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<!DOCTYPE html> <html lang="en" dir="ltr" xmlns="http://www.w3.org/1999/xhtml" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head prefix="og: http://ogp.me/ns# article: http://ogp.me/ns/article# book: http://ogp.me/ns/book#" >  <link rel="dns-prefetch" href="//d33xdlntwy0kbs.cloudfront.net" /> <link rel="dns-prefetch" href="//cdn.jsdelivr.net" /> <link rel="dns-prefetch" href="//www.google.com" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <link rel="dns-prefetch" href="//www.googletagmanager.com" /> <link rel="dns-prefetch" href="//rum-static.pingdom.net" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://www.medrxiv.org/sites/default/files/images/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <meta name="type" content="article" /> <meta name="category" content="article" /> <meta name="HW.identifier" content="/medrxiv/early/2024/09/22/2024.09.19.24313953.atom" /> <meta name="HW.pisa" content="medrxiv;2024.09.19.24313953v1" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Effectiveness of Antimicrobial Photodynamic Therapy Versus Doxycycline in the Treatment of Periodontitis on Glycaemic Control and Periodontal Parameters in Adults with Type 2 Diabetes Mellitus" /> <meta name="DC.Identifier" content="10.1101/2024.09.19.24313953" /> <meta name="DC.Date" content="2024-09-22" /> <meta name="DC.Publisher" content="Cold Spring Harbor Laboratory Press" /> <meta name="DC.Rights" content="© 2024, Posted by Cold Spring Harbor Laboratory. This pre-print is available under a Creative Commons License (Attribution-NoDerivs 4.0 International), CC BY-ND 4.0, as described at http://creativecommons.org/licenses/by-nd/4.0/" /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="Background This meta-analysis aimed to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with systemic doxycycline, as adjunctive treatments to scaling and root planing (SRP) for treating periodontitis in patients with type 2 diabetes mellitus (T2DM). Methods A search across electronic databases including PubMed, Scopus, CENTRAL, OVID EMBASE and OVID MEDLINE was carried out to identify relevant randomised controlled trials (RCTs), comparing aPDT or doxycycline combined with SRP, versus SRP alone. Data were pooled using random-effects models and indirect comparisons were retrieved using the Chi2 test for subgroup differences, to assess the impact of these treatments on glycated haemoglobin (HbA1c), probing depth (PD), and clinical attachment level (CAL). Results Eight RCTs were included. aPDT with SRP showed a significant reduction in probing depth compared to doxycycline (MD = -0.55 mm, 95% CI: -1.03 to -0.07; p = 0.02). A significant difference between the two subgroups was found (p = 0.04), suggesting aPDT was more effective. No significant differences were found for HbA1c or CAL between the two interventions. Conclusions The findings suggest that aPDT may offer greater benefits for the treatment of periodontitis in T2DM patients. This suggests that aPDT could potentially be a non-antibiotic alternative to doxycycline. However, as neither treatment influenced HbA1c, clinicians should not rely on periodontal therapy for glycaemic control. Layperson summary People with type 2 diabetes have a higher risk of getting gum disease because their bodies can’t manage blood sugar levels well. When people with type 2 diabetes get gum disease, the swelling in their gums makes it even harder to control their blood sugar levels, making their diabetes worse. Type 2 diabetics sometimes don’t respond well to regular gum treatments so dentists will also give them antibiotics to treat the gum disease. But when antibiotics are used too often, they can stop working. This is called antibiotic resistance and it’s a big problem in healthcare. Therefore, this study wanted to test if adding a special light therapy to regular gum treatments could replace using antibiotics. The results from this study found that the light therapy was better at healing parts of the gums compared to antibiotics. However, neither treatment made a big difference in blood sugar levels. This is important because it means that the light therapy could replace antibiotics for treating gum disease, reducing the problem of antibiotic resistance. However, more research is needed to see if these treatments could have any beneficial effect on blood sugar levels. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The source data were widely available before carrying out the study. The data used in the meta analysis were extracted from eight RCTs available on various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data used in the meta analysis were extracted from various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE. <https://doi.org/10.1902/jop.2009.090206> <https://doi.org/10.1016/j.pdpdt.2018.04.013> <https://doi.org/10.1016/j.pdpdt.2019.08.003> [https://doi.org/10.4103/jisp.jisp\_7\_23][1] <https://doi.org/10.5005/jp-journals-10024-2722> <https://doi.org/10.1902/jop.2008.070250> <https://doi.org/10.1111/jcpe.12287> <https://doi.org/10.4103/0973-3930.43097> [1]: https://doi.org/10.4103/jisp.jisp_7_23" /> <meta name="DC.Contributor" content="Maisie Abbott" /> <meta name="DC.Contributor" content="Louise Mackenzie" /> <meta name="article:published_time" content="2024-09-22" /> <meta name="citation_title" content="Effectiveness of Antimicrobial Photodynamic Therapy Versus Doxycycline in the Treatment of Periodontitis on Glycaemic Control and Periodontal Parameters in Adults with Type 2 Diabetes Mellitus" /> <meta name="citation_abstract" lang="en" content="<h3>Abstract</h3> <h3>Background</h3> <p>This meta-analysis aimed to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with systemic doxycycline, as adjunctive treatments to scaling and root planing (SRP) for treating periodontitis in patients with type 2 diabetes mellitus (T2DM).</p><h3>Methods</h3> <p>A search across electronic databases including PubMed, Scopus, CENTRAL, OVID EMBASE and OVID MEDLINE was carried out to identify relevant randomised controlled trials (RCTs), comparing aPDT or doxycycline combined with SRP, versus SRP alone. Data were pooled using random-effects models and indirect comparisons were retrieved using the Chi2 test for subgroup differences, to assess the impact of these treatments on glycated haemoglobin (HbA1c), probing depth (PD), and clinical attachment level (CAL).</p><h3>Results</h3> <p>Eight RCTs were included. aPDT with SRP showed a significant reduction in probing depth compared to doxycycline (MD = -0.55 mm, 95% CI: -1.03 to -0.07; p = 0.02). A significant difference between the two subgroups was found (p = 0.04), suggesting aPDT was more effective. No significant differences were found for HbA1c or CAL between the two interventions.</p><h3>Conclusions</h3> <p>The findings suggest that aPDT may offer greater benefits for the treatment of periodontitis in T2DM patients. This suggests that aPDT could potentially be a non-antibiotic alternative to doxycycline. However, as neither treatment influenced HbA1c, clinicians should not rely on periodontal therapy for glycaemic control.</p><h3>Layperson summary</h3> <p>People with type 2 diabetes have a higher risk of getting gum disease because their bodies can’t manage blood sugar levels well. When people with type 2 diabetes get gum disease, the swelling in their gums makes it even harder to control their blood sugar levels, making their diabetes worse. Type 2 diabetics sometimes don’t respond well to regular gum treatments so dentists will also give them antibiotics to treat the gum disease. But when antibiotics are used too often, they can stop working. This is called antibiotic resistance and it’s a big problem in healthcare. Therefore, this study wanted to test if adding a special light therapy to regular gum treatments could replace using antibiotics. The results from this study found that the light therapy was better at healing parts of the gums compared to antibiotics. However, neither treatment made a big difference in blood sugar levels. This is important because it means that the light therapy could replace antibiotics for treating gum disease, reducing the problem of antibiotic resistance. However, more research is needed to see if these treatments could have any beneficial effect on blood sugar levels.</p>" /> <meta name="citation_journal_title" content="medRxiv" /> <meta name="citation_publisher" content="Cold Spring Harbor Laboratory Press" /> <meta name="citation_publication_date" content="2024/01/01" /> <meta name="citation_mjid" content="medrxiv;2024.09.19.24313953v1" /> <meta name="citation_id" content="2024.09.19.24313953v1" /> <meta name="citation_public_url" content="https://www.medrxiv.org/content/10.1101/2024.09.19.24313953v1" /> <meta name="citation_abstract_html_url" content="https://www.medrxiv.org/content/10.1101/2024.09.19.24313953v1.abstract" /> <meta name="citation_full_html_url" content="https://www.medrxiv.org/content/10.1101/2024.09.19.24313953v1.full" /> <meta name="citation_pdf_url" content="https://www.medrxiv.org/content/medrxiv/early/2024/09/22/2024.09.19.24313953.full.pdf" /> <meta name="citation_doi" content="10.1101/2024.09.19.24313953" /> <meta name="citation_num_pages" content="42" /> <meta name="citation_article_type" content="Article" /> <meta name="citation_firstpage" content="2024.09.19.24313953" /> <meta name="citation_author" content="Maisie Abbott" /> <meta name="citation_author_institution" content="University of Brighton" /> <meta name="citation_author_email" content="maisieellaabbott@gmail.com" /> <meta name="citation_author" content="Louise Mackenzie" /> <meta name="citation_author_institution" content="University of Brighton" /> <meta name="citation_reference" content="Abduljabbar, T., Vohra, F., Javed, F. and Akram, Z. 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Frontiers in Microbiology, 8. 10.3389/fmicb.2017.02144." /> <meta name="twitter:title" content="Effectiveness of Antimicrobial Photodynamic Therapy Versus Doxycycline in the Treatment of Periodontitis on Glycaemic Control and Periodontal Parameters in Adults with Type 2 Diabetes Mellitus" /> <meta name="twitter:site" content="@medrxivpreprint" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:image" content="https://www.medrxiv.org/sites/default/files/images/medrxiv_logo_homepage7-5-small-test-up.png" /> <meta name="twitter:description" content="Background This meta-analysis aimed to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with systemic doxycycline, as adjunctive treatments to scaling and root planing (SRP) for treating periodontitis in patients with type 2 diabetes mellitus (T2DM). Methods A search across electronic databases including PubMed, Scopus, CENTRAL, OVID EMBASE and OVID MEDLINE was carried out to identify relevant randomised controlled trials (RCTs), comparing aPDT or doxycycline combined with SRP, versus SRP alone. Data were pooled using random-effects models and indirect comparisons were retrieved using the Chi2 test for subgroup differences, to assess the impact of these treatments on glycated haemoglobin (HbA1c), probing depth (PD), and clinical attachment level (CAL). Results Eight RCTs were included. aPDT with SRP showed a significant reduction in probing depth compared to doxycycline (MD = -0.55 mm, 95% CI: -1.03 to -0.07; p = 0.02). A significant difference between the two subgroups was found (p = 0.04), suggesting aPDT was more effective. No significant differences were found for HbA1c or CAL between the two interventions. Conclusions The findings suggest that aPDT may offer greater benefits for the treatment of periodontitis in T2DM patients. This suggests that aPDT could potentially be a non-antibiotic alternative to doxycycline. However, as neither treatment influenced HbA1c, clinicians should not rely on periodontal therapy for glycaemic control. Layperson summary People with type 2 diabetes have a higher risk of getting gum disease because their bodies can’t manage blood sugar levels well. When people with type 2 diabetes get gum disease, the swelling in their gums makes it even harder to control their blood sugar levels, making their diabetes worse. Type 2 diabetics sometimes don’t respond well to regular gum treatments so dentists will also give them antibiotics to treat the gum disease. But when antibiotics are used too often, they can stop working. This is called antibiotic resistance and it’s a big problem in healthcare. Therefore, this study wanted to test if adding a special light therapy to regular gum treatments could replace using antibiotics. The results from this study found that the light therapy was better at healing parts of the gums compared to antibiotics. However, neither treatment made a big difference in blood sugar levels. This is important because it means that the light therapy could replace antibiotics for treating gum disease, reducing the problem of antibiotic resistance. However, more research is needed to see if these treatments could have any beneficial effect on blood sugar levels. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The source data were widely available before carrying out the study. The data used in the meta analysis were extracted from eight RCTs available on various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data used in the meta analysis were extracted from various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE. <https://doi.org/10.1902/jop.2009.090206> <https://doi.org/10.1016/j.pdpdt.2018.04.013> <https://doi.org/10.1016/j.pdpdt.2019.08.003> [https://doi.org/10.4103/jisp.jisp\_7\_23][1] <https://doi.org/10.5005/jp-journals-10024-2722> <https://doi.org/10.1902/jop.2008.070250> <https://doi.org/10.1111/jcpe.12287> <https://doi.org/10.4103/0973-3930.43097> [1]: https://doi.org/10.4103/jisp.jisp_7_23" /> <meta name="og-title" property="og:title" content="Effectiveness of Antimicrobial Photodynamic Therapy Versus Doxycycline in the Treatment of Periodontitis on Glycaemic Control and Periodontal Parameters in Adults with Type 2 Diabetes Mellitus" /> <meta name="og-url" property="og:url" content="https://www.medrxiv.org/content/10.1101/2024.09.19.24313953v1" /> <meta name="og-site-name" property="og:site_name" content="medRxiv" /> <meta name="og-description" property="og:description" content="Background This meta-analysis aimed to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with systemic doxycycline, as adjunctive treatments to scaling and root planing (SRP) for treating periodontitis in patients with type 2 diabetes mellitus (T2DM). Methods A search across electronic databases including PubMed, Scopus, CENTRAL, OVID EMBASE and OVID MEDLINE was carried out to identify relevant randomised controlled trials (RCTs), comparing aPDT or doxycycline combined with SRP, versus SRP alone. Data were pooled using random-effects models and indirect comparisons were retrieved using the Chi2 test for subgroup differences, to assess the impact of these treatments on glycated haemoglobin (HbA1c), probing depth (PD), and clinical attachment level (CAL). Results Eight RCTs were included. aPDT with SRP showed a significant reduction in probing depth compared to doxycycline (MD = -0.55 mm, 95% CI: -1.03 to -0.07; p = 0.02). A significant difference between the two subgroups was found (p = 0.04), suggesting aPDT was more effective. No significant differences were found for HbA1c or CAL between the two interventions. Conclusions The findings suggest that aPDT may offer greater benefits for the treatment of periodontitis in T2DM patients. This suggests that aPDT could potentially be a non-antibiotic alternative to doxycycline. However, as neither treatment influenced HbA1c, clinicians should not rely on periodontal therapy for glycaemic control. Layperson summary People with type 2 diabetes have a higher risk of getting gum disease because their bodies can’t manage blood sugar levels well. When people with type 2 diabetes get gum disease, the swelling in their gums makes it even harder to control their blood sugar levels, making their diabetes worse. Type 2 diabetics sometimes don’t respond well to regular gum treatments so dentists will also give them antibiotics to treat the gum disease. But when antibiotics are used too often, they can stop working. This is called antibiotic resistance and it’s a big problem in healthcare. Therefore, this study wanted to test if adding a special light therapy to regular gum treatments could replace using antibiotics. The results from this study found that the light therapy was better at healing parts of the gums compared to antibiotics. However, neither treatment made a big difference in blood sugar levels. This is important because it means that the light therapy could replace antibiotics for treating gum disease, reducing the problem of antibiotic resistance. However, more research is needed to see if these treatments could have any beneficial effect on blood sugar levels. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The source data were widely available before carrying out the study. The data used in the meta analysis were extracted from eight RCTs available on various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data used in the meta analysis were extracted from various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE. <https://doi.org/10.1902/jop.2009.090206> <https://doi.org/10.1016/j.pdpdt.2018.04.013> <https://doi.org/10.1016/j.pdpdt.2019.08.003> [https://doi.org/10.4103/jisp.jisp\_7\_23][1] <https://doi.org/10.5005/jp-journals-10024-2722> <https://doi.org/10.1902/jop.2008.070250> <https://doi.org/10.1111/jcpe.12287> <https://doi.org/10.4103/0973-3930.43097> [1]: https://doi.org/10.4103/jisp.jisp_7_23" /> <meta name="og-type" property="og:type" content="article" /> <meta name="og-image" property="og:image" content="https://www.medrxiv.org/sites/default/files/images/medrxiv_logo_homepage7-5-small-test-up.png" /> <meta name="citation_date" content="2024-09-22" /> <link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/10.1101/2024.09.19.24313953v1.full.txt" /> <link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" 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data-apath="/medrxiv/early/2024/09/22/2024.09.19.24313953.atom" data-hw-author-tooltip-instance=""><div class="highwire-cite highwire-cite-highwire-article highwire-citation-medrxiv-article-top clearfix has-author-tooltip" > <h1 class="highwire-cite-title" id="page-title">Effectiveness of Antimicrobial Photodynamic Therapy Versus Doxycycline in the Treatment of Periodontitis on Glycaemic Control and Periodontal Parameters in Adults with Type 2 Diabetes Mellitus</h1> <div class="highwire-cite-authors" ><span class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Maisie</span> <span class="nlm-surname">Abbott</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Louise</span> <span class="nlm-surname">Mackenzie</span></span></span></div> <div class="highwire-cite-metadata" ><span class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">doi:</span> https://doi.org/10.1101/2024.09.19.24313953 </span></div> </div> <div id="hw-article-author-popups-node-870384--21289598137" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Maisie Abbott </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>1</span><span class='nlm-institution'>University of Brighton</span>, Mithras House, Lewes Road, Brighton, BN2 4AT</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Maisie%2BAbbott%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Abbott%20M&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AMaisie%2BAbbott%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-corresp-email-link last"><span>For correspondence: <a href="mailto:maisieellaabbott@gmail.com" class="" data-icon-position="" data-hide-link-title="0">maisieellaabbott@gmail.com</a></span></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Louise Mackenzie </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>1</span><span class='nlm-institution'>University of Brighton</span>, Mithras House, Lewes Road, Brighton, BN2 4AT</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Louise%2BMackenzie%2B" target="_blank" class="" 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data-entity-context="node:870384" data-trigger="full.pdf+html" data-url-enabled="1"><i class="icon-file-alt"></i> Preview PDF</a><a href="/panels_ajax_tab/biorxiv_tab_pdf/node:870384/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li></ul></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="biorxiv_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://www.medrxiv.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-biorxiv_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2 class="">Abstract</h2><div id="sec-1" class="subsection"><p id="p-2"><strong>Background</strong> This meta-analysis aimed to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with systemic doxycycline, as adjunctive treatments to scaling and root planing (SRP) for treating periodontitis in patients with type 2 diabetes mellitus (T2DM).</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>Methods</strong> A search across electronic databases including PubMed, Scopus, CENTRAL, OVID EMBASE and OVID MEDLINE was carried out to identify relevant randomised controlled trials (RCTs), comparing aPDT or doxycycline combined with SRP, versus SRP alone. Data were pooled using random-effects models and indirect comparisons were retrieved using the Chi2 test for subgroup differences, to assess the impact of these treatments on glycated haemoglobin (HbA1c), probing depth (PD), and clinical attachment level (CAL).</p></div><div id="sec-3" class="subsection"><p id="p-4"><strong>Results</strong> Eight RCTs were included. aPDT with SRP showed a significant reduction in probing depth compared to doxycycline (MD = -0.55 mm, 95% CI: -1.03 to -0.07; p = 0.02). A significant difference between the two subgroups was found (p = 0.04), suggesting aPDT was more effective. No significant differences were found for HbA1c or CAL between the two interventions.</p></div><div id="sec-4" class="subsection"><p id="p-5"><strong>Conclusions</strong> The findings suggest that aPDT may offer greater benefits for the treatment of periodontitis in T2DM patients. This suggests that aPDT could potentially be a non-antibiotic alternative to doxycycline. However, as neither treatment influenced HbA1c, clinicians should not rely on periodontal therapy for glycaemic control.</p></div><div id="sec-5" class="subsection"><p id="p-6"><strong>Layperson summary</strong> People with type 2 diabetes have a higher risk of getting gum disease because their bodies can’t manage blood sugar levels well. When people with type 2 diabetes get gum disease, the swelling in their gums makes it even harder to control their blood sugar levels, making their diabetes worse. Type 2 diabetics sometimes don’t respond well to regular gum treatments so dentists will also give them antibiotics to treat the gum disease. But when antibiotics are used too often, they can stop working. This is called antibiotic resistance and it’s a big problem in healthcare. Therefore, this study wanted to test if adding a special light therapy to regular gum treatments could replace using antibiotics. The results from this study found that the light therapy was better at healing parts of the gums compared to antibiotics. However, neither treatment made a big difference in blood sugar levels. This is important because it means that the light therapy could replace antibiotics for treating gum disease, reducing the problem of antibiotic resistance. However, more research is needed to see if these treatments could have any beneficial effect on blood sugar levels.</p></div></div><h3>Competing Interest Statement</h3><p id="p-7">The authors have declared no competing interest.</p><h3>Funding Statement</h3><p id="p-8">This study did not receive any funding</p><h3>Author Declarations</h3><p id="p-9">I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.</p><p id="p-10">Yes</p><p id="p-11">The details of the IRB/oversight body that provided approval or exemption for the research described are given below:</p><p id="p-12">The source data were widely available before carrying out the study.</p><p id="p-13">The data used in the meta analysis were extracted from eight RCTs available on various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE.</p><p id="p-14">I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.</p><p id="p-15">Yes</p><p id="p-16">I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).</p><p id="p-17">Yes</p><p id="p-18">I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.</p><p id="p-19">Yes</p><div class="section data-availability" id="sec-45"><h2 class="">Data Availability</h2><p id="p-82">The data used in the meta analysis were extracted from various electronic databases including PubMed Scopus CENTRAL Embase and MEDLINE.</p><p id="p-83"> <a href="https://doi.org/10.1902/jop.2009.090206">https://doi.org/10.1902/jop.2009.090206</a> </p><p id="p-84"> <a href="https://doi.org/10.1016/j.pdpdt.2018.04.013">https://doi.org/10.1016/j.pdpdt.2018.04.013</a> </p><p id="p-85"> <a href="https://doi.org/10.1016/j.pdpdt.2019.08.003">https://doi.org/10.1016/j.pdpdt.2019.08.003</a> </p><p id="p-86"> <a href="https://doi.org/10.4103/jisp.jisp_7_23">https://doi.org/10.4103/jisp.jisp_7_23</a> </p><p id="p-87"> <a href="https://doi.org/10.5005/jp-journals-10024-2722">https://doi.org/10.5005/jp-journals-10024-2722</a> </p><p id="p-88"> <a href="https://doi.org/10.1902/jop.2008.070250">https://doi.org/10.1902/jop.2008.070250</a> </p><p id="p-89"> <a href="https://doi.org/10.1111/jcpe.12287">https://doi.org/10.1111/jcpe.12287</a> </p><p id="p-90"> <a href="https://doi.org/10.4103/0973-3930.43097">https://doi.org/10.4103/0973-3930.43097</a> </p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-biorxiv-copyright" > <div class="pane-content"> <div class="field field-name-field-highwire-copyright field-type-text 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class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/allergy-and-immunology" class="" data-icon-position="" data-hide-link-title="0">Allergy and Immunology</a> <span class = "article-count">(701)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/anesthesia" class="" data-icon-position="" data-hide-link-title="0">Anesthesia</a> <span class = "article-count">(193)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/cardiovascular-medicine" class="" data-icon-position="" data-hide-link-title="0">Cardiovascular Medicine</a> <span class = "article-count">(2859)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/dentistry-and-oral-medicine" class="" data-icon-position="" data-hide-link-title="0">Dentistry and Oral Medicine</a> <span class = "article-count">(326)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/dermatology" class="" data-icon-position="" data-hide-link-title="0">Dermatology</a> <span class = "article-count">(244)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/emergency-medicine" class="" data-icon-position="" data-hide-link-title="0">Emergency Medicine</a> <span class = "article-count">(431)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/endocrinology-including-diabetes-mellitus-and-metabolic-disease" class="" data-icon-position="" data-hide-link-title="0">Endocrinology (including Diabetes Mellitus and Metabolic Disease)</a> <span class = "article-count">(1011)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/epidemiology" class="" data-icon-position="" data-hide-link-title="0">Epidemiology</a> <span class = "article-count">(12569)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/forensic-medicine" class="" data-icon-position="" data-hide-link-title="0">Forensic Medicine</a> <span class = "article-count">(10)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/gastroenterology" class="" data-icon-position="" data-hide-link-title="0">Gastroenterology</a> <span class = "article-count">(807)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/genetic-and-genomic-medicine" class="" data-icon-position="" data-hide-link-title="0">Genetic and Genomic Medicine</a> <span class = "article-count">(4447)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/geriatric-medicine" class="" data-icon-position="" data-hide-link-title="0">Geriatric Medicine</a> <span class = "article-count">(402)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/health-economics" class="" data-icon-position="" data-hide-link-title="0">Health Economics</a> <span class = "article-count">(716)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/health-informatics" class="" data-icon-position="" data-hide-link-title="0">Health Informatics</a> <span class = "article-count">(2856)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/health-policy" class="" data-icon-position="" data-hide-link-title="0">Health Policy</a> <span class = "article-count">(1050)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/health-systems-and-quality-improvement" class="" data-icon-position="" data-hide-link-title="0">Health Systems and Quality Improvement</a> <span class = "article-count">(1050)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/hematology" class="" data-icon-position="" data-hide-link-title="0">Hematology</a> <span class = "article-count">(376)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/hiv-aids" class="" data-icon-position="" data-hide-link-title="0">HIV/AIDS</a> <span class = "article-count">(893)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/infectious_diseases" class="" data-icon-position="" data-hide-link-title="0">Infectious Diseases (except HIV/AIDS)</a> <span class = "article-count">(13986)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/intensive-care-and-critical-care-medicine" class="" data-icon-position="" data-hide-link-title="0">Intensive Care and Critical Care Medicine</a> <span class = "article-count">(831)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/medical-education" class="" data-icon-position="" data-hide-link-title="0">Medical Education</a> <span class = "article-count">(415)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/medical-ethics" class="" data-icon-position="" data-hide-link-title="0">Medical Ethics</a> <span class = "article-count">(114)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/nephrology" class="" data-icon-position="" data-hide-link-title="0">Nephrology</a> <span class = "article-count">(464)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/neurology" class="" data-icon-position="" data-hide-link-title="0">Neurology</a> <span class = "article-count">(4201)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/nursing" class="" data-icon-position="" data-hide-link-title="0">Nursing</a> <span class = "article-count">(223)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/nutrition" class="" data-icon-position="" data-hide-link-title="0">Nutrition</a> <span class = "article-count">(617)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/obstetrics-and-gynecology" class="" data-icon-position="" data-hide-link-title="0">Obstetrics and Gynecology</a> <span class = "article-count">(788)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/occupational-and-environmental-health" class="" data-icon-position="" data-hide-link-title="0">Occupational and Environmental Health</a> <span class = "article-count">(723)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/oncology" class="" data-icon-position="" data-hide-link-title="0">Oncology</a> <span class = "article-count">(2205)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/ophthalmology" class="" data-icon-position="" data-hide-link-title="0">Ophthalmology</a> <span class = "article-count">(626)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/orthopedics" class="" data-icon-position="" data-hide-link-title="0">Orthopedics</a> <span class = "article-count">(254)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/otolaryngology" class="" data-icon-position="" data-hide-link-title="0">Otolaryngology</a> <span class = "article-count">(319)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/pain-medicine" class="" data-icon-position="" data-hide-link-title="0">Pain Medicine</a> <span class = "article-count">(269)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/palliative-medicine" class="" data-icon-position="" data-hide-link-title="0">Palliative Medicine</a> <span class = "article-count">(83)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/pathology" class="" data-icon-position="" data-hide-link-title="0">Pathology</a> <span class = "article-count">(488)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/pediatrics" class="" data-icon-position="" data-hide-link-title="0">Pediatrics</a> <span class = "article-count">(1172)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/pharmacology-and-therapeutics" class="" data-icon-position="" data-hide-link-title="0">Pharmacology and Therapeutics</a> <span class = "article-count">(489)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/primary-care-research" class="" data-icon-position="" data-hide-link-title="0">Primary Care Research</a> <span class = "article-count">(483)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/psychiatry-and-clinical-psychology" class="" data-icon-position="" data-hide-link-title="0">Psychiatry and Clinical Psychology</a> <span class = "article-count">(3658)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/public-and-global-health" class="" data-icon-position="" data-hide-link-title="0">Public and Global Health</a> <span class = "article-count">(6787)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/radiology-and-imaging" class="" data-icon-position="" data-hide-link-title="0">Radiology and Imaging</a> <span class = "article-count">(1494)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/rehabilitation-medicine-and-physical-therapy" class="" data-icon-position="" data-hide-link-title="0">Rehabilitation Medicine and Physical Therapy</a> <span class = "article-count">(869)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/respiratory-medicine" class="" data-icon-position="" data-hide-link-title="0">Respiratory Medicine</a> <span class = "article-count">(902)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/rheumatology" class="" data-icon-position="" data-hide-link-title="0">Rheumatology</a> <span class = "article-count">(430)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/sexual-and-reproductive-health" class="" data-icon-position="" data-hide-link-title="0">Sexual and Reproductive Health</a> <span class = "article-count">(433)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/sports-medicine" class="" data-icon-position="" data-hide-link-title="0">Sports Medicine</a> <span class = "article-count">(369)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/surgery" class="" data-icon-position="" data-hide-link-title="0">Surgery</a> <span class = "article-count">(473)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/toxicology" class="" data-icon-position="" data-hide-link-title="0">Toxicology</a> <span class = "article-count">(57)</span></div></li> <li class="outer collection depth-2 child"><div class = "data-wrapper"><a href="/collection/transplantation" class="" data-icon-position="" data-hide-link-title="0">Transplantation</a> <span class = "article-count">(202)</span></div></li> <li class="outer collection depth-2 child last"><div class = "data-wrapper"><a href="/collection/urology" class="" data-icon-position="" data-hide-link-title="0">Urology</a> <span class = "article-count">(174)</span></div></li> </ul> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div> </section> </div> <div class="region region-page-bottom" id="region-page-bottom"> <div class="region-inner region-page-bottom-inner"> </div> </div><script type="text/javascript" src="https://www.medrxiv.org/sites/default/files/advagg_js/js__Vh5BcRYb6VtLoN3uam6O4DIKltYUVMjVDWtakoysPq0__Wed8jsPTirEozek7dWSCS8970Cp7a9xKKgFk6FPuSVM__EJK5Ll7b5lGK3vCcC61vJSpnnlwWCn8d6_LJW7hCX3M.js"></script> 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