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Chemical and morphological analysis of dentin irradiated by different high-power lasers: a systematic review

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Abstract

Purpose

This systematic review provides an overview of the main chemical and morphological alterations generated on dentin by different high-power lasers’ irradiation.

Methods

The review was registered in PROSPERO (CRD42023394164) and PRISMA guidelines were followed. The search strategy was conducted on MEDLINE (PubMed), Embase (Elsevier), and Web of Science (Clarivate) databases. The eligibility criteria were established according to the PICOS strategy, focusing on in vitro and ex vivo studies that assessed the chemical and morphological changes in dentin using five high-power lasers: Nd:YAG (1064 nm), Er:YAG (2940 nm), Er, Cr:YSGG (2780 nm), diode (980 nm), and CO2 (10,600 nm). Publication range was from 2010 to 2022. Data was summarized in tables and risk of bias was assessed by QUIN tool.

Results

The search resulted in 2255 matches and 57 studies composed the sample. The methods most used to assess the outcomes were scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and Raman. The studies presented “medium” and “low” risk of bias. The laser prevalently identified was the Er:YAG laser, associated with dentin ablation, absence of smear layer, and exposed tubules. The Nd:YAG laser generated vitreous surface and thermal damage, such as carbonization and cracks. The other lasers caused an irregular surface and no adverse thermal effects. Regarding the chemical structure, only the Er,Cr:YSGG laser caused collagen matrix reduction. The effects found were more intense with higher dosimetry.

Conclusion

Evidence available indicates that the irradiation of dentin with high-power lasers are related to morphological outcomes favorable to adhesive restorative procedures, with minimal changes in collagen matrix and mineral content. However, those observations should be carried carefully by clinicians and more clinical trials regarding the association of high-power laser irradiation and restorative procedure longevity are needed.

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Funding

This work was aided by The São Paulo Research Foundation (FAPESP): 2018/14450-1 and 2021/01623-8 and Coordination for the Improvement of Higher Education Personnel (CAPES): n° 33002029032P4.

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Authors and Affiliations

  1. Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Avenida do Café, s/n – USP’s campus, Ribeirão Preto, SP, 14040-904, Brazil

    Iago Ramirez, Gunther R. Bertolini, Amanda P. Candemil, Manoel D. Sousa-Neto & Aline E. Souza-Gabriel

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  2. Gunther R. Bertolini
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Contributions

I. Ramirez: data screening, writing, manuscript editing; G. R. Bertolini: data screening, writing, manuscript editing; A.P. Candemil: manuscript reviewing, language correction, supervision, data curation; M. D. Sousa-Neto: conceptualization, supervision, manuscript reviewing; A. E. Souza-Gabriel: conceptualization, manuscript reviewing, language correction, supervision, manuscript reviewing and editing. All authors read and approved the final manuscript.

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Correspondence to Aline E. Souza-Gabriel.

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Ramirez, I., Bertolini, G.R., Candemil, A.P. et al. Chemical and morphological analysis of dentin irradiated by different high-power lasers: a systematic review. Lasers Med Sci 38, 255 (2023). https://doi.org/10.1007/s10103-023-03912-0

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