(PR81) Antimicrobial Efficacy of Laser-Activated Irrigation in Endodontic Therapy: A Systematic Review

Background: Laser-assisted irrigation protocols are used in endodontics for optimum disinfection of root canals.

Objective: This systematic review examined the antimicrobial efficacy of laser-assisted irrigation as compared to conventional chemo-mechanical preparation during root canal treatment.

Methods: An electronic database search was performed to identify relevant articles. Articles in English for randomized control studies, cohort studies conducted in vivo on permanent teeth were selected. Analysis of study design, methodology, and quality assessment was performed independently by two authors, with a third consulted when needed. Risk of bias was assessed using the Risk of Bias 2 tool.

Results: Out of 2,082 search results, eight randomized clinical trials (394 participants total) were included. Three studies showed no difference between results obtained for laser-assisted irrigation and chemical disinfection, two studies showed superior results for laser groups, and two studies showed better antimicrobial effect of NaOCl. One study showed superior results when both irrigation protocols were used in combination. Most studies showed low risk of bias, with one study having some concerns and two studies having high risk of bias. The quality of evidence for outcomes is low.

Conclusion: Based on the studies included in the review, all the laser-assisted irrigation protocols have an antimicrobial effect. Application of suitable laser with chemo-mechanical preparation of root canal results in synergistic effects. Clinical Implication: Microorganisms retained in root canals after chemo-mechanical preparation may cause persistent or secondary infection. Elimination or reduction of microbiota is necessary to resolve clinical symptoms and achieve healing of surrounding tissues.