Laser in endodontics: a scoping review

Abstract

Objective: To evaluate the effect of LASER (Light Amplification by Stimulated Emission of Radiation) in endodontics and its effectiveness compared to conventional techniques and methods currently used. Material and method: The electronic databases PubMed, Science direct and Cochrane library, were searched from 2010-2022 to identify clinical trials and in vitro/in vivo trials evaluating the clinical application of laser in endodontics. The search terms utilized various combinations as follows: endodontics or root canal therapy or dentin or dental pulp and laser. Articles were selected according to the inclusion criteria, data were extracted and methodological quality was assessed. Results: Twenty articles were deemed eligible and included in the review. Of these twenty studies, eleven were in vitro trials and nine were in vivo trials. An assessment of the risk of bias of the included studies was used to classify the studies into three categories: low, medium, and high risk of bias. To evaluate the results of these articles, we established the following analysis criteria: root canal disinfection, direct pulp capping, post endodontic pain and opening of dentinal tubuli. The results of the studies included in this review showed that laser appears to improve root canal disinfection, removal of debris and smear layer, adaptation of filling materials to dentin by increasing the penetration of root canal sealants into the dentinal tubuli, improved prognosis of direct pulp capping treatment as well as decreased postoperative endodontic pain. Conclusion: Although laser appears to improve the quality of endodontic treatment, the heterogeneity in the methodology among the eligible studies did not allow a meta-analysis to be performed for clinical decisions with greater certainty of evidence. Further in vivo studies with standardization of laser parameters are needed to validate its utility as an innovative technology in modern endodontics.