Efficacy of photodynamic therapy on candida colonization and clinical symptoms in denture stomatitis: An updated systematic review and meta-analysis

Abstract Background: Photodynamic therapy (PDT) has recently been proposed as a promising therapeutic option for Denture Stomatitis (DS). This updated systematic review and meta-analysis investigated the current evidence regarding the efficacy of PDT for DS. Materials and methods: PubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for meta-analysis. Results: Elven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal, while three studies assessed the adjunctive use of PDT (PDT+antifungal therapy) vs. topical antifungal therapy alone. The results revealed insignificant less efficacy of PDT in comparison to topical antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13), but comparable results at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relative better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy in improvement of the clinical signs. Conclusions : PDT might be a viable option for DS as an adjunct or an alternative to the topical antifungal medications. Further studies with large sample sizes and standardized PDT parameters are warranted.