ELsyad Moustafa Abdou, Abdraboh Abdelrahman Elsaid, Aboelnagga Mona M, Ghali Rami Maher, Lebshtien Ingy Talaat
Department of Removable Prosthodontics, University of Mansoura, University of Delta, Eldakahlia, Egypt.
Department of Removable Prosthodontics, University of Delta, Gamasa, Egypt.
J Oral Implantol. 2019 Oct;45(5):391-397. doi: 10.1563/aaid-joi-D-18-00263. Epub 2019 Aug 7.
The researchers investigated the influence of low-level laser irradiation (LLLI) on implant stability and marginal bone of small-diameter implants retaining mandibular overdentures in patients with moderately controlled diabetes. Twenty patients (mean age = 59.32 ± 4.1 years) with moderately controlled diabetes mellitus (glycated hemoglobin A1c [HbA1c] = 8.1%-10.0 %) were rehabilitated by maxillary and mandibular conventional dentures. Two small-diameter implants (3 × 12 mm) were inserted in the canine areas of the mandible and immediately loaded by mandibular dentures. In a split-mouth design, LLLI was applied to 1 of the 2 implants in a random order (study group [SG]); the other implant was left as a control (control group [CG]). For each patient, gallium aluminum-arsenide diode low-level laser (940-nm wavelength, 0.50 ± 2 mW output power, 0.004 cm spot size; Epic, Biolase, Inc, San Clemente, Calif) was applied around each implant with total delivered energy of 90 J (equally divided by 6 irradiation points) in 3 sessions. The application was done immediately after implant insertion, 3 days and 1 week after surgery. Implant stability (measured by Periotest) and marginal bone loss (MBL; measured by cone beam computerized tomography) were evaluated at implant loading (T1), 6 months (T6), and 12 months (T12). One implant failed in the CG and no failures occurred in the SG, resulting in 95% and 100% survival rates, respectively. The SG recorded higher Periotest values than the CG at all observation times. However, the difference was significant ( = .039) at T6 only. The SG recorded lower MBL values than the CG. No difference in MBL was detected between groups or peri-implant sites (mesial, distal, buccal, and lingual) at T6 and T12. Within the limits of this study, LLLI had no effect on marginal bone around immediately loaded small-diameter implants retaining overdentures in patients with moderately controlled diabetes. However, it was beneficial in improving implant stability 6 months after overdenture insertion.
研究人员调查了低强度激光照射（LLLI）对中度控制糖尿病患者下颌覆盖义齿保留的小直径种植体的种植体稳定性和边缘骨的影响。20例中度控制糖尿病（糖化血红蛋白A1c [HbA1c] = 8.1%-10.0%）患者用上颌和下颌传统义齿进行修复。在下颌犬牙区植入两颗小直径种植体（3×12 mm），并立即用下颌义齿加载。采用分口设计，将LLLI以随机顺序应用于两颗种植体中的1颗（研究组[SG]）；另一颗种植体作为对照（对照组[CG]）。对于每位患者，使用砷化镓铝二极管低强度激光（波长940 nm，输出功率0.50±2 mW，光斑尺寸0.004 cm；Epic，Biolase公司，加利福尼亚州圣克莱门特）围绕每个种植体进行照射，分3次进行，总传递能量为90 J（平均分配到6个照射点）。照射在种植体植入后立即进行，以及术后3天和1周进行。在种植体加载时（T1）、6个月（T6）和12个月（T12）评估种植体稳定性（通过Periotest测量）和边缘骨丢失（MBL；通过锥形束计算机断层扫描测量）。对照组中有1颗种植体失败，研究组中未发生失败，存活率分别为95%和100%。在所有观察时间点，研究组的Periotest值均高于对照组。然而，仅在T6时差异具有统计学意义（P = 0.039）。研究组的MBL值低于对照组。在T6和T12时，两组之间或种植体周围部位（近中、远中、颊侧和舌侧）的MBL未检测到差异。在本研究的范围内，LLLI对中度控制糖尿病患者下颌覆盖义齿保留的即刻加载小直径种植体周围的边缘骨没有影响。然而，它有利于在覆盖义齿植入6个月后提高种植体稳定性。
