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Treatment of oral fungal infections using photodynamic therapy: Systematic review and meta-analysis
Imaan Amina Roomaney1, Haly Karen Holmes2, Mark M Engel3
1Faculty of Dentistry, Department of Craniofacial Biology, University of the Western Cape, Tygerberg, South Africa.
Objectives:
This systematic review evaluated the evidence for the effectiveness of Photodynamic therapy (PDT) in treating oral fungal infections, as an alternative to conventional antifungal medications.
Methods:
Five randomized control trials (168 participants) comparing the treatment of oral fungal infections using met with our inclusion criteria. Clinical and microbiological improvement was assessed by random-effects meta-analysis. Methodological quality assessment and heterogeneity were performed using peer-reviewed criteria. PROSPERO registration: CRD42017076.
Results:
PDT showed statistically non-significant increased clinical efficacy (risk ratio (RR) = 1.47 [95% confidence interval (CI), 0.68; 3.17]; three studies, n = 108 participants, I2 = 50%) and mycological efficacy (mean difference (MD) = 0.54 [95%CI, -0.71; 1.79]; three studies, n = 100; I2 = 39%) at 30 days, as compared with conventional antifungal therapy. Lack of standardization of treatment parameters and variability in the assessment of outcomes was observed across the studies. All included studies had a moderate to low risk of bias.
Conclusions:
PDT showed comparable effectiveness at treating oral fungal infections, particularly denture stomatitis. The small number of studies in this review, small sample size and variability of methods and outcome measures across studies, highlight the need for more standardized studies with longer follow-up periods to enable recommendation of PDT as an alternative to conventional antifungal therapy.
Insights
Photodynamic therapy (PDT) shows comparable effectiveness to conventional treatments for oral fungal infections. Further standardized research is needed to recommend PDT as a primary alternative therapy.
Area of Science:
- Oral medicine
- Dermatology
- Photomedicine
Background:
- Oral fungal infections are common, often treated with conventional antifungal medications.
- Photodynamic therapy (PDT) presents a potential alternative treatment modality.
Purpose of the Study:
- To systematically review and evaluate the effectiveness of PDT for oral fungal infections compared to standard antifungal treatments.
Main Methods:
- A systematic review and meta-analysis of five randomized controlled trials involving 168 participants.
- Assessed clinical and microbiological improvement, methodological quality, and heterogeneity.
Main Results:
- PDT demonstrated statistically non-significant increases in clinical and mycological efficacy at 30 days compared to conventional therapy.
- Observed lack of standardization in treatment parameters and outcome assessment across studies.
Conclusions:
- PDT appears comparable in effectiveness for oral fungal infections, especially denture stomatitis.
- Need for more standardized studies with longer follow-up to recommend PDT as an alternative.
