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

Abstract

To determine whether photofunctionalization influences dental implant osseointegration. 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. 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 12weeks 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%). Photofunctionalization improves osseointegration in the initial healing period of implants, as summarized from available data from rabbit, dog, and rat in vivo models.