EVIDENCIA CIENTÍFICA SOBRE LA ELIMINACIÓN DE TEJIDO CARIOSO MEDIANTE LÁSERES DE ESTADO SÓLIDO: UNA REVISIÓN DEL ALCANCE
DOI:
https://doi.org/10.56238/arev7n11-342Palabras clave:
Láseres de Estado Sólido, Preparación de la Cavidad Dental, Caries DentalResumen
Objetivo: Mapear la evidencia científica disponible sobre el uso de láseres de alta potencia, especialmente láseres de estado sólido, en la eliminación de tejido cariado en dientes permanentes. Metodología: Esta revisión exploratoria siguió las recomendaciones del Instituto Joanna Briggs (JBI) y la lista de verificación PRISMA-ScR. Se realizaron búsquedas en las bases de datos PubMed (MEDLINE) y Biblioteca Virtual en Salud (BVS/BIREME), sin restricciones de fecha. Se incluyeron estudios publicados en revistas indexadas que abordaban el uso de láseres de alta potencia o láseres de estado sólido para la eliminación de tejido cariado en dientes permanentes. Se excluyeron duplicados, estudios no indexados, publicaciones no científicas, artículos académicos y estudios con dientes temporales. Dos revisores independientes realizaron la selección y extracción de datos, y un tercer revisor resolvió las discrepancias. Resultados: Se analizaron 1816 estudios, de los cuales 43 cumplieron los criterios de inclusión. El periodo de publicación de los estudios seleccionados abarcó desde 1995 hasta 2024, con predominio de artículos en inglés y de diseño de laboratorio. Los láseres Er:YAG y Er,Cr:YSGG fueron los más investigados, demostrando eficacia en la eliminación selectiva de tejido cariado, la preservación de la dentina sana y la obtención de superficies microretentivas libres de capa de barrillo dentinario. Varios estudios reportaron una reducción significativa de microorganismos cariogénicos y una buena aceptación por parte del paciente, con menor incomodidad y menor necesidad de anestesia. Sin embargo, el tiempo clínico tiende a ser mayor en comparación con la instrumentación rotatoria, y la eficacia depende directamente de los parámetros operatorios adoptados. Los hallazgos indican que los láseres de estado sólido representan una alternativa mínimamente invasiva y biológicamente segura, especialmente en caries incipientes y en pacientes pediátricos. No obstante, limitaciones como un mayor tiempo clínico, el elevado coste del equipo y el predominio de estudios de laboratorio restringen su adopción generalizada. Conclusión: Se concluye que los láseres Er:YAG y Er,Cr:YSGG presentan un potencial clínico relevante, con evidencia consistente de efectividad y comodidad para el paciente, aunque se necesitan ensayos clínicos adicionales para fortalecer su aplicabilidad en la práctica dental diaria.
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