Mariana Anselmo Assunção, Filipa Passos Sousa, Leonor Assunção Marinho, João Botelho, Marc Quirynen, Nuno Taveira, Ricardo Castro Alves
A total of 30 systematic reviews were included from 198 identified records. Most reviews assessed PDT combined with mechanical debridement and reported improvements in inflammatory parameters, including probing depth, bleeding on probing, and plaque index, particularly in the short to medium term. Antimicrobial effects against peri-implant pathogens were also observed. However, heterogeneity and low methodological quality limit the certainty of evidence, despite potential short-term benefits. SORT analysis revealed a level of evidence of B-C.
INTRODUCTION/OBJECTIVES: This umbrella review aimed to summarise the available evidence from systematic reviews and meta-analyses on the effectiveness of photodynamic therapy (PDT) as an adjunct to non-surgical peri-implant therapy in the management of peri-implant diseases.
DATA AND SOURCES: A comprehensive literature search was conducted in PubMed (MEDLINE), Web of Science, CENTRAL (Cochrane), and LILACS up to August 2025, without restrictions on language or publication date. Grey literature sources were also screened.
STUDY SELECTION: Systematic reviews, with or without meta-analysis, evaluating PDT as an adjunctive therapy in human studies of peri-implant diseases were included. Study selection and data extraction were performed independently by two reviewers. Methodological quality was assessed using the AMSTAR 2 tool. Strength of Recommendation Taxonomy (SORT) was applied to evaluate the strength of the available evidence and support its clinical interpretation.
CONCLUSIONS: A total of 30 systematic reviews were included from 198 identified records. Most reviews assessed PDT combined with mechanical debridement and reported improvements in inflammatory parameters, including probing depth, bleeding on probing, and plaque index, particularly in the short to medium term. Antimicrobial effects against peri-implant pathogens were also observed. However, heterogeneity and low methodological quality limit the certainty of evidence, despite potential short-term benefits. SORT analysis revealed a level of evidence of B-C.
CLINICAL SIGNIFICANCE: Adjunctive photodynamic therapy may provide additional short-term clinical and antimicrobial benefits when used alongside non-surgical peri-implant treatment. However, due to heterogeneity and the low methodological quality of existing evidence, its routine clinical application should be interpreted with caution, reinforcing the need for standardised protocols and well-designed randomised controlled trials.