Laser systems and current applications in endodontics: A review

Abstract

Laser technology has gained increasing attention in endodontics due to its potential to enhance disinfection, improve treatment outcomes, and support minimally invasive clinical approaches. The aim of this review was to provide a comprehensive overview of commonly used laser systems in endodontics and to summarize their current clinical applications. Various laser types, including carbon dioxide (CO₂), diode, neodymium-doped yttrium aluminum garnet (Nd:YAG), neodymium-doped yttrium aluminum perovskite (Nd:YAP), erbium-doped yttrium aluminum garnet (Er:YAG), and erbium chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG), have been evaluated in terms of their mechanisms of action and clinical effectiveness. Lasers are used in multiple endodontic procedures, such as root canal disinfection, smear layer removal, pulp capping, pulpotomy, dentin hypersensitivity management, and treatment of pulp and periapical pathologies. In particular, laser-activated irrigation techniques, including photon-induced photoacoustic streaming (PIPS) and shock wave–enhanced emission photoacoustic streaming (SWEEPS), have shown promising results in improving irrigation efficacy and bacterial elimination, especially in complex root canal anatomies. Compared with conventional irrigation methods, these advanced laser techniques enhance the penetration of irrigants into dentinal tubules while minimizing thermal damage to surrounding tissues. Erbium lasers, owing to their high water absorption and photoacoustic effects, appear to be especially effective for smear layer removal and biofilm disruption. Other laser systems, such as diode and Nd:YAG lasers, also contribute to antimicrobial activity and postoperative pain reduction when used appropriately. However, laser parameters, irradiation time, and safety considerations remain critical for successful clinical outcomes. In conclusion, laser systems offer significant advantages in endodontic therapy by improving disinfection, supporting tissue preservation, and enabling minimally invasive techniques. Further well-designed clinical studies are needed to strengthen the evidence regarding their long-term efficacy, safety, and optimal clinical protocols.