Mansoura University, Operative Dentistry Department, Mansoura, Egypt.
Mansoura University, Biomaterials Department, Mansoura, Egypt.
Lasers Med Sci. 2024 Apr 18;39(1):107. doi: 10.1007/s10103-024-04049-4.
To investigate the in vivo and in situ effect of different types of lasers in prevention of enamel demineralization in high caries risk cases (around orthodontic brackets, around restoration and in caries susceptible pits and fissures). PubMed was searched using the following keyword sequence; (Laser therapy OR laser irradiation OR laser application) AND (enamel caries prevention OR enamel demineralization OR enamel remineralization OR early enamel caries OR early-enamel caries OR enamel resistance OR enamel decalcification OR white spot lesions WSLs OR incipient lesion OR enamel decay OR enamel Dissolution OR enamel microhardness) AND (clinical trial OR Randomized clinical trial OR In situ study). The latest literature search was ended by "30 January 2023". PubMed was used as a primary data base for study selection. Scopus, EBSCO, and Google scholar are checked in our study after results of systematic search on PubMed. Only duplicates were found. Two meta-analyses were carried out. The first, clinical meta-analysis on incidence of white spot lesions (WSLs) following CO2 laser irradiation of enamel. The second meta-analysis on ex-vivo/in situ effect of CO2 laser on microhardness of enamel. In each meta-analysis three studies were included. Risk of bias was assessed. The search identified eight studies (four ex-vivo and four clinical trials). Regarding the clinical meta-analysis, the overall standardized mean difference was 0.21 [ 95% confidence interval (CI): 0.15-0.30, p < 0.00001]. This indicates that the incidence of new WSLs in patients who received low power CO laser treatment was highly significantly lower than placebo groups. The heterogeneity was considerable (I = 71%). In the second meta-analysis, the overall standardized mean difference was 49.55 [ 95% confidence interval (CI): 37.74, 61.37, p < 0.00001]. This indicates that microhardness of enamel receiving low power (0.4-5 W) CO laser irradiation is highly significantly lower than control untreated enamel. The heterogeneity was substantial (I = 48%). Within the limitations of this study, Low level laser therapy concept with CO2 laser seems to be effective in preventing enamel caries.Prospero registration number: CRD42023437379.
为了研究不同类型的激光在预防高龋风险病例（正畸托槽周围、修复体周围和龋齿易感窝沟和裂隙内）中牙釉质脱矿方面的体内和原位作用，我们使用以下关键词序列在 PubMed 上进行了搜索：（激光治疗 OR 激光照射 OR 激光应用）和（牙釉质龋预防 OR 牙釉质脱矿 OR 牙釉质再矿化 OR 早期牙釉质龋 OR 早期牙釉质龋 OR 牙釉质抵抗力 OR 牙釉质脱钙 OR 白垩斑 WSLs OR 早期病变 OR 牙釉质龋 OR 牙釉质溶解 OR 牙釉质显微硬度）和（临床试验 OR 随机临床试验 OR 原位研究）。最新的文献检索截止日期为“2023 年 1 月 30 日”。PubMed 被用作研究选择的主要数据库。在我们的研究中，在对 PubMed 进行系统搜索后，还检查了 Scopus、EBSCO 和 Google Scholar。只发现了重复项。进行了两项荟萃分析。第一项是关于 CO2 激光照射牙釉质后白斑（WSLs）发生率的临床荟萃分析。第二项是关于 CO2 激光对牙釉质显微硬度的离体/原位效应的荟萃分析。在每项荟萃分析中，都纳入了三项研究。评估了偏倚风险。搜索确定了八项研究（四项离体和四项临床试验）。关于临床荟萃分析，总的标准化均数差为 0.21[95%置信区间（CI）：0.15-0.30，p<0.00001]。这表明接受低功率 CO 激光治疗的患者中新 WSLs 的发生率明显低于安慰剂组。异质性很大（I=71%）。在第二项荟萃分析中，总的标准化均数差为 49.55[95%置信区间（CI）：37.74，61.37，p<0.00001]。这表明接受低功率（0.4-5 W）CO 激光照射的牙釉质的显微硬度明显低于未经处理的对照牙釉质。异质性很大（I=48%）。在本研究的限制范围内，CO2 激光的低水平激光治疗概念似乎在预防牙釉质龋方面有效。Prospéro 注册号：CRD42023437379。
