Effect of erbium family laser etching on shear bond strength of enamel surfaces: A meta-analysis-PRISMA

Background: Recently, laser etching has appealed to people's attention. It is meaningful to compare the effect of erbium-doped yttrium-aluminum-garnet (Er:YAG) and erbium-chromium; yttrium-scandium-gallium-garnet (Er,Cr:YSSG) laser etching parameters with acid etching on bond strength of enamel surfaces. As far as we know, there still remains no related meta-analysis. To evaluate the efficacy of Er:YAG and Er,Cr:YSSG lasers etching on shear bond strength (SBS) of brackets bonded to enamel. The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, conducted with literature search. Methods: Twelve relevant randomized controlled trials (RCTs) were included. Results: The pooled analysis of SBS showed that there were no significant differences between erbium family lasers and acid etching. In the mass, we noticed they did not achieve statistical significance in the lasers etching and acid etching. However, pooled analysis of 5 studies showed the SBS bonding to enamel was lower in Er,Cr:YAG laser group compared with acid group. As a whole, there were statistical significance between erbium lasers groups and acid etching group in adhesive remnant index (ARI) aspects, which less adhesives remained can reduce damage to enamel. With regard to the rate of teeth with ARI score <= 2, the results in Er:YAG laser etching group were obviously higher than acid etching group. Conclusion: Our data indicated that erbium lasers may be considered bonding of brackets to enamel instead of acid etching bonding to enamel.

Automated summary

Through meta-analysis, we found that there were no significant differences in bond strength between erbium lasers and acid etching, but the Er,Cr:YAG laser group had lower shear bond strength (SBS) than the acid group. In addition, there were statistical significant differences between the erbium laser groups and the acid etching group in terms of adhesive remnant index (ARI) and ARI score.