Elafifi-Ebeid Haitham, Betancourt Pablo, Parada-Avendaño Isabel, Arnabat-Domínguez Josep
Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain.
Research Centre for Dental Sciences (CICO), Department of Integral Adult Dentistry, Universidad de La Frontera, Temuco 4810296, Chile.
J Clin Exp Dent. 2023 Feb 1;15(2):e149-e159. doi: 10.4317/jced.59941. eCollection 2023 Feb.
Post-endodontic pain (PEP) management is an important factor to be considered in endodontic treatment. Several risk factors have been described that can attribute to its appearance. Laser-assisted disinfection has been described by many authors for its antimicrobial effect. Few studies described the relation between laser disinfection and its effect on PEP. The objective of this review is to describe the relation between different intracanal laser disinfection techniques and their effects on PEP.
An electronic search strategy was performed in Pubmed, Embase, and Web of Science (WOS) databases without restrictions as to the date of publication. Eligibility criteria were randomized controlled clinical trials (RCT) that used one of the different intracanal laser disinfection techniques in their experimental groups evaluating PEP outcome were included. Risk of bias analysis was performed by the Cochrane risk of bias tool.
The initial research identified 245 articles from which 221 were excluded and 21 studies were sought for retrieval and 12 articles met our inclusion criteria for the final qualitative analysis. The laser systems used were Nd:YAG, Er:YAG and, diode lasers including photodynamic therapy.
The diode lasers showed the most promising results in terms of PEP reduction while Er:YAG showed more short-term efficacy (6 hours postoperative interval). The variables could not be analyzed homogenously due to the differences in the study designs. More RCT are needed comparing different laser disinfection techniques with the same baseline endodontic pathology to establish a specific protocol for the best outcome. Root canal treatment, Post-endodontic pain, Intracanal laser disinfection, laser dentistry.
根管治疗后疼痛(PEP)的管理是根管治疗中需要考虑的一个重要因素。已经描述了几种可能导致其出现的危险因素。许多作者都描述了激光辅助消毒的抗菌作用。很少有研究描述激光消毒与其对PEP的影响之间的关系。本综述的目的是描述不同根管内激光消毒技术与其对PEP的影响之间的关系。
在PubMed、Embase和科学网(WOS)数据库中进行电子检索,检索日期无限制。纳入标准为随机对照临床试验(RCT),其实验组使用不同的根管内激光消毒技术之一评估PEP结果。采用Cochrane偏倚风险工具进行偏倚风险分析。
初步检索到245篇文章,其中221篇被排除,21篇文章进行检索,12篇文章符合最终定性分析的纳入标准。所使用的激光系统包括Nd:YAG、Er:YAG和二极管激光,包括光动力疗法。
就减少PEP而言,二极管激光显示出最有前景的结果,而Er:YAG显示出更多的短期疗效(术后6小时间隔)。由于研究设计的差异,无法对变量进行统一分析。需要更多的RCT比较不同激光消毒技术与相同基线根管病理情况,以建立最佳结果的特定方案。根管治疗、根管治疗后疼痛、根管内激光消毒、激光牙科。