Zayed Sara Mahmoud, Hakim Ahmed Adel Abdel
Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Saudi J Med Med Sci. 2020 May-Aug;8(2):80-86. doi: 10.4103/sjmms.sjmms_410_19. Epub 2020 Apr 17.
Photobiomodulation (PBM) has been shown to have a positive effect on dental implant osseointegration and stability in and animal studies; however, its usefulness in dental implant clinical practice is yet unclear.
The objective was to assess the clinical effectiveness of PBM on dental implants' osseointegration.
Two reviewers independently conducted a comprehensive electronic search of articles published from inception up to January 10, 2020, in PubMed, Cochrane Library and Embase databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized clinical trials (RCTs) and nonrandomized clinical studies that compared the effect of PBM on dental implant stability with control groups were included. Animals and studies studies as well as studies with confounders such as application of orthodontic were excluded. Risk of bias (using Cochrane Risk of Bias tool for RCTs and Risk of Bias in Non-Randomized Studies of Interventions tool for nonrandomized studies) was assessed by both authors. Owing to substantial heterogeneity, only a narrative synthesis of the included studies is presented.
Seven relevant clinical studies were included, and they used a variety of PBM parameters and devices. The posterior region of the jaw was found to be more frequently evaluated. For assessing the effect of PBM on implant stability, five studies used resonance frequency analysis and two used periotest; three studies additionally used biomarkers for assessment. Four studies found that PBM has a potential positive effect on the outcome of dental implant stability, whereas three studies reported that PBM has no effect on implant stability.
The findings of this systematic review suggest that postoperative application of PBM may potentially have some positive effect on dental implant's osseointegration and stability. However, additional studies are required with uniformity in methods to provide a more robust assessment of this effect.
光生物调节作用（PBM）在体外和动物研究中已显示出对牙种植体骨整合和稳定性有积极影响；然而，其在牙种植体临床实践中的效用尚不清楚。
评估PBM对牙种植体骨整合的临床效果。
两名综述作者按照系统评价和Meta分析的首选报告项目（PRISMA）指南，独立对PubMed、Cochrane图书馆和Embase数据库中从建库至2020年1月10日发表的文章进行全面电子检索。纳入比较PBM与对照组对牙种植体稳定性影响的随机临床试验（RCT）和非随机临床研究。排除动物和体外研究以及存在混杂因素（如正畸应用）的研究。两位作者均使用偏倚风险评估工具（RCT使用Cochrane偏倚风险工具，非随机研究使用干预性非随机研究中的偏倚风险工具）评估偏倚风险。由于存在实质性异质性，仅对纳入研究进行叙述性综合分析。
纳入7项相关临床研究，这些研究使用了多种PBM参数和设备。发现下颌后部区域是更常被评估的部位。为评估PBM对种植体稳定性的影响，5项研究使用了共振频率分析，2项研究使用了牙周探测仪；3项研究还使用了生物标志物进行评估。4项研究发现PBM对牙种植体稳定性结果可能有积极影响，而3项研究报告PBM对种植体稳定性无影响。
本系统评价的结果表明，术后应用PBM可能对牙种植体的骨整合和稳定性有一定积极影响。然而，需要更多方法统一的研究来对这种影响进行更有力的评估。
