Effectiveness of lasers in preventing white spot lesions in patients undergoing fixed orthodontic treatment- A systematic review

• Author Details:   
• Harneet Kaur
• Lekha Indukuru
• Deepali Garg
• Namrata Dogra
• Prasad Mandava
• Ganugapanta Vivek Reddy
• Singaraju Gowri Sankar ^*

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Objectives: To evaluate and compare the in vivo efficacy of various laser modalities in preventing white spot lesions (WSLs) in orthodontic patients with fixed appliances

Materials and Methods: We searched four online databases (Cochrane Library, PubMed Central, Science Direct, and Ovid®) up to August 31, 2024, identifying 1,605 articles. Eleven papers satisfied the eligibility criteria and were incorporated into the qualitative synthesis. The potential for bias in the chosen studies was assessed utilizing the Cochrane ROB-2 tool. PROSPERO- CRD2020212233

Results: Among the 11 included articles (9 randomized controlled trials and two clinical trials), four studies focused on argon lasers, four on CO2 lasers, one on both CO2 and Erbium-Chromium: Yttrium-Scandium-Gallium-Garnet lasers (Er, Cr: YSGG) in separate groups, one on Neodymium-doped yttrium Aluminum garnet (Nd), and one on a diode laser. Overall, the studies exhibited a moderate risk of bias. Laser treatments, particularly CO₂, Er: YAG, and Nd: YAG lasers, effectively prevent WSLS, enamel demineralisation, and caries while improving microhardness. Combining lasers with fluoride boosts their protective effects, especially in high-risk groups like children with partially erupted molars. CO₂ lasers demonstrate consistent effectiveness, while Nd:YAG and Er:YAG lasers exhibit favorable outcomes.

Conclusion: Overall, laser exposure to enamel surfaces before fixed orthodontic treatment is a valuable adjunct in preventive dentistry, helping reduce enamel side effects during orthodontic treatment.