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 nonsignificant difference (p = 0.06, mean difference: 1.02, 95 % CI: 0.28 to 1.75, I-2=28 %), while the Periotest method indicated significant improvement in stability (p < 0.01, mean difference:-0.51, 95 % CI:-0.78 to-0.24, I-2=71 %). PBM resulted in a significant bone density increase (p < 0.01, mean difference: 26, 95 % CI: 6.93 to 45.06, I-2=91 %), but marginal bone loss showed no significant difference (p = 0.11, mean difference: 0.00, 95 % CI:-0.06 to 0.05, I-2=45 %). Implant survival rate did not significantly differ (p = 0.73, mean difference: 1.56, 95 % CI: 0.38 to 6.46, I-2=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.