Evidências científicas quanto a remoção de tecido cariado com a utilização de lasers de estado sólido: uma revisão de escopo

Abstract

Objective: To map the scientific evidence available on the use of high-power lasers, particularly solid-state lasers, for the removal of carious tissue in permanent teeth. Methodology: This scoping review followed the methodological guidance of the Joanna Briggs Institute (JBI) and the PRISMA-ScR reporting standards. Searches were conducted in the PubMed (MEDLINE) and Virtual Health Library (BVS/BIREME) databases with no date restrictions. Eligible studies included those published in indexed scientific journals addressing the use of high-power or solid-state lasers for the removal of carious tissue in permanent human teeth. Duplicate records, non-indexed publications, non-scientific materials, academic theses, and studies involving primary teeth were excluded. Study selection and data extraction were performed independently by two reviewers, with disagreements resolved by a third reviewer. Results: A total of 1,816 studies were screened, of which 43 met the eligibility criteria. The publication period of the included studies ranged from 1995 to 2024, with a predominance of English-language articles and laboratory-based designs. Er:YAG and Er,Cr:YSGG lasers were the most extensively investigated, demonstrating effectiveness in selectively removing carious dentin while preserving sound tissue and producing smear-free, micro-retentive surfaces. Several studies also reported significant reductions in cariogenic microorganisms and high patient acceptance, including reduced discomfort and decreased need for local anesthesia. However, laser-based procedures generally required longer clinical time compared with rotary instrumentation, and their performance depended heavily on the operational parameters employed. Discussion: The findings indicate that solid-state lasers constitute a minimally invasive and biologically safe alternative, particularly for incipient lesions and pediatric patients. Nevertheless, limitations such as longer clinical time, high equipment costs, and the predominance of laboratory research limit their widespread implementation in routine dental practice. Conclusion: Overall, Er:YAG and Er,Cr:YSGG lasers demonstrate relevant clinical potential, supported by consistent evidence of effectiveness and patient comfort, although additional well-designed clinical trials are required to strengthen their applicability in contemporary restorative dentistry.