Combined Effects of Topical Fluorides and Semiconductor Lasers on Prevention of Enamel Caries: A Systematic Review and Meta-Analysis

Abstract

Objective: Compare the effects of combined treatment of topical application of fluoride and semiconductor laser (F&L) with topically using fluoride (F) on remineralisation and prevention of enamel caries. Background: There is no agreement on whether semiconductor lasers can promote the effect of topical fluoride on the remineralisation and prevention of dental caries. This study is the first systematic review and meta-analysis to investigate the pooled effect of data from studies that compared the combined use of semiconductor lasers and topical fluorides with the single use of fluoride on remineralisation and prevention of caries. Methods: We performed literature search on Scopus, Web of Science and PubMed. The keywords were as follows: ((diode lasers) OR (diode laser) OR (quantum cascade laser) OR (quantum cascade lasers) OR (Gallium Aluminum Arsenide lasers) OR (Gallium Aluminum Arsenide laser) OR (GaAlAs lasers) OR (GaAlAs Laser) OR (semiconductor laser) OR (semiconductor lasers)) AND ((caries) OR (dental caries) OR (remineralisation) OR (remineralization) OR (demineralization) OR (demineralisation)) AND fluoride. We carried out meta-analysis to compare the microhardness of demineralised enamel, lesion depth (LD) and percent reduction of calcium (Ca%) of sound enamel receiving F&L with F. Results: The search identified nine laboratory studies, which used 445 to 980 nm semiconductor lasers with various fluorides. The standard mean difference of microhardness of demineralised enamel between F&L and F was 1.06 (CI:0.12, 2.00, p=0.03). No difference was found in LD (CI:−1.63, 0.10, p=0.08) and Ca% (CI:−0.52, 1.28, P=0.40) on sound enamel between the two groups. Conclusion: Semiconductor lasers enhance the effect of fluoride on remineralising but not on preventing enamel caries. Moreover, substantial heterogeneity was found among the studies and the results should be interpreted cautiously.