Using Spirulina as an adjuvant to the treatment of Periodontitis: a systematic review of clinical trials

Abstract

<title>Abstract</title> <bold>Background: </bold>This study aims to assess the clinical effectiveness of spirulina as an adjuvant to non-surgical periodontal therapy (NSPT) in contrast with the use of NSPT alone for the treatment of periodontitis. <bold>Method: </bold>A systematic search was conducted in MEDLINE, EMBASE, Scopus, Central Cochrane Library, Scielo, Epistemonikos, and Google Scholar databases until April, 1st 2022. Adults with periodontitis who received NSPT were included. The intervention group consisted of subjects that were administered spirulina as an adjuvant to NSPT; the control group received NSPT alone. The search terms included randomized controlled clinical trials (RCT), with no language restrictions, and the following clinical periodontal parameters were established as primary change results: bleeding on probing index, probing depth, clinical attachment levels and gingival index. The risk of bias (RoB) was assessed by the RoB-2 tool. The mean differences were calculated and grouped through a meta-analysis, by using a random effects model. <bold>Results: </bold>The risk of bias in the selected articles varied from “serious” to “very serious”. It was detected that there was a higher reduction in probing depth stemming from the use of spirulina as an adjuvant to NSPT, as compared with the probing depth values seen when receiving NSPT alone. <bold>Conclusion: </bold>The evidence on the reduction of probing depth experienced by those participants who were treated with spirulina as an adjuvant to NSPT, compared to the one observed in those receiving NSPT alone, is weak. However, its clinical relevance can be argued upon given the scarce number of articles with high certainty and the high heterogeneity of the studies analyzed. <bold>Systematic Review Registration: </bold>The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the reference number CRD42022318265.