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This systematic review evaluates in vitro studies on laser surface treatment of zirconia implants using searches across major databases from after 2005. Nine studies met inclusion criteria, showing laser irradiation improves roughness, wettability, protein adsorption, and osteoblastic adhesion, proliferation, and differentiation, while also reducing bacterial adhesion and supporting antimicrobial potential.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/impact-of-laser-surface-modification-on-zirconia-implants-a-systematic-review-of-in-vitro-evidence/454887/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/impact-of-laser-surface-modification-on-zirconia-implants-a-systematic-review-of-in-vitro-evidence/454887.png","ImageObject",300,407,{"name":92,"@type":93},"Stanford","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are laser surface modifications used for zirconia implants?","Question",{"text":112,"@type":113},"Laser treatment is used to overcome zirconia’s low surface bioactivity by creating controlled micro- and nanoscale changes that enhance osseointegration-related surface properties.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What outcomes did the included in vitro studies report after laser treatment?",{"text":117,"@type":113},"Laser irradiation increased surface roughness and wettability, enhanced protein adsorption, and promoted osteoblastic adhesion, proliferation, and differentiation while improving antimicrobial potential through reduced bacterial adhesion.",{"name":119,"@type":110,"acceptedAnswer":120},"Which laser types and parameters are highlighted as relevant?",{"text":121,"@type":113},"The review discusses multiple laser types (including femtosecond and Nd:YAG) and emphasizes that biological and mechanical outcomes depend on parameters such as wavelength, energy, and pulse duration, with excessive energy potentially inducing phase transformation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},454887,1791117451,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336477552062,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Review began 11/30/2025  \nReview ended 12/03/2025  \nPublished 12/08/2025  \n© Copyright 2025  \nBhosale et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98697  \nOpen Access Review Article  \nImpact of Laser Surface Modification on Zirconia Implants: A Systematic Review of In Vitro Evidence  \nSanjana Bhosale 1, Arti Gangurde 1, Manish Chauhan 1, Niraja Jaiswal 1, Radha L. Harimkar 1, Sahil Shaikh 1 1. Prosthodontics and Crown and Bridge, Government Dental College and Hospital, Mumbai, IND  \nCorresponding author: Sanjana Bhosale, [sanjanabhosale161@gmail.com](sanjanabhosale161@gmail.com)  \nAbstract  \nZirconia implants have emerged as a viable alternative to titanium due to their superior aesthetics, chemical stability, and biocompatibility. However, their inherently low surface bioactivity has resulted in the development of advanced surface modification techniques to improve osseointegration and biological performance. This systematic review evaluated in vitro studies investigating the effects of laser surface treatment on zirconia implants. A comprehensive electronic and manual search was conducted in PubMed, Cochrane Library, Google Scholar, Scopus, ScienceDirect, and EBSCOhost, including studies published after 2005. Nine in vitro studies met the inclusion criteria. The results demonstrated that laser irradiation significantly enhanced surface roughness, wettability, and protein adsorption while promoting osteoblastic adhesion, proliferation, and differentiation. Femtosecond and Nd:YAG lasers produced well-defined microand nano-topographies without inducing deleterious phase transformation or compromising mechanical integrity. Additionally, laser-treated zirconia exhibited reduced bacterial adhesion, suggesting improved antimicrobial potential. Despite methodological variations, all studies indicated positive biological and structural outcomes associated with laser modification. Laser surface modification thus represents a precise, reproducible, and contamination-free approach for enhancing zirconia implant performance.  \nCategories: Dentistry  \nKeywords: antimicrobial properties, laser surface modification, osseointegration, wettability, zirconia implants  \nIntroduction And Background  \nThe introduction of zirconia implants has marked a paradigm shift in modern implantology, providing anesthetic and biocompatible alternative to conventional titanium implants. Titanium remains the gold standard owing to its long-term clinical success; however, drawbacks such as corrosion, ion release, and metallic discoloration under thin gingiva have prompted the search for metal-free substitutes [1-3]. Zirconia, a high-strength ceramic, has gained attention due to its great biocompatibility, corrosion resistance, and tooth-like color, making it ideal for patients with metal hypersensitivity or demanding esthetic needs [4] . The earliest in vivo investigation that evaluated zirconia ceramic implants placed in beagle dogs was [provided by Akagawa et al. in 1993](provided by Akagawa et al. in 1993) [5].  \nDespite these advantages, zirconia implants exhibit distinct challenges concerning osseointegration, surface bioactivity, and mechanical reliability [6,7] . Unlike titanium, which forms a naturally bioactive oxide layer, zirconia requires surface modification to enhance bone-implant interaction [8,9] . Successful osseointegration depends on surface topography, chemistry, and wettability, which regulate osteoblast adhesion and bone formation [10, 11].  \nTo overcome the chemical inertness of zirconia, numerous surface treatments have been explored, including sandblasting, acid etching, plasma spraying, and hydrothermal processing, to increase roughness and bioactivity [12-15] . However, results remain inconsistent becaus","cbCaietQyF1ShGAh","https://ap.wps.com/l/cbCaietQyF1ShGAh","pdf",607289,15,"English","# Abstract\n# Introduction And Background\n## Rationale for Zirconia Versus Titanium\n## Need for Surface Modification\n## Laser Surface Treatment in Dentistry\n## Reported Biological and Antimicrobial Effects\n## Parameters, Risks, and Research Need","[{\"question\":\"Why are laser surface modifications used for zirconia implants?\",\"answer\":\"Laser treatment is used to overcome zirconia’s low surface bioactivity by creating controlled micro- and nanoscale changes that enhance osseointegration-related surface properties.\"},{\"question\":\"What outcomes did the included in vitro studies report after laser treatment?\",\"answer\":\"Laser irradiation increased surface roughness and wettability, enhanced protein adsorption, and promoted osteoblastic adhesion, proliferation, and differentiation while improving antimicrobial potential through reduced bacterial adhesion.\"},{\"question\":\"Which laser types and parameters are highlighted as relevant?\",\"answer\":\"The review discusses multiple laser types (including femtosecond and Nd:YAG) and emphasizes that biological and mechanical outcomes depend on parameters such as wavelength, energy, and pulse duration, with excessive energy potentially inducing phase transformation.\"}]","Impact of Laser Surface Modification on Zirconia Implants - A Systematic Review of In Vitro Evidence | PDF",1790741621,38]