Can laser therapy used in endodontic treatment improve apical periodontitis repair? A systematic review

Purpose The aim of this systematic review was to determine whether combining laser therapy with conventional endodontic treatment would improve apical periodontitis (AP) repair. Methods This study was developed according to the Cochrane criteria for the creation of systematic reviews and meta-analyses and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed/MedLine, SCOPUS, and Cochrane Library databases were searched for articles published up to September 2020 to answer the PICO question: Could lasers used in conjunction with endodontic treatment (ET) improve AP repair, compared with conventional ET, in permanent teeth with necrotic pulp and AP? The outcome evaluated was reduction of AP. Results The literature search retrieved a total of 1719 articles, and, after applying the eligibility criteria, 5 were included in the present study. All studies compared the use of laser to ET of teeth with AP. Radiographic analysis was performed between 0 and 12 months, and the data revealed a reduction in the size of AP for both treatments. Conclusion The results of this systematic review evidenced scarcity of randomized clinical trials, few studies analyzing AP repair, short time of clinical control, methodological differences and high risk of bias among researches, and absence of evidence-based clinical protocols; thus, these aspects do not permit to conclude whether combining laser therapy with conventional ET would improve AP repair and indicate the necessity of more studies.