Photofunctionalization as a suitable approach to improve the osseointegration of implants in animal models—A systematic review and meta‐analysis

Abstract

Objectives To determine whether photofunctionalization influences dental implant osseointegration. Material and methods Data on osseointegration rates were extracted from 8 databases, based on bone‐to‐implant contact (BIC) and pushout tests. Internal validity was accessed through the SYRCLE risk of bias tool for animal experimental studies. Meta‐analyses were performed for investigation of the influence of photofunctionalization on implant osseointegration, with a random effect and a confidence interval of 95%. The certainty of evidence was accessed through the GRADE approach. Results Thirty‐four records were identified, and 10 were included in the meta‐analysis. Photofunctionalized implants showed higher mean values for BIC in rabbits (MD 6.92 [1.01, 12.82], p = .02), dogs (MD 23.70 [10.23, 37.16], p = .001), rats (MD 20.93 [12.91, 28.95], p < .0001), and in the pooled BIC analyses (MD 14.23 [7.80, 20.66], p < .0001) compared to those in control implants in the overall assay. Conversely, at late healing periods, the pooled BIC meta‐analyses showed no statistically significant differences (p > .05) for photofunctionalized and control implants at 12 weeks of follow‐up. For pushout analysis, photofunctionalized implants presented greater bone strength integration (MD 19.92 [13.88, 25.96], p < .0001) compared to that of control implants. The heterogeneity between studies ranged from “not important” to “moderate” for rabbits I2 = 24%, dogs I2 = 0%, rats I2 = 0%, and pooled BIC (I2 = 49%), while considerable heterogeneity was observed for pushouts (I2 = 90%). Conclusion Photofunctionalization improves osseointegration in the initial healing period of implants, as summarized from available data from rabbit, dog, and rat in vivo models.

Clinical Applications of Photofunctionalization on Dental Implant Surfaces: A Narrative Review

“…There were some disadvantages in pre-clinical studies, which resulted in a risk of bias [ 23 , 24 ]. The quality assessment revealed that no animal study revealed a low risk of bias for all domains [ 23 , 24 ].…”

“…There were some disadvantages in pre-clinical studies, which resulted in a risk of bias [ 23 , 24 ]. The quality assessment revealed that no animal study revealed a low risk of bias for all domains [ 23 , 24 ]. However, photofunctionalization still showed a benefit in the initial phase of osseointegration in different animal models [ 24 ].…”

“…Furthermore, PhF applied in the spine surgery of 13 patients was included [ 22 ]. Except for some pre-clinical review papers on in vitro or animal studies, to my best knowledge, this paper is the first review focused on the clinical application of photofuctionalization [ 4 , 23 , 24 , 25 ].…”

Effect of photofunctionalization on titanium bone-implant integration in ovariectomized rats

“…One of the methods for modifying the surface of titanium implants is a photofunctionalization process in which titanium is irradiated with ultraviolet rays 10) . In animal models, it has been reported that the boneimplant contact rate becomes 90% or more, and the bone-implant bond strength increases 3 times by photofunctionalization treatment 10,11) . It has been reported that photofunctionalization improves the adhesion, proliferation, and functional expression of bone lineage cells early after implantation, even in rat models of osteoporosis 12) .…”

An In-Vitro Analysis of Peri-Implant Mucosal Seal Following Photofunctionalization of Zirconia Abutment Materials

“…UV irradiation of the implant surface has been reported to enhance the wettability of the implant surface and promote fast bone healing [ 17 , 18 ]. The effect of photofunctionalization on titanium in improving osseointegration has been documented in animals [ 18 , 19 , 20 ] and human studies [ 21 , 22 ]. Nevertheless, the effect on the peri-implant tissue is not well described in the literature.…”