Abstract：
Background: Studies have shown positive effects of erbium lasers in removal of biofilms. A review article was required with quantitative data for confirmation of their effects, but there is still no a comprehensive study reviewing their effects based on the root canal and implant surface. This systematic review and meta-analysis was conducted to evaluate the efficiency of erbium lasers in removal of the root canal system and surface biofilms. Methods: Studies were searched with keywords in databases of PubMed, Scopus, Europe PMC, Cochrane Central, Embase, and Web of Science and screened by referees. Data were included based on mean ± standard deviation and size of control and laser groups. Effect sizes were assessed as standardized mean differences and calculated for each study and for the root and dental surface. Laser characteristics and bacteria were considered as moderators. Results: Nineteen articles in the current study comprised 565 samples (283 control samples and 282 laser samples). The analyses showed the significant effects of erbium lasers on bacterial biofilms on the implant surface [-0.496, 95% confidence interval, CI (-0.720 to -0.273); I2 = 26.94; p = 0.029; Q = 13.28] and root canal [-0.551, 95% CI (-0.656 to -0.445); I2 = 23.89; p = 0.031; Q = 10.46]. Results showed that highest efficiency lasers were obtained at higher wavelengths of 2940 nm, 75-100 mJ energy, and 100-150 μsec and <50-Hz pulses. Conclusions: Erbium lasers can be used to remove biofilms on dental implant surfaces and root canal systems and are safe options for untouchable sites in the root canal.
摘要：
背景：研究表明，铒激光在去除生物膜方面具有积极作用。需要一篇带有定量数据的评论文章来确认其效果，但目前还没有一个全面的研究，基于根管和种植体表面审查其效果。进行了系统评价和荟萃分析，以评估铒激光去除根管系统和表面生物膜的效率。方法：使用PubMed数据库中的关键词搜索研究，Scopus,欧洲PMC,CochraneCentral,Embase,和WebofScience，并由裁判筛选。包括基于平均值±标准偏差和对照组和激光组的大小的数据。效果大小被评估为标准化的平均差异，并针对每个研究以及根部和牙齿表面进行计算。激光特性和细菌被认为是调节剂。结果：本研究中的19篇文章包括565个样本（283个对照样本和282个激光样本）。分析显示，铒激光对植入物表面细菌生物膜的显着影响[-0.496，95％置信区间，CI（-0.720至-0.273）；I2=26.94；p=0.029；Q=13.28]和根管[-0.551，95％CI（-0.656至-0.445）；I2=23.89；p=0.031；Q=10.46]。结果表明，在2940nm的较高波长下获得了最高效率的激光器，75-100mJ能量，和100-150μsec和<50-Hz脉冲。结论：铒激光可用于去除牙种植体表面和根管系统上的生物膜，是根管中不可触及部位的安全选择。
