Comparative Efficacy of Laser Versus Conventional Method in the Success of Circumferential Supracrestal Fiberotomy in Orthodontic Patients: A Systematic Review.

Introduction: The relapse of rotated teeth is a significant concern in orthodontics, and circumferential supracrestal fiberotomy (CSF) presents a potential solution. Traditionally, CSF is performed using a surgical blade; however, employing a laser may reduce complications. This study aimed to systematically review the literature comparing laser-assisted CSF with conventional methods in orthodontic patients. Methods: A comprehensive search was conducted across the PubMed, Scopus, Web of Science, and Cochrane Library databases using a specific search strategy up to June 16, 2024. Data extraction was done in accordance with the defined inclusion and exclusion criteria. Results: Initially, a total of 293 articles were identified through the search process, and ultimately, four were selected for analysis based on specific inclusion and exclusion criteria. The studies involved various types of lasers including diode (810 to 940 nm), Er:YAG, and Er,Cr:YSGG lasers, and examined the effects of low-level laser therapy (LLLT) in conjunction with surgical interventions. Regarding relapse rates, two studies reported that both laser and surgical blade techniques demonstrated comparable efficacy, while adjunctive LLLT was effective in reducing relapse. In the other two studies, the use of laser therapy was found to be effective in decreasing relapse rates compared to the control group. Pain assessment results were inconclusive; one study reported reduced pain in the laser group, while another found no significant difference in pain levels between the laser and blade techniques. Furthermore, no significant differences were observed in periodontal pocket depth or gingival recession between the two methods. Conclusion: Within the limitations of the current systematic review, our findings indicate that there is no significant difference in relapse rates between laser and blade CSF procedures. Furthermore, our results suggest that the incorporation of photobiomodulation at higher doses is correlated with a reduction in relapse rates following fiberotomy procedures.