Lasers can be effective in root canal treatments, particularly as an adjunct to traditional disinfection methods. However, the evidence is not yet conclusive, and further high-quality studies are needed to establish standardized protocols and confirm their efficacy.
Effectiveness of Lasers in Root Canal Treatment
- Adjunctive Use with Traditional Methods: Lasers, when used in conjunction with traditional chemical disinfectants like sodium hypochlorite, have shown enhanced bacterial reduction in root canals. For instance, combining laser irradiation with sodium hypochlorite resulted in a 92.7% reduction in bacterial load, which was more effective than using sodium hypochlorite or laser alone (Wenzler et al., 2021; Asnaashari et al., 2022; Bago et al., 2013).
- High-Power Lasers: High-power lasers, such as diode lasers, have demonstrated significant antibacterial effects when used as an adjunct to conventional irrigation methods. They can enhance the disinfection process by reaching areas that are difficult to access with traditional techniques (Asnaashari et al., 2022; Palacios et al., 2024).
- Antimicrobial Photodynamic Therapy (aPDT): This method, which combines lasers with photosensitizers, has shown potential in removing biofilms from infected root canals. However, the results are inconsistent, and more research is needed to optimize protocols (Bordea et al., 2019; Bago et al., 2013).
Limitations and Considerations
- Quality of Evidence: Many studies have limitations such as small sample sizes, lack of standardized protocols, and high heterogeneity, which make it difficult to draw definitive conclusions about the efficacy of laser monotherapy in root canal disinfection (Fransson et al., 2013; Dawasaz, 2021).
- Need for Further Research: There is a consensus on the need for more high-quality, randomized controlled trials to better understand the role of lasers in endodontic therapy and to develop standardized treatment protocols (Fransson et al., 2013; Bordea et al., 2019; Dawasaz, 2021).
Conclusion
Lasers show promise as an adjunctive tool in root canal treatments, enhancing the effectiveness of traditional disinfection methods. However, due to the variability in study designs and outcomes, more rigorous research is necessary to establish their role and optimize their use in clinical practice.
References
Fransson, H., Larsson, K., & Wolf, E. (2013). Efficacy of lasers as an adjunct to chemo-mechanical disinfection of infected root canals: a systematic review.. International endodontic journal, 46 4, 296-307. https://doi.org/10.1111/iej.12003
Wenzler, J., Falk, W., Frankenberger, R., & Braun, A. (2021). Impact of Adjunctive Laser Irradiation on the Bacterial Load of Dental Root Canals: A Randomized Controlled Clinical Trial. Antibiotics, 10. https://doi.org/10.3390/antibiotics10121557
Asnaashari, M., Sadeghian, A., & Hazrati, P. (2022). The Effect of High-Power Lasers on Root Canal Disinfection: A Systematic Review.. Journal of lasers in medical sciences, 13, e66. https://doi.org/10.34172/jlms.2022.66
Bordea, I., Hanna, R., Chiniforush, N., Grădinaru, E., Câmpian, R., Sîrbu, A., Amaroli, A., & Benedicenti, S. (2019). Evaluation The Outcome Of Various Laser Therapy Applications In Root Canal Disinfection: A Systematic Review.. Photodiagnosis and photodynamic therapy. https://doi.org/10.1016/j.pdpdt.2019.101611
Bago, I., Plecko, V., Pandurić, D., Schauperl, Z., Baraba, A., & Anić, I. (2013). Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment.. International endodontic journal, 46 4, 339-47. https://doi.org/10.1111/j.1365-2591.2012.02120.x
Palacios, M., Reyes, N., Guerra, N., & Arteaga, A. (2024). Diode laser to enhance irrigation of the root canal system: systematic literature review. Salud, Ciencia y Tecnología. https://doi.org/10.56294/saludcyt2024921
Dawasaz, A. (2021). In Vivo Efficacy of Diode Laser as a Monotherapy in Root Canal Disinfection: A Systematic Review and Meta-Analysis.. Photobiomodulation, photomedicine, and laser surgery. https://doi.org/10.1089/photob.2021.0073
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