean fungal CFU/ml among smokers (25.5±8.3 CFU/ml) compared with their respective baseline values 106.7±6.3 CFU/ml (P<0.01). Among non-smokers, the mean CFU/ml values were 12.7±0.8 CFU/ml compared with their respective baseline values (93.6±8.4 CFU/ml) (P<0.01). At 3-months follow-up, fungal CFU/ml levels were statistically significantly higher among smokers (25.5±8.3 CFU/ml) compared with non-smokers (12.7±0.8 CFU/ml) (P<0.05)., Conclusion: aPDT is effective in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with. The role of denture is also emphasized., (Copyright © 2017. Published by Elsevier B.V.)

Background: The aim of the present systematic review was to assess the efficacy of laser-assisted (low level laser therapy [LLLT], high intensity laser therapy [HILT], or antimicrobial photodynamic therapy [aPDT]) scaling and root planing (SRP) compared with SRP alone on the expression of inflammatory cytokines in the gingival crevicular (GCF) of patients with chronic periodontitis (CP)., Methods: In order to address the focused question: "What is the efficacy of SRP with and without laser and/or aPDT on the expression of pro-inflammatory cytokines in the GCF of patients with CP?" an electronic search without time or language restrictions was conducted up to and including February 2017 in indexed databases using various key words., Results: Twenty-two randomized control trials were included in the present systematic review. Nine studies and six studies assessed the efficacy of LLLT and HILT, as adjunct to SRP, respectively. Seven studies assessed the efficacy of aPDT as adjunct to SRP on down-regulating the expression of pro-inflammatory cytokines in the GCF among patients with CP. The outcomes of the studies included based upon the reduction in the levels of pro-inflammatory cytokines were inconsistent., Conclusion: The role of laser-assisted SRP on the expression of pro-inflammatory cytokines in the GCF of patients with CP remains unclear. Further long term and well-designed randomized clinical trials are needed in this regard., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: The aim was to assess the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in reducing periimplant inflammation among cigarette-smokers and non-smokers., Methods: Cigarette-smokers and non-smokers were randomly divided into 2 groups. In the test-group, participants underwent full mouth scaling and periimplant MD with adjunct aPDT; and in the control-group, the participants underwent full mouth scaling and periimplant MD alone. Periimplant bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were measured at baseline and at 6- and 12-months follow-up. Statistical analysis was performed using the Kruskal-Wallis test. P-values<0.05 were considered statistically significant., Results: Eighty-four smokers (41 patients in the test group and 43 in the control group) and 82 non-smokers (40 patients in the test group and 42 in the control group) were included. Among smokers and non-smokers, periimplant PD was significantly higher in the control-group compared with the test-group (P<0.05) at 6-months of follow-up. There was no statistically significant difference in BOP, PD and CBL among smokers and non-smokers in the test- and control-groups at 12-months of follow-up. BOP was comparable among smokers at all time intervals., Conclusion: In the short-term, MD with adjunct aPDT is more effective in reducing periimplant probing depth than MD alone in smokers and non-smokers. However, in the long-term outcomes of MD either with or without aPDT among smokers and non-smokers are comparable., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: The aim of the present review was to study the efficacy of scaling and root planing (SRP) with and without adjunct antibacterial photodynamic therapy (aPDT) on the expression of cytokines in the gingival crevicular fluid (GCF) of patients with periodontitis., Methods: In order to address the focused question: "What is the efficacy of SRP with and without aPDT on the expression of cytokines in the GCF of patients with periodontitis" an electronic search without time or language restrictions was conducted up to and including July 2016 in indexed databases using various key words. The exclusion criteria included reviews, laboratory and experimental studies, case reports, commentaries, letters to the editor, interviews, updates, studies where intervention group received aPDT without previous SRP, and studies where local delivery of antibiotics was used as adjunctive therapy to aPDT., Results: Six randomized control trials were included in the present systematic review. All studies included a control group which received only SRP. Results from 34% of studies reported lower cytokine levels among individuals receiving adjunct aPDT to SPT compared to patients receiving SRP alone. Selective cytokines reduction in the GCF following SRP with adjunct aPDT compared with SRP alone was reported in 50% of the studies. In one study SRP with adjunct aPDT failed to reduce GCF cytokine concentration., Conclusion: From the literature reviewed the efficacy aPDT as adjunct to SRP in downregulating GCF cytokines remains debatable. Further well-designed studies are needed in this regard., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: The aim of the present study was to review the pertinent literature on the effects of mechanical curettage (MC) with and without adjunct photodynamic therapy (PDT) for the management of peri-implantitis., Methods: The addressed focused question was "Is PDT effective in the treatment of peri-implantitis?" A search without language or time restrictions up to March 2016 was conducted using various key words. The exclusion criteria included; review papers, in vitro Studies, case reports, commentaries, interviews, and letters to the editors., Results: In total 9 studies were included. Among them 5 studies were clinical and 4 were experimental. All the studies used PDT as an adjunctive to MC in their test groups. The laser wavelengths used ranged from 660nm to 830nm. One study showed significant reduction of the bleeding scores, inflammatory exudates and Aggregatibacter actinomycetemcomitans count in group with PDT as an adjunctive when compared to MC and 0.2% chlorhexidine. However, in four clinical studies comparable periodontal parameters were reported when PDT is used as an adjunct to MC was compared to MC in treatment of peri-implantitis. In three experimental studies, outcomes were significantly better in group with PDT as an adjunct to MC when compared to MC alone at follow-up., Conclusion: The role of PDT as an adjunct to MC in the treatment of peri-implantitis is debatable. Further longterm randomised control trails are needed to justify the role PDT as an adjunct to MC in treatment of peri-implantitis., (Copyright © 2016. Published by Elsevier B.V.)

Objective: There are no studies that have assessed the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of periimplant inflammation in patients with type 2 diabetes mellitus (T2DM). The aim of the present 12-month follow-up study was to assess the efficacy of MD with and without adjunct aPDT in the treatment of periimplant inflammation in patients with T2DM., Methods: Sixty-seven patients with diagnosed periimplant inflammation and T2DM were included. Treatment-wise, the patients were divided into 2 groups: (a) test-group (n=34): patients receivedMD+aPDT; and (b) control group (n=33): patients received MD only. Periimplant bleeding on probing (BOP), probing depth (PD) ≥4mm and mesial and distal marginal bone loss (MBL) were measured at baseline and after 6 and 12 months of therapy in both groups. The Kruskal-Wallis test was used to compare the periimplant BOP, PD, MBL and HbA1c levels in both groups. P-values less than 0.05 were considered statistically significant., Results: Mean preoperative hemoglobin A1c (HbA1c) for patients in the control group and test group were 8.5% and 8.8%, respectively. In the control group, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in test group, there was a significant decrease (P<0.05) in HbA1c levels at 6 and 12 months of follow-up. Both PD and BOP were significantly lower in the test group compared to the control group at all follow-up durations. At 6 and 12 months of follow-up, there was no significant difference in MBL in both groups., Conclusion: In patients with T2DM, MD with adjunct aPDT is more effective in the treatment of periimplant inflammation compared with MD alone., (Copyright © 2016 Elsevier B.V. All rights reserved.)