Work

Global consensus report of the World Federation for Laser Dentistry (WFLD) on laser-assisted caries treatment and prevention

Year: 2025

Type: article

Abstract: BACKGROUND: This article presents the global consensus report of the World Federation for Laser Dentistry (WFLD) on laser-assisted caries prevention and management. Laser-assisted caries removal is a minimally invasive approach based on selective ablation, targeting demineralized tissues while preserving the adjacent healthy enamel and dentin. This approach aligns with the principles of modern conservative dentistry. Erbium-doped yttrium aluminum garnet (Er:YAG) and erbium, chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG) lasers are highly absorbed by water and hydroxyapatite (HAP), enabling precise ablation with minimal thermal diffusion and collateral damage. Laser wavelengths can also exhibit bactericidal effects through thermal and photomechanical mechanisms, reducing the microbial load in carious lesions. OBJECTIVES: The aim was to review, evaluate and consolidate the current evidence on the use of laser technologies in caries prevention and treatment, in light of the emerging scientific knowledge and clinical advancements. MATERIAL AND METHODS: This summary is based on the current evidence from in vitro, ex vivo and clinical studies evaluating the interaction of erbium-based lasers (Er:YAG, Er,Cr:YSGG) with enamel and dentin, their effect on the microbial load, fluoride uptake and resin adhesion, and their use in photobiomodulation (PBM) therapy. RESULTS: Laser irradiation induces physicochemical changes in enamel, such as superficial melting and recrystallization, reducing porosity and increasing resistance to acid attacks. Fluoride uptake is enhanced through microstructural modifications, especially when combined with topical fluoride. Subablative laser settings synergize with fluoride to enhance retention without damaging enamel. Laser conditioning before fissure sealing improves surface energy and resin adhesion, reducing microleakage. Photobiomodulation promotes remineralization in early lesions via cellular stimulation. CONCLUSIONS: Laser-assisted caries treatment offers precise, minimally invasive management of dental caries with added benefits, such as microbial reduction, structural enhancement and improved adhesion. Careful control of parameters is essential to balance efficacy and safety. Further studies are needed to standardize protocols and confirm long-term outcomes in clinical practice.

Source: Dental and Medical Problems

DOI: 10.17219/dmp/211449