Clinical assessment of patient-centered outcomes of diode laser ablation, electrocautery, blade scalpel surgery, and tissue punch for second-stage uncovering: a randomized controlled trial study

Abstract

There are multiple ways to modify soft tissue to reveal dental implants and start the prosthetic phase of treatment. A critical step in implant therapy is the implant uncovering procedure, which exposes the implant fixture and allows for proper prosthetic restoration. To assess and compare the clinical outcomes of different surgical techniques used to uncover dental implants in the second stage of surgery. In this prospective, randomized, comparative study, a total of 120 implants from 80 participants were evaluated using four uncovering techniques (cold surgery, diode laser, electrocautery, and tissue punch; n = 30 per technique), and they were followed up for 7 days. Then, associations between categorical variables, such as age, gender, implant site, operative efficiency, intraoperative bleeding, postoperative pain, swelling, wound healing, comfort, satisfaction, and complication profiles, were examined and compared. The groups were comparable in terms of age and gender distribution (p > 0.05). The diode laser and tissue punch achieved the shortest procedure times (1.6 ± 0.4 and 2.5 ± 0.5 min, respectively), the least intraoperative bleeding (p < 0.001), markedly lower postoperative pain/swelling, and the highest patient satisfaction/comfort (p < 0.001). By day 7, all patients were pain-free (p < 0.001), with excellent wound healing using the diode laser (83.3%) and satisfactory with the tissue punch (10% excellent and 50% good). However, the blade scalpel technique resulted in more bleeding, discomfort, and delayed healing, while electrocautery showed increased thermal effects. The diode laser and tissue punch techniques demonstrated the most efficient, minimally invasive, and patient-friendly outcomes for dental implant uncovering. Both provided superior healing, reduced postoperative complications, and higher satisfaction compared to other methods. Consort flow diagram illustrates participant enrollment, allocation, follow-up, and analysis Consort flow diagram illustrates participant enrollment, allocation, follow-up, and analysis