Is There a Relationship between Laser Therapy and Root Canal Cracks Formation? A Systematic Review

Area of Science:

• Dental research
• Endodontics
• Biomaterials science

Background:

• Crack formation in endodontically treated teeth is critical for long-term prognosis.
• Laser therapy is increasingly used in endodontics.
• Understanding laser-induced dentinal cracks is essential.

Purpose of the Study:

• To systematically review and evaluate the association between laser therapy and root canal dentinal crack formation.
• To compare crack formation between laser devices and ultrasonic tips.

Main Methods:

• Systematic literature search of multiple databases and gray literature.
• Inclusion of studies evaluating laser-induced cracks in human root dentin.
• Risk of bias assessment using a modified CONSORT checklist.
• Meta-analysis of crack incidences, complete/incomplete cracks, and intra-dentinal cracks.

Main Results:

• Fifteen of 22 included studies indicated that lasers can form cracks in root dentin.
• Meta-analysis revealed no statistically significant difference in crack formation between ultrasonic tips and laser devices.
• The findings were consistent across studies, including those with baseline sample assessments.

Conclusions:

• Laser irradiation can induce and propagate cracks in root dentin, posing a concern for tooth longevity in endodontics.
• Current evidence suggests no difference in crack formation compared to ultrasonic instrumentation.
• Further research is needed to standardize methodologies and establish parameters to mitigate potential harmful effects of lasers on dentin.