Post-endodontic pain evaluation after different intracanal laser assisted disinfection techniques. A Systematic Review.

Background: Post-endodontic pain (PEP) management is an important factor to be considered in endodontic treatment. Several risk factors have been described that can attribute to its appearance. Laser-assisted disinfection has been described by many authors for its antimicrobial effect. Few studies described the relation between laser disinfection and its effect on PEP. The objective of this review is to describe the relation between different intracanal laser disinfection techniques and their effects on PEP. Material and Methods: An electronic search strategy was performed in Pubmed, Embase, and Web of Science (WOS) databases without restrictions as to the date of publication. Eligibility criteria were randomized controlled clinical trials (RCT) that used one of the different intracanal laser disinfection techniques in their experimental groups evaluating PEP outcome were included. Risk of bias analysis was performed by the Cochrane risk of bias tool. Results: The initial research identified 245 articles from which 221 were excluded and 21 studies were sought for retrieval and 12 articles met our inclusion criteria for the final qualitative analysis. The laser systems used were Nd:YAG, Er:YAG and, diode lasers including photodynamic therapy. Conclusions: The diode lasers showed the most promising results in terms of PEP reduction while Er:YAG showed more short-term efficacy (6 hours postoperative interval). The variables could not be analyzed homogenously due to the differences in the study designs. More RCT are needed comparing different laser disinfection techniques with the same baseline endodontic pathology to establish a specific protocol for the best outcome.