Flapless Piezoelectric Implant Surgery with Photobiomodulation: A Non-Clinical Mechanistic–Bayesian Framework and Study Protocol
Pankaj Dhawan, Puneet Batra, Ashish KakarAbstract
Background:
Flapless guided placement, piezoelectric osteotomy, and photobiomodulation (PBM) each have individual biological rationale in implant surgery. Their combined, standardised use has not been prospectively validated.
Aim:
The aim is to develop a non-clinical, mechanistic–Bayesian framework specifying the intervention, Bayesian prior distributions, and validation strategy for a future randomised trial comparing an integrated flapless piezoelectric PBM protocol against conventional guided flapped rotary placement.
Materials and Methods:
A selective, non-exhaustive narrative review, not a systematic review or formal evidence synthesis, was used to identify representative evidence. No predefined eligibility criteria, database search strategy, or PROSPERO registration was undertaken or is applicable to this article type. 48-hour pain (0–100 mm Visual Analogue Scale) and implant stability quotient (ISQ) at 3 months, both assessed by blinded evaluators.
Conclusion:
The integrated protocol is biologically plausible but hypothesis generating. Prior distributions are derived from selective narrative evidence and carry acknowledged, formally quantified uncertainty, addressed through mandatory pre-specified sensitivity analyses. Pilot and definitive randomised trials are required before clinical adoption.