CAN COMBINING LOW LEVEL LASER THERAPY WITH COMPUTER GUIDED FLAPLESS PIEZOSURGICAL OSTEOTOMY ACHIEVE A PAINLESS IMPLANT SURGERY? FINDINGS OF SPLIT MOUTH RANDOMIZED CONTROLLED TRIAL.

Objective: Developing a safe and accurate surgical technique that offers higher patient satisfaction will be a great improvement in the field of oral implantology. This study was to investigate the effect of Low-Level Laser Therapy (LLLT) on pain and swelling after flapless computer guided implant site preparation utilizing a novel surgical guide designed to be used with piezotome.

Methods: A total of thirty patients were enrolled in this study having history of bilateral extractions in the lower molar area not less than 6 months ago. One side from each patient was randomly selected for the intervention group to receive LLLT immediately after insertion of bendable one-piece implant (Rough-B Implant, Monoimplant, Novodent SA, Swizerland) using diode laser with a wavelength of 980 nm and a 100 mW energy for 1 minute. The other side received placebo LLLT and was regarded as a control group. Piezo-surgical implant site preparation was done on both sides using a third generation piezotome (Surgic Touch, Guilin Woodpecker Medical Instrument Co., Ltd, China). Pain and swelling scores were measured by utilizing a Visual Analogue Scale (VAS) and a graded swelling scale respectively. The measurements were recorded on both sides after 2, 6 and 24 hour of the day of surgery then at 2, 3, 4 and 7 days post-surgically.

Results: In general, the overall scores were ranging from very mild to mild degree of pain and swelling. Females reported significantly higher pain score than males with a mean score of 20.3 ± 5.1 for females and 14.7 ± 3.1 for males (P < .05). Swelling showed no statistically significant results between females and males (P> .05). Pain scores were found to be significantly lower in the LLLT side after 2, 6, 24, 48 hour of implant insertion (P < .05). Moreover, Sweling scores were also found to be significantly lower in the LLLT side after 2, 6, 24, 48 hour, and at day 3 of implant insertion (P < .05). However, day 4 and day 7 showed very minimal if any pain and swelling with insignificant differences between the 2 sides (P > .05).

Conclusions: LLLT was found to be an effective non pharmacological method for relieving pain after implant insertion. Piezosurgical flapless implant placement combined with LLLT is considered an effective, tolerable and minimally invasive procedure (ClinicalTrials.gov NCT01857804).