Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil.
J Evid Based Dent Pract. 2024 Sep;24(3):101990. doi: 10.1016/j.jebdp.2024.101990. Epub 2024 Mar 28.
The present systematic review with a network meta-analysis (NMA) aimed to evaluate the effect of high-power lasers, associated or not with fluoride compounds, to control and prevent Erosive Tooth Wear (ETW).
The review was registered in the PROSPERO (CRD42021242547) and followed the PICO question: P (population): enamel and dentin substrate; I (Intervention): high-power laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control of ETW. The electronic databases PubMed, Scopus, and EMBASE were searched. Two independent reviewers evaluated in vitro and in situ studies. The risk of bias was assessed using the RoBDEMAT tool. The estimated treatment effect derived from direct and indirect comparisons were analyzed and the difference between these effects was calculated based on the data of enamel and dentin surface loss (in μm).
A total of 179 studies were retrieved and after the exclusion of duplicates, 103 studies had their titles and abstracts evaluated. Thirty-nine studies had their full text analyzed for data extraction (Cohen Kappa = 0.88). For sound enamel, the laser irradiation (L), fluoride application (F) and, the association of treatments (L + F) promoted higher protection than No-Treatment (NT). For eroded enamel, L + F and F did not differ, but both treatments reduced surface loss compared to NT and L. For sound and eroded dentin, treatments with laser increased surface loss.
Although a high-power laser has some potential to prevent erosive tooth wear, this effect is not better than that of standard fluoride. The use of laser in the management of dentin erosive wear can be harmful.
本系统评价通过网络荟萃分析（NMA）旨在评估高强度激光（联合或不联合氟化物）对控制和预防侵蚀性牙齿磨损（ETW）的效果。
本综述在 PROSPERO（CRD42021242547）中注册，并遵循 PICO 问题：P（人群）：牙釉质和牙本质基质；I（干预）：高强度激光照射，联合或不联合氟化物；C（对照）：无治疗；O（结局）：预防/控制 ETW。电子数据库 PubMed、Scopus 和 EMBASE 进行了检索。两位独立的审查员评估了体外和原位研究。使用 RoBDEMAT 工具评估偏倚风险。直接和间接比较得出的治疗效果进行了分析，并根据牙釉质和牙本质表面损失（以μm 为单位）的数据计算了这些效果之间的差异。
共检索到 179 项研究，在排除重复项后，有 103 项研究的标题和摘要进行了评估。39 项研究对全文进行了分析以提取数据（Cohen Kappa = 0.88）。对于健康牙釉质，激光照射（L）、氟化物应用（F）和联合治疗（L + F）比不治疗（NT）提供更高的保护。对于侵蚀性牙釉质，L + F 和 F 之间没有差异，但与 NT 和 L 相比，这两种治疗方法都减少了表面损失。对于健康和侵蚀性牙本质，激光治疗增加了表面损失。
尽管高强度激光具有一定预防侵蚀性牙齿磨损的潜力，但这种效果并不优于标准氟化物。激光在处理牙本质侵蚀性磨损中的使用可能有害。
