The use of a diode laser and a scalpel blade in stage-two dental implant surgery: a comparative study.

INTRODUCTION: The use of lasers in dental implant procedures raises questions regarding the preservation of keratinized tissues and implant outcomes. AIM: This study aimed to compare the clinical effects (pain and impression time) and soft tissue healing (keratinization, peri-implant probing, bleeding, and healing) of diode lasers and scalpels used during second-stage dental implant surgery. MATERIALS AND METHODS: A Prospective randomized clinical trial with a 1:1 allocation ratio was conducted. This study included 30 patients, each with a single, fully osseointegrated implant. Patients were categorized into two groups. The study group underwent second-stage implant surgery using a 970 nm diode laser. In the control group, implants were exposed using a conventional surgical blade. A comparison between the diode laser and conventional scalpel groups was made based on clinical outcomes (pain and impression time) and soft tissue healing (keratinization, peri-implant probing, bleeding, and healing). Data were analyzed using a paired t-test. RESULTS: Pain intensity significantly decreased from immediate postoperative to 7 days in both scalpel (49.87±6.78, t=28.48, df=14, p<0.001) and diode laser (7.67±7.58, t=3.91, df=14, p=0.002) groups. Immediately after surgery, pain scores were significantly higher in the scalpel group compared with the diode laser group (94.53±4.45 vs. 46.93±5.85, t=25.076, df=26.151, p<0.001). Although pain decreased in both groups by day 7, the scalpel group continued to exhibit significantly greater pain (44.67±5.96 vs. 39.27±3.73, t=2.974, df=23.513, p=0.007). Impression time (p=0.231) and gingival keratinized tissue (p=0.736) did not differ significantly between the scalpel and diode laser approaches. At week 6, the scalpel group exhibited a significantly higher mean periimplant bleeding index (2.60 ± 0.507) compared with the laser group (0.667 ± 0.258, p < 0.001). However, after 12 weeks, no significant difference was observed (1.58 ± 0.19 vs. 1.55 ± 0.21, p = 0.748). Laser surgery produced significantly better early wound healing at all intervals (p < 0.001), while intraoperative bleeding was more common with the scalpel technique than with the diode laser (100% vs. 66.7%, p = 0.042). CONCLUSION: Compared with the scalpel method, the diode laser method resulted in a significant reduction in pain intensity, improved wound healing, and less peri-implant bleeding during the second-stage dental implant surgery.