Effect of Carbon-dioxide Lasers on Preventing Caries: A Literature Review

Objectives: To systematically review the evidence regarding the mechanisms of carbon dioxide lasers (λ=10,600 nm) on preventing dental caries.
Methods: A systematic search of the articles archived in the PubMed, Scopus and Web of Science databases was performed. The keywords used to identify the relevant articles were ((CO₂laser) OR (carbon dioxide laser)) AND ((dental caries) OR (tooth remineralization)). There was no publication-year limit, and the last search was made in December 2017. The titles and abstracts of the initially identified articles were screened. Duplicate records, non-English articles, reviews and irrelevant studies were removed. Full texts were retrieved for publications that studied mechanisms of actions of carbon dioxide lasers on preventing dental caries.
Results: The search identified 495 potentially relevant publications. A total of 252 duplicate records were removed. Twenty-one articles investigating the effect of carbon dioxide lasers on enamel and dentin were included. Results of the studies showed that carbon dioxidelaser could cause chemical and morphological changes to mineral tissues, including reduction of carbonate content and recrystallization of mineral structure. Carbon dioxidelaser increased the micro hardness and decreased the mineral loss of enamel and dentin. While studies showed varied results of carbon dioxide laser and topical fluoride on enamel, studies revealed carbon dioxide laser and topical fluoride enhanced fluoride uptake and reduced mineral loss of dentin from acid challenge.
Conclusions: Carbon dioxide (10,600 nm)laser can prevent demineralization of enamel and dentin. Furthermore, it has a synergistic effect with fluoride in promoting the remineralization of dentin.