Advances in laser-assisted regenerative endodontic procedures: a scoping review

Abstract

OBJECTIVES: This scoping review explores advancements in integrating laser technologies into regenerative endodontic procedures (REPs) and evaluates their potential benefits compared to conventional approaches. DATA AND SOURCES: The review encompassed searches in electronic databases - Embase, Cochrane Library, PubMed, Scopus, and Web of Science (September 27th, 2024) - and grey literature from Google Scholar and ProQuest. STUDY SELECTION: Out of 480 identified references, 14 studies met the inclusion criteria. Laser applications were categorized into photobiomodulation (PBM), photodynamic therapy (PDT), and other laser-assisted techniques, such as Er:YAG laser-assisted irrigation and diode laser dentin etching. PBM showed enhanced tissue regeneration through improved angiogenesis, cell proliferation, and the release of growth factors such as TGF-β1. PDT provided antimicrobial effects without compromising cell viability. Er:YAG laser-assisted irrigation demonstrated increased growth factor release but posed risks of irrigant extrusion. Additionally, diode laser dentin etching enhanced stem cell attachment, offering improvements to REPs. CONCLUSIONS: With an expanding evidence base, laser technologies hold promise for becoming integral to REPs, enabling minimally invasive and effective treatments for necrotic and traumatized immature teeth. Nonetheless, the limited number of studies highlights the need for further research. Standardized clinical trials are crucial to establish long-term outcomes and address safety concerns. CLINICAL SIGNIFICANCE: REPs offer a promising approach for treating immature necrotic teeth, and the use of lasers in endodontics has demonstrated advantages over traditional methods. This scoping review aimed to explore significant findings regarding the use of laser-assisted therapies in REPs.