Application of Laser Treatment in Adhesive Bonding of Liners to Polymethyl Methacrylate Denture Resins: A Systematic Review and Meta-Analysis.

Abstract

Objective: This systematic review and meta-analysis aimed to assess the influence of laser treatment on adhesive bonding of liners to polymethyl methacrylate (PMMA) denture base resins. Methods: The focused question was: "Does the application of laser treatment (Intervention) influence the adhesive bonding strength (Outcome) of liners to PMMA denture base resins (Population) as compared with untreated or unconditioned surfaces (Control)?" In vitro and clinical reports as well as reports on influence of laser treatments on bonding strength of liners to PMMA denture resins in comparison with untreated surfaces were included. Reports without any control group[s], without any application of laser[s] for PMMA denture bases that did not utilize PMMA denture bases, and not evaluate bond strength of PMMA denture base resins were excluded. An electronic search was conducted on PubMed, Scopus, and Web of Science. Meta-analyses were performed for calculating the standard mean difference (SMD) with a 95% confidence interval (95% CI). Results: Nine of the 12 included studies found that laser irradiation treatment produced significant surface texture alterations of the PMMA denture base and improved the adhesion between the PMMA denture base and soft lining. According to the meta-analysis, tensile bond strength showed an SMD of -2.49% (95% CI: -3.89 to -1.08; p = 0.0005), suggesting a statistically significant difference between the control and test groups (i.e., favoring laser-treated samples than untreated samples). Regarding shear bond strength scores, the outcomes showed an SMD of -2.24% (95% CI: -3.79 to -0.69; p = 0.005), suggesting a statistically significant difference between the control and test groups (i.e., favoring laser-treated samples than untreated samples). Conclusions: Despite the high heterogeneity among the included studies, it can be concluded that laser treatment might improve the bonding strengths of liners to PMMA denture base resins as compared with untreated surfaces. To validate the aforementioned conclusions, further verification is required through the implementation of well-designed randomized controlled trials with large sample sizes.