Photodiagnosis and Photodynamic Therapy 15 (2016) 191–196 Contents lists available at ScienceDirect Photodiagnosis and Photodynamic Therapy jou rn al homepage: www.elsevier.com/locate/pdpdt Review Is mechanical curettage with adjunct photodynamic therapy more effective in the treatment of peri-implantitis than mechanical curettage alone? Alexis Ghanem a,* , Sandeep Pasumarthy a , Vinisha Ranna a , Sergio Varela Kellesarian a , Tariq Abduljabbar b , Fahim Vohra b , Hans Malmstrom a a Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA b Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riaydh, Saudi Arabia a r t i c l e i n f o Article history: Received 23 May 2016 Received in revised form 15 June 2016 Accepted 22 June 2016 Available online 23 June 2016 a b s t r a c t Background: The aim of the present study was to review the pertinent literature on the effects of mechan- ical 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 660 nm to 830 nm. 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. © 2016 Published by Elsevier B.V. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2. Materials and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2.1. Focused question . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2.2. Selection criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2.3. Search strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2.4. Screening methods and data abstraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2.5. Study selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 2.6. Methodological study quality assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 3.1. General characteristics of included studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 3.2. Laser and photosensitizer related parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 3.3. Clinical studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 * Corresponding author. E-mail address: alexis ghanem@urmc.rochester.edu (A. Ghanem). http://dx.doi.org/10.1016/j.pdpdt.2016.06.007 1572-1000/© 2016 Published by Elsevier B.V.