Laser Literature Review - August 2021

Compiled by Dr Igor Cernavin, Prosthodontist, Honorary Senior Fellow University of Melbourne School of Medicine, Dentistry and Health Sciences, Australian representative of World Federation of Laser Dentistry (WFLD).

Sokout et al1 investigated the pulpal effect of diode low-level laser therapy (LLLT) of the 810 nm laser on the alleviation of pain in patients requiring dental procedures. They concluded that the 810 nm low-level laser is a powerful device for induced anesthesia applications in patients requiring dental procedures. It also lessens the patients' fear of dental procedures.

Grzech-Lesniak and coworkers2 measured the quantity of aerosols released during various dental procedures (caries and prosthetic treatment, debonding of orthodontic brackets, root canal irrigation) while employing the Er:YAG lasers combined with a high-volume evacuator, or salivary ejector. They found that the use of the Er:YAG lasers during dental treatment significantly generates less aerosol in the dental office setting, which reduces the risk of transmission of viruses or bacteria.

Kinalski et al3 assessed the influence of low-level laser therapy (LLLT) on stability in implants placed in healed sites and concluded that it did not influence the stability.

Camargo and coworkers4 evaluated the effects of infrared light laser therapy (ILLT) on ligature-induced periodontitis in rats using micro-computed tomography (micro-CT), histology, fibroblast migration, and viability analysis. They found that infrared light laser therapy seemed to preserve the bone structure in the in vivo periodontitis induction model at 30 days and did not reduce cell viability or increase fibroblast migration in vitro. The ILLT provides positive effects on mandibular bone microstructure.

Chow et al5 published a review of the current concepts on treatment of Alveolar Osteitis (Dry Sockets) and concluded that LLLT was the most effective form of treatment.

Nayyer and coworkers6 compared external root resorption during orthodontic tooth movement between patients who were subjected to photobiomodulation and those who were not and concluded that it did reduce resorption.

Simon et al7 published an interesting study to implement the use of lasers to accurately and predictably access teeth to follow the principles of minimally invasive endodontics.

The abstract is reproduced in full.

INTRODUCTION: Ideal endodontic access provides unobstructed entry to the pulp chamber and visualization of the canal orifices while preserving the maximum amount of tooth structure. The aim of this study is to implement the use of lasers to accurately and predictably access teeth to follow the principles of minimally invasive endodontics.

METHODS: Traditional, conservative, ultra conservative, bridge, truss and orifice directed accesses were performed. A computer-controlled 9.3-mm CO2 laser ablation system was assembled and coupled with custom software capable of combining CBCT volumetric data with spatially calibrated digital images of teeth to provide an augmented reality environment for designing and preparing endodontic accesses. Twenty (n=20) sound posterior teeth with fully developed root canal systems were imaged with CBCT and accessed via laser ablation in vitro.

RESULTS: All twenty (20/20) teeth were successfully accessed without iatrogenic errors. Volumetric renderings from post access CBCT scans were used to verify the access and determine accuracy qualitatively. Volumetric measurements of hard tissue removed were Traditional=39.41-mm3, Conservative=9.76-mm3, Ultra-conservative=7.1-mm3, Bridge=11.53-mm3, Truss=19.21-mm3 and Orifice directed=16.86-mm3.

CONCLUSIONS: Digital image guidance based on feature recognition and registration with CBCT data is a viable method to address the challenge of dynamic navigation for accessing the pulp chamber. Modern lasers with high pulse repetition rates integrated with computer-controlled scanning systems are suitable for the efficient cutting of dental hard tissues.

Guimaraes, L S; and coworkers8 assessed the efficacy of photobiomodulation in reducing postoperative symptoms and the use of analgesics in teeth with asymptomatic apical periodontitis treated with foraminal enlargement in a single visit and concluded that there was no effect.

.Palled et al9 evaluated whether low-level laser therapy improves healing of the implant surgical site with clinical and biochemical parameters and concluded that it does.

Tzanakakis and coworkers 10 , published a review on the use of lasers in dental materials. The abstract is reproduced in full.

Lasers have been well integrated in clinical dentistry for the last two decades, providing clinical alternatives in the management of both soft and hard tissues with an expanding use in the field of dental materials. One of their main advantages is that they can deliver very low to very high concentrated power at an exact point on any substrate by all possible means. The aim of this review is to thoroughly analyze the use of lasers in the processing of dental materials and to enlighten the new trends in laser technology focused on dental material management. New approaches for the elaboration of dental materials that require high energy levels and delicate processing, such as metals, ceramics, and resins are provided, while time consuming laboratory procedures, such as cutting restorative materials, welding, and sintering are facilitated. In addition, surface characteristics of titanium alloys and high strength ceramics can be altered. Finally, the potential of lasers to increase the adhesion of zirconia ceramics to different substrates has been tested for all laser devices, including a new ultrafast generation of lasers.

Ciurescu,et al11 evaluated the clinical outcomes 2 years after the adjunctive use of an InGaAsP diode and Er,Cr:YSGG laser for nonsurgical treatment of severe periodontitis. They concluded that in patients with stage III or IV grade B periodontitis, InGaAsP and Er,Cr:YSGG used adjunctively to subgingival debridement may additionally improve the clinical outcomes compared to mechanical debridement alone over a period of 24 months.

Mahdian, Mina; Behboodi, Soodabeh; (...); Natto, Zuhair S12 published a paper regarding the use of LLLT for dentine hypersensitivity and concluded that limited and uncertain evidence from meta-analyses suggests that the application of laser overall may improve pain intensity when tested through air blast or tactile stimuli at short, medium, or long term when compared to placebo/no treatment. Overall, laser therapy appears to be safe. Future studies including well-designed double-blinded RCTs are necessary to further investigate the clinical efficacy of lasers as well as their cost-effectiveness.

Aoki and coworkers13 evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scaling and root planning treatment (Er:YAG laser-assisted comprehensive periodontal pocket therapy). They found that this form of treatment reduced the necessity of more conventional surgical therapies.

REFERENCES

1. Sokouti Emamzadeh Hashemi, Iman; Maleki, Dina; Seyyed Monir, Seyyed Ebrahim; et al. Effects of Diode Low-Level Laser Therapy of 810 Nm on Pulpal Anesthesia of Maxillary Premolars: A Double-Blind Randomized Clinical Trial. European endodontic journal Published: ‏ 2021-May-25 (Epub 2021 May 25).

2. Grzech-Lesniak, Kinga; Matys, Jacek. The Effect of Er:YAG Lasers on the Reduction of Aerosol Formation for Dental Workers. Materials (Basel, Switzerland) Volume: 14 Issue: 11 Published: ‏ 2021 May 26.

3. Kinalski, Mateus de Azevedo; Agostini, Bernardo Antonio; Bergoli, Cesar Dalmolin; et al. Influence of low-level laser therapy on implant stability in implants placed in healed sites: a randomized controlled trial. International journal of implant dentistry Volume: ‏ 7 Issue: ‏ 1 Pages: ‏ 49 Published: ‏ 2021 Jun 01.

4.Camargo, Gabriela Alessandra da Cruz Galhardo; Barbosa, Lucas Mota de Oliveira; Stumbo, Milla Bonecini; et al. Effects of infrared light laser therapy in vivo and in vitro periodontitis models. Journal of periodontology Published: ‏ 2021-May-29 (Epub 2021 May 29).

5. Chow O, Wang R, Ku D, Huang W. Alveolar osteitis: A review of current concepts. J Oral Maxillofac Surg 78:1288-1296,2020.

6. Nayyer, Nida; Tripathi, Tulika; Rai, Priyank; et al. Effect of photobiomodulation on external root resorption during orthodontic tooth movement-a randomized controlled trial. International orthodontics Volume: ‏ 19 Issue: ‏ 2 Pages: ‏ 197-206 Published: ‏ 2021-Jun (Epub 2021 Feb 18).

7. Simon, Jacob C; Kwok, Jason W; Vinculado, Frank; et al. Computer-Controlled CO2 Laser Ablation System for CBCT and Digital Image Guided Endodontic Access: A Pilot Study. Journal of endodontics Published: ‏ 2021-Jun-10 (Epub 2021 Jun 10).

8. Guimaraes, L S; Silva, Eab; Hespanhol, F G; et al. Effect of photobiomodulation on postoperative symptoms in teeth with asymptomatic apical periodontitis treated with foraminal enlargement: a randomized clinical trial. International endodontic journal Published: ‏ 2021-Jun-26 (Epub 2021 Jun 26).

9. Palled, Varsha; Rao, Jitendra; Chand, Pooran Assessment of the Healing of Dental Implant Surgical Site Following Low-Level Laser Therapy Using Bioclinical Parameters: An Exploratory Study. 2021-Jun-01 | The Journal Of Oral Implantology.

10. Tzanakakis, Emmanouil-George C; Skoulas, Evangelos; The Use of Lasers in Dental Materials: A Review. 2021-06-18 | Materials (Basel, Switzerland).

11. Ciurescu, Codruta Elena; Gutknecht, Norbert; (...); Cosgarea, Raluca. Two-year outcomes following the adjunctive use of InGaAsP and Er,Cr:YSGG lasers in nonsurgical periodontal therapy in patients with stages III and IV periodontitis. 2021-Jul-08 | Quintessence International (Berlin, Germany : 1985).

12. Mahdian, Mina; Behboodi, Soodabeh; (...); Natto, Zuhair S. Laser therapy for dentinal hypersensitivity. 2021-07-13 | The Cochrane Database Of Systematic Reviews.

13. Aoki, Akira; Mizutani, Koji; (...); Iwata, Takanori. Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study. 2021-Jul-19 | Clinical oral investigations.