MODERN LASER TECHNOLOGIES IN DENTISTRY: A STATE-OF-THE-ART NARRATIVE REVIEW

Background:Laser technologies have become increasingly important in modern dentistry due to their selective interaction with biological tissues, minimally invasive characteristics, and wide range of clinical applications. The appropriate selection of a laser system requires a comprehensive understanding of laser–tissue interactions, wavelength-dependent absorption mechanisms, and the specific biological effects associated with different technologies. This narrative review aims to summarize current knowledge regarding the physical principles, clinical applications, safety aspects, and future perspectives of erbium, Nd:YAG, CO₂, and diode laser systems, with particular emphasis on recent advances and clinical experience reported in the Russian Federation. Materials and Methods:A narrative literature review was conducted to evaluate the physical properties, mechanisms of biological interaction, clinical effectiveness, and safety characteristics of erbium, Nd:YAG, CO₂, and diode lasers used in dentistry. The review included evidence related to their applications in restorative dentistry, oral surgery, periodontology, endodontics, pediatric dentistry, therapeutic procedures, and photobiomodulation. Publications describing technological developments and clinical experiences from Russia were also analyzed. Results:Erbium lasers (2780/2940 nm) demonstrate strong absorption by water and hydroxyapatite, enabling selective hard tissue ablation with minimal thermal effects. They allow caries removal without smear layer formation, enhance microbial reduction, and improve adhesion of restorative materials. Nd:YAG lasers (1064 nm) are selectively absorbed by hemoglobin and melanin, producing coagulative and antibacterial effects. Their applications include periodontal therapy and root canal disinfection, contributing to microbial reduction and improved treatment outcomes. CO₂ lasers (10,600 nm) exhibit high water absorption and remain highly effective for soft tissue surgery, including frenectomy, gingivectomy, and lesion removal, providing precise cutting, excellent hemostasis, and favorable healing. Diode lasers (450–980 nm) interact primarily with melanin and hemoglobin and are widely used for soft tissue procedures, periodontal de-epithelialization, hypersensitivity management, and photobiomodulation. Despite their advantages, all dental lasers are classified as Class IV devices, requiring strict safety measures, protective eyewear, and effective aspiration systems. Limitations include equipment costs and the need for specialized training. Russian developments, including L’Med-1 and ALTA Blue, demonstrate important contributions to domestic laser dentistry. Conclusion:Laser technologies significantly enhance conventional dental approaches by improving precision, hemostasis, disinfection, and tissue response. Future progress will depend on multi-wavelength systems, digital integration, standardized clinical protocols, professional education, and further clinical research.