Non-Cochrane · intervention · PM41753135
Laser-Assisted Strategies for Alveolar Bone Preservation After Tooth Extraction: A Systematic Review and Meta-Analysis.
Gryka-Deszczyńska Magdalena, Dembicka-Mączka Diana, Fiegler-Rudol Jakub, et al. · Journal of clinical medicine · 2026 · PubMed · doi:10.3390/jcm15041447
Findings
14 findings
| Population | ||||
|---|---|---|---|---|
| Adults undergoing tooth extraction | Er:YAG laser applied to the extraction socket | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) · Laser type subgroup (Table 1 value; conflicts with text) | MD 1.42 [0.98, 1.86] Moderate Downgraded: risk of bias, imprecision, publication bias 7 studies |
| Adults undergoing tooth extraction | Er:YAG laser applied to the extraction socket | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) | MD 1.12 [0.9, 1.4] Moderate Downgraded: risk of bias, imprecision, publication bias 7 studies |
| Adults undergoing tooth extraction | Surgically applied Nd:YAG laser | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) · Laser type subgroup (Table 1 value; conflicts with text) | MD 1.13 [0.9, 1.36] Moderate Downgraded: risk of bias, imprecision, publication bias 7 studies |
| Adults undergoing tooth extraction | Surgically applied Nd:YAG laser | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) | MD 1.15 [0.88, 1.4] Moderate Downgraded: risk of bias, imprecision, publication bias 7 studies |
| Adults undergoing tooth extraction | Nd:YAG-based photobiomodulation (PBM) | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) · Laser type subgroup (Table 1 value; conflicts with text) | MD 0.95 [0.73, 1.17] Moderate Downgraded: risk of bias, imprecision 6 studies |
| Adults undergoing tooth extraction | Nd:YAG-based photobiomodulation (PBM) | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) · Abstract and Results 3.5 estimate | MD 1.2 [1.0, 1.4] Moderate Downgraded: risk of bias, imprecision 6 studies |
| Adults after single or multiple tooth extractions | Nd:YAG-based photobiomodulation (PBM) after tooth extraction | Passive healing or conventional mechanical debridement without laser | Alveolar ridge preservation (preserved bone volume) 8 to 12 weeks when several time points were reported | MD 1.2 [0.9, 1.45] Moderate Downgraded: risk of bias, imprecision 6 studies |
| Adults undergoing tooth extraction | Nd:YAG-based photobiomodulation (PBM) | Conventional extraction or surgery without laser (standard care) | Alveolar bone preservation (ridge height, width, volume or density) 8-12 weeks (interval selected when multiple time points) · Results 3.6 estimate (no CI given) Unresolved: the two extractors disagree on this row. | MD 1.5 Moderate Downgraded: risk of bias, imprecision Studies not reported |
| Adults undergoing tooth extraction | Laser-assisted extraction (Er:YAG, surgical Nd:YAG or Nd:YAG PBM, all laser types pooled) | Conventional extraction without laser | Alveolar bone preservation (ridge height, width, volume or density) Over 3 months · Follow-up: over 3 months | MD 0.87 [0.62, 1.12] GRADE not reported 6 studies |
| Adults undergoing tooth extraction | Laser-assisted extraction (Er:YAG, surgical Nd:YAG or Nd:YAG PBM, all laser types pooled) | Conventional extraction without laser | Alveolar bone preservation (ridge height, width, volume or density) Assessment method: optical or mechanical (calibrated probe, scanning) | MD 0.98 [0.74, 1.22] GRADE not reported 11 studies |
| Adults undergoing tooth extraction | Laser-assisted extraction (Er:YAG, surgical Nd:YAG or Nd:YAG PBM, all laser types pooled) | Conventional extraction without laser | Alveolar bone preservation (ridge height, width, volume or density) Up to 3 months · Follow-up: up to 3 months | MD 1.09 [0.84, 1.34] GRADE not reported 12 studies |
| Adults undergoing tooth extraction | Laser-assisted extraction (Er:YAG, surgical Nd:YAG or Nd:YAG PBM, all laser types pooled) | Conventional extraction without laser | Alveolar bone preservation (ridge height, width, volume or density) All studies pooled (funnel plot apex and bounds) Unresolved: the two extractors disagree on this row. | MD 1.2 [0.8, 1.6] Moderate Downgraded: risk of bias, publication bias 37 studies |
| Adults undergoing tooth extraction | Laser-assisted extraction (Er:YAG, surgical Nd:YAG or Nd:YAG PBM, all laser types pooled) | Conventional extraction without laser | Alveolar bone preservation (ridge height, width, volume or density) Assessment method: CBCT | MD 1.32 [1.02, 1.62] GRADE not reported 10 studies |
| Adults undergoing tooth extraction | Laser-assisted extraction (Er:YAG, surgical Nd:YAG or Nd:YAG PBM, all laser types pooled) | Conventional extraction without laser | Alveolar bone preservation (ridge height, width, volume or density) Up to 1 month · Follow-up: up to 1 month | MD 1.26 [0.95, 1.57] GRADE not reported 9 studies |
Included primary studies 35
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Zhou 2023 matched by author and year (probable) | NR | 2 other reviews | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Abdulsamee 2017 All Tissues Dental Laser Er:YAG laser- Review Article DOI:10.26717/bjstr.2017.01.000104 | 2017 | 1 other review | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Choi 2019 matched by author and year (probable) | NR | 1 other review | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Abdulsamee 2017 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Almoharib 2025 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Almoharib 2025 Erbium-Doped Yttrium Aluminium Garnet (Er:YAG) Lasers in the Treatment of Peri-Implantitis. PMID:39897297 | 2025 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Choi 2019 Adjunctive Nd:YAG Laser Irradiation for Ridge Preservation and Immediate Implant Procedures: A Consecutive Case Series. PMID:31490043 | 2019 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Couso-Queiruga 2021 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Couso-Queiruga 2021 Post-extraction dimensional changes: A systematic review and meta-analysis. PMID:33067890 | 2021 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| da Hora Sales 2022 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| da Hora Sales 2022 Is the Er: YAG Laser Effective in Reducing Pain, Edema, and Trismus After Removal of Impacted Mandibular Third Molars? A Meta-Analysis. PMID:34793714 | 2022 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Fukuoka 2011 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Fukuoka 2011 Influence of carbon dioxide laser irradiation on the healing process of extraction sockets. PMID:20863148 | 2011 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Karim 2023 To evaluate the effects of Low-level laser therapy (LLLT) on wound healing of extraction socket: A systematic review DOI:10.3329/bjms.v22i3.65328 | 2023 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Karim 2023 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Kesler 2011 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Kesler 2011 Platelet derived growth factor secretion and bone healing after Er:YAG laser bone irradiation. PMID:20594059 | 2011 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Liu 2020 Clinical comparison between Er: YAG and CO2 laser in treatment of oral tumorous lesions: A meta-analysis. PMID:32791674 | 2020 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Martins 2011 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Martins 2011 Bone healing after bur and Er:YAG laser ostectomies. PMID:20674121 | 2011 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Matsumoto 2004 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Matsumoto 2004 An improved 3D shape context based non-rigid registration method and its application to small animal skeletons registration. PMID:20044235 | 2010 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Passanezi 2015 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Passanezi 2015 Lasers in periodontal therapy. PMID:25494605 | 2015 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Reynolds 2020 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Santos 2012 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Stubinger 2007 Er:YAG laser osteotomy for removal of impacted teeth: clinical comparison of two techniques. PMID:17868108 | 2007 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Stübinger 2007 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Swider 2019 Er:YAG and diode laser application in implant bed preparation and implant uncovering: A case report. PMID:30720935 | 2019 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Świder and Dominiak 2019 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Taniguchi 2021 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Taniguchi 2021 Er:YAG Laser-Assisted Bone Regenerative Therapy for Implant Placement: A Case Series. PMID:34328480 | 2021 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Van As 2004 matched by author and year (probable) | NR | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Van As 2004 Erbium lasers in dentistry. PMID:15464563 | 2004 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
| Zhou 2023 Influence of Er:YAG laser irradiation on the outcomes of alveolar ridge preservation at the infected molar sites: a randomized controlled… PMID:37221532 | 2023 | this review only | Alveolar bone preservation (ridge height, width, volume or density) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults after single or multiple tooth extractions without systemic diseases affecting bone regeneration | Adults after tooth extraction (48 studies included, 37 in meta-analysis; sample sizes 10 to 135; mean ages 35 to 65 years) |
| Intervention | Er:YAG, Nd:YAG and Nd:YAG-PBM in the post-extraction phase | Er:YAG (n=7), surgical Nd:YAG (n=7), Nd:YAG-based PBM (n=6) |
| Comparison | Passive healing, traditional mechanical debridement, or intergroup comparison of laser protocols | Conventional extraction or surgery without laser |
| Outcomes | Morphometric changes in alveolar bone (height, width, volume, density) at defined follow-up intervals | Preserved alveolar bone (mean difference, mm) |
| Study designs | Clinical studies (prospective and retrospective), CBCT or calibrated mechanical or optical measurement | 12 randomised controlled trials, 8 prospective non-randomised studies, 5 animal models, 4 meta-analyses, 4 reviews, 4 clinical cases or series |
| Timing | Follow-up up to 1 month, up to 3 months, over 3 months; 8 to 12 weeks chosen when several time points | 7 days to 24 weeks; most informative 8 to 12 weeks |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | No | No | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |