Lasers for caries removal in deciduous and permanent teeth

Area of Science:

• Dental Science
• Minimally Invasive Dentistry
• Laser Dentistry

Background:

• Dental caries remains a significant public health concern, with mechanical drills being the standard treatment.
• Adhesive materials and minimally invasive strategies, including lasers, offer alternatives for conservative tissue removal.
• Lasers are explored for controlled ablation, potentially reducing pain and patient anxiety associated with drilling.

Purpose of the Study:

• To systematically compare the efficacy and outcomes of laser-based caries removal versus conventional mechanical drilling.
• To evaluate effects on deciduous and permanent teeth across various age groups.

Main Methods:

• Comprehensive search of multiple electronic databases and clinical trial registries.
• Inclusion of randomized controlled trials, split-mouth, and cluster-randomized trials comparing laser therapy to drill ablation.
• Independent screening, data extraction, and risk of bias assessment by two reviewers.

Main Results:

• Nine trials involving 662 participants were included; most trials had small sample sizes and were at high risk of bias.
• No significant difference in caries removal effectiveness between lasers and drills (low-quality evidence).
• Lasers demonstrated significantly lower incidence of moderate/high pain and reduced need for anesthesia compared to drills (low-quality evidence).

Conclusions:

• Insufficient evidence exists to support laser therapy as a superior alternative to traditional drills for caries removal.
• Preliminary evidence suggests lasers may improve pain control and reduce anesthesia requirements, but requires further high-quality research.
• Well-designed randomized trials are necessary to definitively assess laser efficacy and safety for caries treatment.