Major clinical outcomes of laser therapy in endodontic treatments: a systematic review

Abstract

Introduction: In the setting of endodontic treatment, postoperative pain continues to be a problem in up to 58% of patients. This is due to the release of inflammatory mediators whenever the pulp or periradicular tissues are injured during root canal treatment or retreatment. The application of lasers in endodontics has increased due to their safety and effectiveness in dental treatments. Objective: It was to develop a systematic review to present the main clinical outcomes of the use of laser therapy in endodontic treatments. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 98 articles were found, 35 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=72.7% <50%. It was concluded that low-level laser therapy has been used in endodontics to promote analgesia, modulation of inflammation, and tissue healing. Analgesia mediated by low-level laser therapy results in vasodilation, and increased levels of adenosine triphosphate and cortisol, inhibiting the production of inflammatory factors. Recent studies reported that the use of low-level lasers enabled the treatment of post-endodontic pain compared to control. Furthermore, studies have shown that laser therapy can increase collagen synthesis and, concerning bone, modulate inflammation, accelerate cell proliferation, as well as stimulate bone stem cells, and accelerate their repair process.