The Role of Photodynamic Therapy Mediated by Natural Photosensitisers in the Management of Peri-Implantitis: A Systematic Review
Abstract
Background: Peri-implantitis, an inflammatory condition leading to progressive bone loss around dental implants, represents a significant challenge in modern implant dentistry. Conventional mechanical debridement and adjunctive antibiotics or antiseptics often fail to fully eradicate complex biofilms and may promote antibiotic resistance. Photodynamic therapy (PDT) mediated by natural photosensitizers (e.g., curcumin, riboflavin, and 5-aminolevulinic acid) has emerged as a potential adjunctive strategy for peri-implantitis management due to its targeted antimicrobial and anti-inflammatory effects. Objectives: This systematic review aimed to evaluate the antimicrobial efficacy, clinical outcomes, and safety of PDT mediated by natural photosensitizers in the treatment of peri-implantitis and to identify optimal protocols regarding photosensitizer concentrations, light source parameters, and application techniques. Methods: Following PRISMA 2020 guidelines, databases (PubMed/Medline, Embase, Scopus, and Cochrane Library) were searched from 1 January 2015 to 3 January 2025 for English-language publications. Studies assessing naturally based PDT interventions for peri-implantitis or in vitro biofilms from diseased implant surfaces were included. Quality assessment used the Revised Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and a tailored nine-item framework for in vitro studies. Eleven studies met the inclusion criteria. Results: Despite heterogeneity in…
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