Erbium Lasers for the Prevention of Enamel and Dentin Demineralization: A Literature Review

Objective: The aim of this article is to review the current literature concerning Erbium lasers: Er:YAG (λ=2.94μm), Er:YSGG (λ=2.79μm), and Er,Cr:YSGG (λ=2.78μm) for the prevention of enamel and dentin demineralization. Methods: Features such as laser parameters, reported outcome, inhibition of demineralization, and mechanisms of laser action were analyzed. A total of 55 publications were found in four electronic databases and were complemented by hand searching. Results: Evidence regarding the potential of laser-induced prevention of demineralization (LIPD) was demonstrated in the literature, especially when subablative parameters were applied. Although ablation parameters have shown partial positive results in LIPD, some studies have shown severe morphological alterations in enamel and dentin. Until now, there are still no reports on the long-term effects of laser treatment. Additionally, it is unclear if there is a best combination of mechanisms that leads to the optimal LIPD. Other variables that are poorly investigated in the literature and have an important role in LIPD include pulse width, water irrigation, and air flow. Conclusions: This review demonstrates the current knowledge concerning the use of erbium lasers in LIPD, and brings forth essential questions that should be further addressed.