SEM image at 30X showing the Laser-Lok zone on a
The uniformity of the Laser-Lok microstructure and
nanostructure is evident using extreme magnification.
Unique surface characteristics
Laser-Lok microchannels is a series of cell-sized circumferential channels that are precisely created using laser ablation technology. This technology produces extremely consistent microchannels that are optimally sized to attach and organize both osteoblasts and fibroblasts.41,20 The Laser-Lok microstructure also includes a repeating nanostructure that maximizes surface area and enables cell pseudopodia and collagen microfibrils to interdigitate with the Laser-Lok surface.
Human histology shows the apical extent of the junctional epithelium below which there is a supracrestal connective tissue attachment to the Laser-Lok surface.11
Polarized lights show the connective tissue is functionally oriented.11
Colorized SEM of a dental implant harvested at 6 months post-op shows the connective tissue is physically attached and interdigitated with the Laser-Lok surface.
Different than other surface treatments
Virtually all dental implant surfaces on the market are grit-blasted and/or acid-etched. These manufacturing methods create random surfaces that vary from point to point on the implant and alter cell reaction depending on where each cell comes in contact with the surface.42 While random surfaces have shown higher osseointegration than machined surfaces,43 only the Laser-Lok surface has been shown using light microscopy, polarized light microscopy and scanning electron microscopy to also be effective for soft tissue attachment.11,27
The clinical advantage
The Laser-Lok surface has been shown in several studies to offer a clinical advantage over other implant designs. In a prospective, controlled multi-center study, Laser-Lok implants, when placed alongside identical implants with a traditional surface, were shown at 37 months post-op to reduce bone loss by 70% (or 1.35mm).12 In a retrospective, private practice study, Laser-Lok implants placed in a variety of site conditions and followed up to 3 years minimized bone loss to 0.46mm.15 In a prospective, University-based overdenture study, Laser-Lok implants reduced bone loss by 63% versus NobelReplace® Select.13
Bone Level (mm)
Crestal Bone Loss Laser-Lok Control
In a 3-year multicenter perspective study, Laser-Lok showed superior
bone maintenance over identical implants without Laser-Lok.12
Comparative histologies show the biologic differences between standard abutments and Laser-Lok
abutments including changes in epithelial downgrowth, connective tissue and crestal bone health.27
Comparative SEM images show the variation in tissue attachment strength on standard and Laser-Lok
abutments when a tissue flap is incised vertically and manually lifted using forceps.27
The establishment of a physical, connective tissue attachment to the Laser-Lok surface has generated an entirely new area of research and development: Laser-Lok applied to abutments. This could provide an opportunity to use Laser-Lok abutments to create a biologic seal and Laser-Lok implants to establish superior osseointegration20 - a solution that offers the best of both worlds. Alternatively, Laser-Lok abutments could support peri-implant health around implants without Laser-Lok. In a recent study, Laser-Lok abutments and standard abutments were randomly placed on implants with a grit-blasted surface to evaluate the differences. In this proof-of-principle study, a small band of Laser-Lok microchannels was shown to inhibit epithelial downgrowth and establish a connective tissue attachment similar to Laser-Lok implants.27 This time, however, the attachment was established above the dental implant-abutment connection and even on implants with a machined collar.27 The resulting crestal bone levels were higher than what was seen with standard abutments and provides some insight into the role soft tissue stability may play in maintaining crestal bone health.