Available online 26 April 2024

Author links open overlay panel, , , , AbstractStatement of problem

The management of patients with narrow-mandibular ridges who seek prosthetic rehabilitation is challenging.

Purpose

The purpose of this one-year preliminary clinical study was to compare the effects of laser biostimulation and a placebo on peri-implant tissues for a 2-implant-retained mandibular polyetheretherketone (PEEK) overdenture on expanded narrow mandibular ridges.

Material and methods

Eighteen completely edentulous participants were enrolled for mandibular ridge splitting in the canine regions, followed by expansion, the placement of implants, and the application of a bone graft. In the test group, laser therapy was applied labially and lingually at the surgical sites, while a placebo laser was used in the control group. PEEK overdentures retained by LOCATOR attachments were provided after 6 months. Clinical evaluations were performed using probing depth, plaque, bleeding, and gingival indices at insertion and 3, 6, and 12 months after insertion. Vertical bone loss (VBL) was evaluated with periapical radiograph at insertion and 6 and 12 months later. The Mann-Whitney test was used to test the difference between the 2 different groups at each evaluation time (α=.05). The Friedman-test was used, followed by Wilcoxon signed rank test, to test the change over time in the same group, and the Bonferroni adjusted significance level was used for multiple comparisons.

Results

Some clinical and radiographic parameters significantly increased with time in both groups (P<.001). Significant differences between the 2 groups were revealed in bleeding scores at 3 months (P=.006) and 6 months (P=.018). Also, significant differences between the 2 groups were observed in gingival scores at 3 months (P=.002), 6 months (P=.015), and 12 months (P=.019) after overdenture insertion in favor of the laser group. Peri-implant VBL was significantly higher in the non-laser group at 6 months (P=.015), and 12 months (P=.001).

Conclusions

Within the limitations of this clinical study, respecting the small sample size and the short follow-up period, laser bio-stimulation after 1-stage ridge splitting in narrow mandibular ridges enhanced the soft and hard peri implant tissues when used with LOCATOR attachments and PEEK overdentures.

Section snippetsMATERIAL AND METHODS

This preliminary study was conducted on 18 completely edentulous participants (8 men and 10 women), whose ages ranged between 50 and 65 years (mean 60). No sample size calculation was performed; instead, the study was conducted based on the availability of participants, and the research was not funded. The study was approved by the Local Ethics Committee, number 01100918 and ClinicalTrials.gov identifier NCT05837078, and each participant signed an informed consent form after being informed

RESULTS

All eligible participants attended the regular visits except for one who was excluded from the laser group as she had been diagnosed with diabetes during follow-up.

Peri-implant VBL increased significantly with time in both groups. The time at which it increased is presented in Table 1. While studying the difference between the 2 groups, a significant increase in VBL was detected in the nonlaser group compared with the laser group at T1 and T2 (P=.015 and.001, respectively) (Table 1).

Probing

DISCUSSION

Significant differences were found for some clinical and radiographic parameters between the study groups, with better results related to the laser group. Therefore, the null hypothesis that no statistically significant difference would be found in peri-implant tissue health whether or not LLLT was done was rejected.

Plaque scores increased significantly at 3 months for the nonlaser group (P=.006) and at 6 months for the laser group (P=.007) after denture insertion, while no significant

CONCLUSIONS

Based on the findings of this preliminary clinical study, the following conclusion was drawn:

1. Peri-implant soft and hard-tissue outcomes improved when 1-stage mandibular ridge splitting was combined with laser biostimulation therapy using PEEK superstructures and LOCATOR attachments with resilient characteristics.

CRediT authorship contribution statement

Fatma Ahmad El Waseef: Performing the randomization, validation, contributing to the writing and critically revising of the manuscript and accomplishment of the editing procedures. Marwa Adel Helmy: Resources, performing the prosthetic procedures, denture constructions and contributing to the writing of the manuscript. Wael Mohamed Said Ahmed: Performing all the surgical procedures and follow-up steps. Salah Abd El Fattah Hegazy: methodology, designing and planning of the research,

Acknowledgments

This work is dedicated to the late Prof. Nesreen El Mekawy, a supervisor for this research who passed away in March 2021—Allah bestows her with paradise.

References (43)K.E. El-Kholey et al.Role of diode laser in preservation of the marginal bone around early loaded endosseous implant

Life Sci

(2012)

J. Matys et al.Er:YAG laser, piezosurgery, and surgical drill for bone decortication during orthodontic mini-implant insertion: Primary stability analysis-an animal study

Lasers Med Sci

(2018)

G. Uçar et al.Effects of low level laser therapy on injection pain and anesthesia efficacy during local anesthesia in children: A randomized clinical trial

Int J Paediatr Dent

(2022)

J. Matys et al.Effect of diode lasers with wavelength of 445 and 980 nm on a temperature rise when uncovering implants for second stage surgery: An ex-vivo study in pigs

Adv Clin Exp Med

(2017)

R. Zein et al.Effect of low-level laser therapy on bone regeneration during osseointegration and bone graft

Photomed Laser Surg

(2017)

L. Mayer et al.Histologic and resonance frequency analysis of peri-implant bone healing after low-level laser therapy: An in vivo study

Int J Oral Maxillofac Implants

(2015)

O. Dörtbudak et al.Effect of low-power laser irradiation on bony implant sites

Clin Oral Implants Res

(2002)

J.S. Feine et al.The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous participants

Int J Oral Maxillofac Implants

(2002)

M.R.A. Abbasi et al.Comparison of stress induced in mandible around an implant-supported overdenture with LOCATOR attachment and telescopic crowns, a finite element analysis

Med Pharm Rep

(2020)

T. Jemt et al.In vivo load measurements on osseointegrated implants supporting fixed or removable prostheses: A comparative pilot study

Int J Oral Maxillofac Implants

(1991)

M.A. Elsyad et al.Effect of implant position on clinical and radiographic outcomes of LOCATOR-retained mandibular overdentures: A 1-year prospective study

J Prosthodont

(2019)

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