Available online 28 March 2024, 101990

Author links open overlay panel, , , , ABSTRACTStatement of problem

: Erosive Tooth Wear (ETW) is a clinical condition with a high prevalence. Suggested preventive/treatment strategies include fluoride application and high-power laser irradiation. Controversial results have been reported regarding the effect of high-power lasers against ETW.

Objective

: 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 ETW.

Material and Methods

: 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).

Results

: 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.

Conclusions

: 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.

Section snippetsINTRODUCTION

Erosive Tooth Wear (ETW) is a clinical condition where acids of non-bacterial origin promote a chemical dissolution of dental hard tissues, resulting in its superficial softening.1 Under mechanical forces, such as abrasion, the softened tissue is lost layer by layer. Once the enamel is removed, dentin is exposed to the oral cavity.2 The progression of ETW can compromise the functional and esthetic properties of the tooth. As a consequence, there is the formation of concavities and changes in

Research strategies

The protocol for this review was registered in the International Prospective Register of Systematic Reviews database (PROSPERO – CRD42021242547) and followed the guidelines for systematic reviews incorporating network meta-analyses (PRISMA extension statement).21 The PICO question was established as follows: P (population): enamel and dentin substrate; I (Intervention): laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control

Study Selection

A total of 179 documents were identified in the electronic search: 82 were obtained from PubMed, 55 from Embase, and 42 from Scopus. With the aid of Microsoft Excel software, 56 duplicates were found and removed. Manually, another 20 duplicates were identified and removed. Thus, the titles and abstracts of 103 studies were evaluated and 57 were not included, as these studies did not perform an erosive and/or erosive/abrasive challenge (n = 29); and did not evaluate the protective effect of the

DISCUSSION

The present systematic review with a network meta-analysis aimed to provide the best scientific evidence concerning the ability of high-power lasers, associated or not with fluoride compounds, in the prevention and control of ETW. The results of the present study showed that, for sound enamel (when these treatments were used as a preventive approach), all treatments tested promoted a higher reduction in enamel surface loss, compared to the negative control, no treatment – NT. Based on this

CONCLUSIONS

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. The present conclusions are based on studies presenting high heterogeneity and high-risk of bias, especially due to the sample-sized description and the randomization of the specimens.

CONFLICTS OF INTEREST

None.

CRediT authorship contribution statement

Leonardo Custódio de Lima: Writing – review & editing, Writing – original draft, Visualization, Validation, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Karin Landmayer: Writing – review & editing, Writing – original draft, Visualization, Validation, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Mariana Minatel Braga: . Taís Scaramucci: Writing – review & editing, Writing –

ACKNOWLEDGEMENTS

The authors would like to thanks São Paulo Research Foundation (FAPESP) for the scholarship for the first author (grant #2020/07986-2); the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001, for the scholarship of the second author; and the National Council for Scientific and Technological Development (CNPq), process # 309658/2022-5.

View full text

© 2024 Elsevier Inc. All rights reserved.