Effect of Low-Level Diode Laser Bio-Stimulation on Implant Stability Before, During and After Immediate Implants in Mandibular Molars. (A Randomized Clinical Study)

Abstract

Aim: Tooth loss can affect the person’s life dramatically. Tooth loss is accompanied by bone loss in all dimensions, so preservation of the bone is mandatory for placement of dental implant. Immediate implant can preserve alveolar bone. Due to difference in shape between the implants and extracted roots a gap appears between the immediately placed implant and the extraction socket resulting in jumping distance, Bone grafts are commonly used to fill this gap, recent studies suggest that jumping gaps shouldn’t always be grafted. Low level bio stimulation has stimulatory effect on bone cells so it can be used in immediate implants to increase bone formation around the implants. Materials and methods: this study was carried in the hospital of future university. A total of twelve patients with non-restorable mandibular molar participated in this study. A total of twenty implants were placed immediately in mandibular molar region without bone grafting, thew were divided equally into two groups. Surgical technique was similar for both groups. After immediate implant placement with primary stability of 35 N, both groups received custom made healing collar using flowable composite to seal the jumping distance.The study group (intervention) received a total of 60J/cm2 .10J/cm2 3 days before extraction, another 10J/cm2 at the fresh socket, another 10 J/cm2 after osteotomy, another 10J/cm2 after implant placement, another 20J/cm2 at the follow up visit with 3 days interval. After six weeks secondary implant stability was measured for both groups using Resonance Frequency Analysis device (RFA). Prosthetic phases started for implants that showed sufficient secondary stability. Results: All implants enrolled in this study showed sufficient secondary stability except for one totally avulsed implant from the control group. Study group showed more stability upon measuring using RFA device after six weeks of implant placement. The study group has shown a higher secondary stability compared to control group, the mean ISQ value of study (71.89±2.67) was significantly higher than control (62.43±8.62). Conclusion: Based on the results of our study we concluded that low level diode laser 980nm has a stimulatory effect on bone formation when applied before, during and after immediate implant placement, According to this study 60J/cm2 is recommended dose and it also gave better soft tissue healing results