目的:本研究旨在评估光生物调节疗法(PBM)在增强牙种植体骨整合方面的有效性。
方法:PubMed,ScienceDirect,Cochrane图书馆,Scopus,和谷歌学者被搜索。纳入了评估PBM有效性的研究,包括明确的干预/对照组。而那些缺乏指定激光类型的人,涉及严重的颌面部缺损或手术,且未报告与PBM治疗后牙种植体骨整合相关的结局被排除.使用Robvis进行随机对照试验(RCT),使用ROBINS-I进行非RCT评估研究偏倚风险。荟萃分析采用随机效应模型,显著性水平为0.01。
结果:该研究回顾了26篇论文,涉及571例接受PBM/低水平激光治疗(LLLT)或安慰剂/对照牙种植手术的患者。植入物稳定性商(ISQ)分析显示无显着差异(p=0.06,平均差:1.02,95%CI:0.28至1.75,I2=28%),而Periotest方法表明稳定性显着提高(p<0.01,平均差:-0.51,95%CI:-0.78至-0.24,I2=71%)。PBM导致骨密度显着增加(p<0.01,平均差:26,95%CI:6.93至45.06,I2=91%),但是边缘骨丢失没有显着差异(p=0.11,平均差:0.00,95%CI:-0.06至0.05,I2=45%)。种植成活率无显著差异(p=0.73,平均差:1.56,95%CI:0.38~6.46,I2=0%)。大多数研究提出了关于随机化的担忧。
结论:PBM可以提高种植体的稳定性,根据Periotest的评估,增加骨密度,增强骨整合。然而,用ISQ评估的植入物稳定性,边缘性骨丢失,和植入物存活率在研究组之间具有可比性。
OBJECTIVE: This study aimed to assess the effectiveness of photobiomodulation therapy (PBM) in enhancing bone integration with dental implants.
METHODS: 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.
CONCLUSIONS: 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.