Therapeutic and Adverse Effects of Lasers in Dentistry: A Systematic Review

Abstract

Laser therapy has become one of the gold standards of treatment in routine dentistry. In the 1970s, CO2 lasers were the first lasers to be used in oral surgery on soft tissues. Subsequently, other lasers (Diode, Nd YAG, Er: YAG, Argon and Erbium) have also been used in periodontics, implantology, orthodontics and restorative dentistry, as well as for hard tissues, such as bone, enamel and dentin. The purpose of this systematic review is to analyze both the therapeutic properties and adverse effects of laser use in dentistry, related to a non-targeted choice of medical device based on clinical need as well as an inadequate learning curve. A systematic review was performed following the PRISMA guidelines using Pubmed, Scopus and Web of Science. The use of lasers requires a specific learning curve modifying the standard surgical approach. The use of lasers provides multiple therapeutic benefits but can lead to some failures in dental treatments. In restorative dentistry, it has been found that lasers can cause cracks that can lead to fractures and/or affect the composite restoration. In periodontal treatments, the use of lasers can produce thermal damage to pulp tissue. In surgical treatments, the use of a laser caused bleeding, post-operative pain and a burning sensation. The failure of tissue cooling during laser beam emission could produce the necrosis of hard and soft tissues.

Infrared diode laser enhances human periodontal ligament stem cells behaviour on titanium dental implants

“…Moreover, laser application allows cutting of the peri-implant bone selectively and with less invasiveness than alternative techniques. Although lasers have demonstrated efficacy in numerous dental procedures, their utilization is subject to potential contraindications and limitations 4 . Hard lasers have the potential to harm the dental pulp, and certain laser operations may still necessitate the use of anaesthesia.…”

Low-Level Light Therapy in Orthodontic Treatment: A Systematic Review

“…The short-term activation of the respiratory chain and oxidation of nicotinamide adenine dinucleotide (NADH) brought on by the respiratory chain's absorption of light results in modifications to the mitochondrial and cytoplasmic redox states. The electron transport chain becomes active and causes the cytoplasm to become more alkaline, the electrical potential of the mitochondrial membrane to increase, the reserve of ATP to increase, and then the synthesis of nucleic acids to begin [8,9].…”

“…For example, it can be used to alleviate the painful sensation caused by the needle insertion of needed anesthesia [14] or to disinfect carious lesions or root canals during ongoing devitalization through photoactivation [15], and it may also be useful in the treatment of sore mouth syndrome, although this has yet to be demonstrated with large-scale clinical trials [16]. Thanks to its effect on osteoblast proliferation and bone formation, its ability to interact selectively with the mouth cavity's tissues, its healing effect, and its biostimulating effect favoring the healing process, the dental laser is particularly suitable for surgery/implantology [9,17]. In recent years, it has also gained popularity in the orthodontic branch, particularly for tooth movement, root resorption, pain perception during treatment, and the stability of orthodontic miniscrews.…”