DOI: 10.4103/sjoralsci.sjoralsci_70_25 ISSN: 2542-7849

Efficacy of laser treatments in biofilm management on titanium implants: A systematic review

Jyotishree Palai, Mirna Garhnayak, Sangram Panda, Abhijita Mohapatra, Gopal Krishna Choudhry, Swagatika Panda
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Abstract

Introduction:

The efficacy of laser decontamination for managing biofilm-associated peri-implantitis lacks a clear, evidence-based synthesis. This systematic review aimed to analyze and compare the in vitro and in situ efficacy of different laser systems in reducing biofilms on titanium implant surfaces.

Materials and Methods:

The review protocol was registered on PROSPERO (CRD420245654010). A systematic search of PubMed, Scopus, Google Scholar, DOAJ, and Cochrane databases was conducted for English-language studies (2014-2024). Two independent reviewers screened records, extracted data, and assessed the risk of bias using the QUIN tool.

Results and Discussion:

From 552 initial records, 11 studies were included in the study. A quantitative synthesis revealed a hierarchy of efficacy: erbium-doped yttrium aluminium garnet (Er: YAG) lasers showed the greatest biofilm reduction, with log reductions from 1.71 to >4.45 log₁₀ colony-forming unit and bacterial kill rates of 90.0% to 99.3%. Neodymium-doped yttrium aluminium garnet lasers demonstrated rapid bactericidal action, whereas diode lasers worked best as an adjunct to chemical agents. Evidence showed that efficacy is laser-specific and depends on precise parameter settings to balance antimicrobial outcomes with implant surface integrity.

Conclusions:

in vitro evidence confirms that laser therapy, particularly Er: YAG systems within defined parameters (40–120 mJ, 20–30 Hz), effectively decontaminates titanium implant biofilm. The evidence supports investigating lasers within structured clinical protocols, but cannot assert superiority over standard care. Focused clinical trials are needed to translate this in vitro efficacy into demonstrated clinical effectiveness for peri-implantitis management.

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