Erbium, Chromium-Doped Yttrium-Scandium-Gallium-Garnet Laser in Endodontics: A Narrative Review

Erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser-assisted endodontics has been investigated as an adjunctive approach to enhance irrigant activation, root canal disinfection, smear layer removal, and cleaning of complex anatomical areas. Owing to its wavelength of approximately 2780 nm, Er,Cr:YSGG laser energy is highly absorbed by water and hydroxyapatite, allowing interaction with both irrigation solutions and dental hard tissues. This interaction may generate photoacoustic streaming, cavitation-like fluid movement, microjet-like hydrodynamic effects, and localized photothermal effects within the root canal system. This narrative review provides a descriptive and critical overview of the mechanisms, clinical applications, current evidence, and limitations of Er,Cr:YSGG laser-assisted endodontics. Available studies have evaluated its use in primary root canal treatment, retreatment procedures, regenerative endodontics, and endodontic microsurgery. Laboratory-based evidence suggests potential benefits in smear layer removal, debris reduction, antimicrobial activity, organic tissue dissolution, irrigant penetration into dentinal tubules, and obturation quality. However, most findings are derived from in vitro or ex vivo studies, and their direct translation to postoperative pain reduction, periapical healing, or long-term clinical success remains uncertain. Current evidence indicates that the efficacy and safety of Er,Cr:YSGG laser-assisted protocols are strongly influenced by laser parameters, tip design, tip position, application time, irrigant type, canal anatomy, and operator experience. Therefore, Er,Cr:YSGG lasers should not be considered a replacement for conventional chemomechanical preparation, but rather as an adjunctive technology that may support standard endodontic protocols when used under appropriate safety-oriented conditions. Further well-designed clinical studies with standardized parameters and long-term outcomes are needed.