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May 2024 Literature Review

Compiled by Dr Igor Cernavin, Prosthodontist, Honorary Senior Fellow University of Melbourne School of Medicine, Dentistry and Health Sciences.


Tu et al1 published an article on the safety and efficacy of the Er:YAG laser in debonding dental accessories. They found that laser removal using Er:YAG laser of dental accessories such as brackets, crowns, and veneers is fundamentally safe, time-saving, and does not cause damage to the enamel nor the underlying dentin. However, there was no distinct advantage with laser removal.


Pourhajibagher and coauthors2 published a review of the literature on the application of photosensitive dental materials as a novel antimicrobial option in dentistry. The abstract is reproduced in full.


The formation of dental plaque is well-known for its role in causing various oral infections, such as tooth decay, inflammation of the dental pulp, gum disease, and infections of the oral mucosa like peri-implantitis and denture stomatitis. These infections primarily affect the local area of the mouth, but if not treated, they can potentially lead to life-threatening conditions. Traditional methods of mechanical and chemical antimicrobial treatment have limitations in fully eliminating microorganisms and preventing the formation of biofilms. Additionally, these methods can contribute to the development of drug-resistant microorganisms and disrupt the natural balance of oral bacteria. Antimicrobial photodynamic therapy (aPDT) is a technique that utilizes low-power lasers with specific wavelengths in combination with a photosensitizing agent called photosensitizer to kill microorganisms. By inducing damage through reactive oxygen species (ROS), aPDT offers a new approach to addressing dental plaque and associated microbial biofilms, aiming to improve oral health outcomes. Recently, photosensitizers have been incorporated into dental materials to create photosensitive dental materials. This article aimed to review the use of photosensitive dental materials for aPDT as an innovative antimicrobial option in dentistry, with the goal of enhancing oral health.


Naghsh et al3 compared the effectiveness of Gluma and high-power 980-nm diode laser, alone or in combination, in the treatment of cervical dentin hypersensitivity. They concluded that that the 980-nm diode laser alone was more effective


Hadis and coworkers4 published an article on the harnessing the power of light and its photonic energy as a powerful tool in biomedical applications. The abstract is reproduced in full.


Harnessing the power of light and its photonic energy is a powerful tool in biomedical applications. Its use ranges from biomaterials processing and fabrication of polymers to diagnostics and therapeutics. Dental light curable materials have evolved over several decades and now offer very fast (≤ 10 s) and reliable polymerization through depth (4-6 mm thick). This has been achieved by developments on two fronts: (1) chemistries with more efficient light absorption characteristics (camphorquinone [CQ], ~30 L mol-1 cm1 [ʎmax 470 nm]; monoacylphosphine oxides [MAPO], ~800 L mol-1 cm-1 [ʎmax 385 nm]; bisacylphosphine oxide [BAPO], ~1,000 L mol-1 cm-1 [ʎmax 385 nm]) as well mechanistically efficient and prolonged radical generation processes during and after light irradiation, and; (2) introducing light curing technologies (light emitting diodes [LEDs] and less common lasers) with higher powers (≤ 2 W), better spectral range using

multiple diodes (short: 390-405 nm; intermediate: 410-450 nm; and long: 450-480 nm), and better spatial power distribution (i.e. homogenous irradiance). However, adequate cure of materials falls short for several reasons, including improper selection of materials and lights, limitations in the chemistry of the materials, and limitations in delivering light through depth. Photonic energy has further applications in dentistry which include transillumination for diagnostics, and therapeutic applications that include photodynamic therapy, photobiomodulation, and photodisinfection. Light interactions with materials and biological tissues are complex and it is important to understand the advantages and limitations of these interactions for successful treatment outcomes. This article highlights the advent of photonic technologies in dentistry, its applications, the advantages and limitations, and possible future developments.


Binrayes 5 published a review explaining the diverse applications and advancements of lasers in prosthodontics. It also highlighted the integration of lasers in diagnostic protocols, treatment modalities, and the fabrication of prosthetic restorations which readers may find of interest.


Ghahari, et al6 published a systematic review on the efficiency of Erbium Lasers in the removal of root canal system and surface biofilms. They concluded that Erbium lasers can be used to remove biofilms on dental implant surfaces and root canal systems and are safe options for untouchable sites in the root canal.

Odagiri, Yukari; and coworkers7 investigated the effect of painless low-power Er:YAG laser irradiation of conventional and polymer-infiltrated ceramic network (PICN) type CAD-CAM resin-based composites (RBCs) on resin bonding. They found that low-power Er:YAG laser irradiation of the conventional CAD-CAM RBCs was shown to be effective as a surface pretreatment for resin bonding, while the laser irradiation of PICN-type CAD-CAM RBCs was not effective.

Altuhafy et al8 published a systematic review of randomized control trials on the effectiveness of photobiomodulation on oral myofunctional therapy in orofacial pain disorders. The abstract is reproduced in full.

Orofacial pain can significantly affect physical, psychological, and overall quality of life. This study aimed to compare the effectiveness of combining photobiomodulation (PBM) with orofacial myofunctional therapy (OMT) in managing orofacial pain disorders. An electronic search of randomized controlled trials in electronic databases was performed until March 2024. Randomized controlled trials (RCTs) focusing on PBM and OMT for the management of orofacial pain were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions. A total of 10 RCTs were included, out of which 7 RCTs revealed that the combined approach of PBM and OMT had a more pronounced impact on diminishing pain and enhancing functional activity in patients with orofacial disorders. One study reported significant increases in pressure pain threshold for TMJ, masseter, and anterior temporalis muscles at both sides in the post-treatment compared with the pre-treatment in both groups. The risk of bias was low in 7, moderate in 2, and high in 1 study. The efficacy of a combined modality treatment of PBM with OMT for orofacial pain disorder shows promising results. However, further randomized controlled trials with extended follow-up periods standardized PBM and OMT parameters are warranted to obtain firm conclusions.



Zanin and coworgers9 published a case report on Er:YAG Laser and Hemolasertherapy in bone and gingival gain. The abstract is reproduced in full.

Background: Modern dentistry has increasingly valued conservative and biologically less invasive clinical practices, seeking to preserve the patients' tissues and natural dental elements. Most extractions in the dental clinic are preceded by periodontal disease that presents bone and gingival tissue loss, compromising the aesthetics as well as the support of dental elements. Objectives: The clinical approach in these cases often involves bone exertion followed by the successful installation of osseointegrated implants. Material and Methods: In this study, a case of extensive periodontal involvement and mobility of dental elements was carried out in a minimally invasive way, using the Er:YAG laser for periodontal decontamination and the hemolasertherapy technique to regenerate adjacent tissues, totaling nine weeks of treatment. Results: Clinical and radiographical improvement of tissue health and complete preservation of dental elements were observed. Conclusion: The patient underwent a follow-up appointment 2 years after the start of treatment when it was still possible to verify the stability of the clinical condition and the tissue gains obtained.

Wang et al10 reviewed in-vitro studies that evaluated the influence of erbium laser pretreatment on dentin shear bond strength (SBS) and bond failure modes. They concluded that Er:YAG and Er,Cr:YSGG lasers improved dentin SBS especially when the acid etch-and-rinse pretreatment was combined with Er:YAG laser. Shear bond strength and failure mode do not appear to be directly related.


Alzahrani and coworkers11 published a paper on the use of phtobiomodulation in orthodontics. The abstract is reproduced in full.

Accelerated orthodontics has revolutionized traditional dental practices by employing innovative techniques to expedite tooth movement and enhance treatment outcomes. Among these advancements, low-level laser therapy (LLLT) has emerged as a promising adjunctive method that offers a non-invasive and efficient approach to accelerate orthodontic tooth movement. By harnessing the power of low-level lasers, LLLT aims to stimulate cellular activity, promote bone remodeling, and reduce treatment duration, thereby revolutionizing the landscape of orthodontic care. In this review, we discuss the mechanism of action, methods, efficacy, advantages, limitations, and future scope of LLLT, uncovering its transformative impact on the field of accelerated orthodontics.





References

1. Tu, Shanshan; Sun, Chunyan; (...); Xiong, Zhengdong. Safety and Efficacy of the Erbium Laser in Debonding Dental Accessories: A Narrative Review. Photobiomodulation, photomedicine, and laser surgery. 2024-apr-10. 2. Pourhajibagher, Maryam; Bahrami, Rashin and Bahador, Abbas. Application of photosensitive dental materials as a novel antimicrobial option in dentistry: A literature review. 2024-aprJournal of dental sciences 19 (2) , pp.762-772. 3. Naghsh, Narges; Hosseini, Arezoo; (...); Birang, Reza. Evaluation of Three Methods for the Treatment of Dentin Hypersensitivity: A Randomised Clinical Trial. 2024-apr-12International dental journal. 4 4. Hadis, Mohammed A; Shortall, Adrian C and Palin, William M. The power of light - From dental materials processing to diagnostics and therapeutics. 2024-03-18 Biomaterial investigations in dentistry 11, pp.40308. 5. Binrayes, Abdulaziz An Update on the Use of Lasers in Prosthodontics. 2024-03-30Cureus 16 (3) , pp.e57282. 6. Ghahari, Parastou; Ghahhary, Arezou; (...); Sadat Afraz, Elham. The Efficiency of Erbium Lasers in the Removal of Root Canal System and Surface Biofilms: A Systematic Review and Meta-Analysis. 2024-apr Photobiomodulation, photomedicine, and laser surgery 42 (4) , pp.267-274. 7. Odagiri, Yukari; Horie, Taku; (...); Fujitani, Morioki. Effect of low power Er:YAG laser irradiation of CAD-CAM resin-based composites on resin bonding. 2024-aprAmerican journal of dentistry 37 (2) , pp.71-77. 8. Altuhafy, Maryam; Ahmed, Shahneel; (...); Khan, Junad. Effectiveness of photobiomodulation and orofacial myofunctional therapy in orofacial pain disorders. A systematic review of randomized control trials. 2024-05-09Lasers in medical science 39 (1) , pp.127. 9. Zanin, Fatima; Silva, Gabriela; (...); Brugnera, Aldo Jr. Er: YAG Laser and Hemolasertherapy: Bone and Gingiva Gain-Case Report. 2024-may-17Photobiomodulation, photomedicine, and laser surgery 10. Wang, Jun; Chen, Shuomin; (...); Huang, Shengbin. The Influence of Erbium Laser Pretreatment on Dentin Shear Bond Strength and Bond Failure Modes: A Systematic Review and Network Meta-Analysis. 2024-jan-15The journal of adhesive dentistry 26 (1) , pp.147-170. 11. Alzahrani, Afnan M; Aljibrin, Faisal J; (...); Dahhas, Feras Y. Photobiomodulation in Orthodontics: Mechanisms and Clinical Efficacy for Faster Tooth Movement. 2024-04-26Cureus 16 (4) , pp.e59061

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