Effect of 808 nm Semiconductor Laser on the Stability of Orthodontic Micro-Implants: A Split-Mouth Study

Comparative efficacy of photobiomodulation on osseointegration in dental implants: A systematic review and meta-analysis

AIM

This study aimed to assess the effectiveness of photobiomodulation therapy (PBM) in enhancing bone integration with dental implants.

METHOD

PubMed, ScienceDirect, the Cochrane Library, Scopus, and Google Scholar were searched. Studies assessing PBM effectiveness with defined intervention/control groups were included, while those lacking specified laser types, involving severe maxillofacial defects or surgery, and not reporting outcomes related to dental implant osseointegration post-PBM therapy were excluded. The studies' risk of bias was assessed using Robvis for randomized controlled trials (RCTs) and ROBINS-I for non-RCTs. The meta-analysis was conducted utilizing a random-effects model at a significance level of 0.01.

RESULTS

The study reviewed 26 papers involving 571 patients undergoing dental implant procedures with PBM/Low-Level Laser Therapy (LLLT) or placebo/control. Implant stability quotients (ISQ) analysis showed a non-significant difference (p = 0.06, mean difference: 1.02, 95 % CI: 0.28 to 1.75, I2=28 %), while the Periotest method indicated significant improvement in stability (p < 0.01, mean difference: -0.51, 95 % CI: -0.78 to -0.24, I2=71 %). PBM resulted in a significant bone density increase (p < 0.01, mean difference: 26, 95 % CI: 6.93 to 45.06, I2=91 %), but marginal bone loss showed no significant difference (p = 0.11, mean difference: 0.00, 95 % CI: -0.06 to 0.05, I2=45 %). Implant survival rate did not significantly differ (p = 0.73, mean difference: 1.56, 95 % CI: 0.38 to 6.46, I2=0 %). Most studies raised concerns regarding randomization.

CONCLUSION

PBM could improve implant stability, as assessed with Periotest, and increase bone density, enhancing osseointegration. However, implant stability assessed with ISQ, marginal bone loss, and implant survival rate were comparable between the study groups.

Surface Functionalization of Titanium-Based Implants with a Nanohydroxyapatite Layer and Its Impact on Osteoblasts: A Systematic Review

This study aims to evaluate the influence of a nanohydroxyapatite layer applied to the surface of titanium or titanium alloy implants on the intricate process of osseointegration and its effect on osteoblast cell lines, compared to uncoated implants. Additionally, the investigation scrutinizes various modifications of the coating and their consequential effects on bone and cell line biocompatibility. On the specific date of November 2023, an exhaustive electronic search was conducted in esteemed databases such as PubMed, Web of Science, and Scopus, utilizing the meticulously chosen keywords ((titanium) AND ((osteoblasts) and hydroxyapatite)). Methodologically, the systematic review meticulously adhered to the PRISMA protocol. Initially, a total of 1739 studies underwent scrutiny, with the elimination of 741 duplicate records. A further 972 articles were excluded on account of their incongruence with the predefined subjects. The ultimate compilation embraced 26 studies, with a predominant focus on the effects of nanohydroxyapatite coating in isolation. However, a subset of nine papers delved into the nuanced realm of its modifiers, encompassing materials such as chitosan, collagen, silver particles, or gelatine. Across many of the selected studies, the application of nanohydroxyapatite coating exhibited a proclivity to enhance the osseointegration process. The modifications thereof showcased a positive influence on cell lines, manifesting in increased cellular spread or the attenuation of bacterial activity. In clinical applications, this augmentation potentially translates into heightened implant stability, thereby amplifying the overall procedural success rate. This, in turn, renders nanohydroxyapatite-coated implants a viable and potentially advantageous option in clinical scenarios where non-modified implants may not suffice.

The Effect of Photobiomodulation Therapy on the Stability of Orthodontic Mini-implants in Human and Animal Studies: A Systematic Review and Meta-analysis

Introduction: The present study aimed to systematically explore available literature on the possible impact of photobiomodulation (PBM) therapy on the stability and success of orthodontic mini-implants. Methods: A comprehensive electronic search was conducted in PubMed, ISI Web of Science, Scopus, Cochrane and Embase databases for human and animal studies published until July 2021. Two independent researchers reviewed the studies based on specific eligibility criteria. Results: 15 studies were included in the systematic review after a comprehensive search. Ten studies were included in the meta-analysis. Four were human RCT studies that evaluated the stability with Preriotest. Three other human RCT studies and two animal studies had evaluated the Implant stability quotient (ISQ). Two human RCTs that had evaluated displacement of mini-implants were also analyzed. The analysis of Periotest stability results showed a positive effect of PBM on mini-implant stability at 30 and 60 days after implantation (P<0.05). In human studies using the ISQ method, a slight improvement was seen in the PBM groups; however, this was not statistically significant (CI=-1.92-2.70, SMD=0.39). In studies that examined the displacement of mini-implants, no statistically significant difference was observed between irradiated and non-irradiated groups (CI=-1.92-2.70, SMD=0.03). According to the results of animal studies, which had used the ISQ method, the use of laser was statistically effective in increasing the stability of mini-implants (SMD=1.43, CI=1.00-1.85). Conclusion: PBM therapy can be suggested as an adjunctive clinical method to improve the stability of mini-implant treatment. Further well-designed clinical studies can help establish evidence-based dosing and irradiation protocols.

Efficacy of compound topical anesthesia combined with photobiomodulation therapy in pain control for placement of orthodontic miniscrew: a double-blind, randomized clinical trial

This study aims to investigate the effect of compound topical anesthetic (CTA) application combined with photobiomodulation therapy (PBMT) on the level of pain perceived during placement of miniscrews and 24 h post the procedure in the buccal side of the maxillary bone. This randomized, prospective, single-center, split-mouth, double-blinded study included 25 subjects (12 males and 13 females, aged 16 to 35). Two anesthetic techniques before implantation were performed including Profound gel +PBM with 980 nm diode laser and local anesthesia with 2% lidocaine hydrochloride. Then, the miniscrews with the size of 1.6 mm in diameter and 8 mm in length were placed with a hand driver in the buccal side of the maxillary bone. The pain immediately after miniscrew placement (T1), also 12 h (T2), and 24 h (T3) post the procedure were collected by visual analog scale (VAS). Data were analyzed by SPSS version 22. There were no statistically significant differences in mean VAS scores within or between CTA combined with PBMT or injection applications, immediately after miniscrew placement (P = 0.75), 12 h after miniscrew placement (P = 0.4), and 24 h after miniscrew placement (P = 1.0). Compound topical anesthetic combined with PBMT provided adequate local anesthesia for the placement of miniscrews in the buccal side of the maxillary bone.

Influence of low-level-laser therapy on the stability of orthodontic mini-screw implants. A systematic review and meta-analysis

BACKGROUND

The influence of low-level-laser therapy (LLLT) on the stability of orthodontic mini-screw implants (MSIs) has not been systematically reviewed.

OBJECTIVES

The aim was to assess the influence of LLLT on the stability of orthodontic MSIs.

METHODS

An unrestricted search of indexed databases was performed.

SELECTION CRITERIA

Randomized controlled clinical trials (RCTs) investigating the influence of LLLT on orthodontic MSI stability.

DATA COLLECTION AND ANALYSIS

Two authors independently performed study retrieval and selection, and data extraction. The risk of bias (RoB) of individual studies was assessed using the Cochrane RoB Tool for RCTs. Meta-analyses were performed separately for RCTs using periotest and resonance frequency analysis (RFA) to measure MSI stability; and a random effects model was applied. Subgroup analyses were performed based on the time-points of MSI stability evaluation. The quality of available evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation approach.

RESULTS

Initially, 1332 articles were screened. Six RCTs with a split-mouth design were included. The periotest was used in 4 RCTs and 2 RCTs used RFA to measure MSI stability. All RCTs had a low RoB. Subgroup analyses based on periotest indicated that MSIs treated with LLLT had significantly higher stability than untreated MSIs at 21 and 30 days [weighted mean difference (MD) = -2.76, confidence interval (CI): [-4.17, -1.36], P-value = 0.0001) and at 60 days (weighted MD = -3.47, CI: [-4.58, -2.36], P < 0.00001); and the level of certainty was high. Subgroup analyses based on RFA showed higher stability of MSIs treated with than without LLLT at 56 and 60 days (standardized MD = 0.82, CI: [0.32, 1.32], P = 0.001), and at 70 and 90 days (standardized MD = 0.86, CI: [0.36, 1.36], P = 0.0007); and the level of certainty was moderate.

LIMITATIONS

Due to limited number of relevant studies, it was not possible to perform sensitivity analysis, subgroup analyses for patient and intervention-related characteristics, and reporting biases assessment.

CONCLUSIONS

The role of LLLT on the secondary stability of MSIs placed in patients undergoing OT remains debatable.

CLINICAL TRIAL REGISTRATION

PROSPERO (CRD42021230291).

Effect of photobiomodulation therapy on mini-implant stability: a systematic review and meta-analysis

The study aimed to assess trials investigating the effect of PBMT on mini-implant stability. Electronic searches of seven databases and manual search were conducted up to May 2020. Randomized controlled trials and controlled clinical trials evaluating the effect of PBMT on mini-implant stability were included. The risks of bias of individual studies were performed using ROB 2.0 and ROBINS-I-tool based on different study design. Meta-analysis was conducted to compare mini-implant stability exposed to PBMT with control ones at different time points after implantation. Among the 518 records initially identified, seven studies were included in this study. Six studies investigated low-level laser therapy (LLLT) and one study evaluated light-emitting diode (LED) therapy. Two studies were eligible for meta-analysis, which showed that LLLT significantly improved mini-implant stability 60 days after initial implantation (MD - 3.01, 95% CI range [- 4.68, - 1.35], p = 0.0004). High energy density of LLLT began to show beneficial effect on mini-implant stability as early as 3 days after implantation, while the significant effect of low energy density displayed later than 30 days after insertion. LED therapy could improve mini-implant stability after 2 months post-insertion. In conclusion, PBMT appears to be beneficial in ameliorating mini-implant stability. High energy density of LLLT might exert more rapid effect than low energy density. More high-quality clinical trials are needed to further demonstrate PBMT' effects on orthodontic mini-implants.

Effects of low-level laser therapy on the orthodontic mini-implants stability: a systematic review and meta-analysis

Objectives

The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability.

Materials and methods

An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted.

Results

Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement.

Conclusions

LLLT shows positive effects on the OMI stability.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40510-021-00350-y.