Effects of Laser Applications on Fibroblasts Cultured on Zirconia Surfaces-A Systematic Review

Background/Objectives: This systematic review aimed to evaluate and summarize the available evidence on the effects of light-based applications, including laser irradiation on fibroblast responses to zirconia surfaces. Methods: A comprehensive electronic search was performed in PubMed, Scopus, Web of Science, Embase, and WorldCat databases. After duplicate removal and eligibility screening, 17 studies met the inclusion criteria. Only in vitro and animal studies assessing fibroblast behavior on zirconia after light- or laser-based surface irradiation were included. Due to heterogeneity in study designs and parameters, data were qualitatively synthesized. Results: All included studies confirmed the biocompatibility of laser-modified zirconia surfaces. Various laser systems-including Er:YAG, Er,Cr:YSGG, Nd:YAG, diode, excimer, and femtosecond lasers-were investigated. Most studies reported enhanced fibroblast adhesion, proliferation, and cytoskeletal organization compared with untreated controls. Two of the included studies demonstrated an antibacterial effect of erbium lasers treatment on zirconia surfaces. However, outcomes varied depending on the laser parameters, irradiation energy, and zirconia type used. Conclusions: Laser-based surface modification of zirconia appears safe and biocompatible, with evidence indicating favorable effects on fibroblast adhesion, proliferation, and organization. While these findings are promising for optimizing soft-tissue integration around zirconia implant abutments, further standardized and long-term studies are necessary to determine optimal laser settings and confirm clinical applicability.