Effect of laser-microtextured abutments on peri-implant outcomes: a systematic review and meta-analysis

Objectives To evaluate the potential of laser-microtextured abutments (LMAs) compared to machined abutments (MAs) in peri-implant clinical and radiographic outcomes. Materials and methods Eligible studies consisted of randomized clinical trials (RCTs) retrieved from MEDLINE, Web of Science, Scopus, and Embase databases. The study adhered to the PRISMA statement, and the protocol was registered at the PROSPERO (registration number CRD42023443112). The risk of bias was evaluated according to version 2 of the Cochrane risk of bias tool (RoB 2). Meta-analyses were performed using random effect models. Afterward, the GRADE approach was used to determine the certainty of evidence. Results Four RCTs were included from a total of 2,876 studies. LMAs had lower peri-implant sulcus depth at 6–8 weeks (WMD: -0.69 mm; 95% CI: -0.97, -0.40; p = 0.15, I 2 = 53%) and at one year (WMD: -0.75 mm; 95% CI: -1.41, -0.09; p = 0.09, I 2 = 65%), but the certainty of evidence was low. In addition, the marginal bone loss favored the LMAs group (WMD: -0.29 mm; 95% CI: -0.36, -0.21; p = 0.69, I 2 = 0%) with moderate evidence. There were fewer sites with bleeding on probing in the LMAs group (WMD: -1.10; 95% CI: -1.43, -0.77; p = 0.88, i 2 = 0%). There was no statistical difference between groups for the modified gingival index and modified plaque index. Furthermore, all studies were classified as having some concerns risk of bias. Conclusions There was low to moderate certainty evidence that LMAs can favor peri-implant clinical and radiographic parameters compared to MAs. Clinical Relevance Laser-microtextured abutments may benefit peri-implant clinical and radiographic outcomes.