# Effectiveness of Laser-Assisted Teeth Bleaching: A Systematic Review
###### Abstract  
Objective: Esthetic dentistry is an important factor in increasing patients' quality of life. This study aimed to investigate the impact of laser use on bleaching procedures for natural teeth and dental restorative materials. Methods: In January 2024, an electronic search was conducted using PubMed, Web of Science (WoS), and Scopus databases with the keywords (tooth) AND (laser) AND (bleaching), following PRISMA guidelines and the PICO framework. The initial search yielded 852 articles, of which 441 were screened. After applying inclusion criteria, 376 articles were excluded as they did not focus on the use of lasers in bleaching natural teeth and restorative materials. Consequently, 40 articles were included in the final review. Results: Of the 40 qualified publications, 29 utilized a diode laser, of which 10 authors concluded that it increases the whitening effect comparing classical methods. Three of included publications investigated the whitening of dental materials, while another three focused on endodontically treated teeth. Whitening procedures on ceramics effectively removed discoloration, but the resulting color did not significantly differ from the initial shade. Conversely, composite materials not only failed to bleach but also exhibited altered physical properties, thereby increasing their susceptibility to further discoloration. The KTP laser demonstrated promising outcomes on specific stains. The ErC:YSGG and Er:YAG lasers also showed beneficial effects, although there were variations in their efficacy and required activation times. Conclusions: The findings partially indicate that laser-assisted bleaching improves the whitening of natural teeth. Further research on the effect of laser bleaching on the physical parameters of restorative materials is necessary. Keywords:dental lasers; dental restorative materials; laser-assisted whitening; tooth whitening; VITA shade guide +
Footnote †: journal:  
_Applied_  
_Systems_  
_Systematic Review_  
_Effectiveness of Laser-Assisted Teeth Bleaching: A Systematic Review_  
_A Systematic Review_  
treatment sessions to achieve the desired results. This can lead to tooth sensitivity, which is a common side effect [7]. Furthermore, the outcomes of bleaching treatments are frequently unsatisfactory when it comes to dental restorations, such as composite resins and porcelain crowns. These materials often do not respond uniformly to bleaching agents, leading to discrepancies in color and overall esthetic results. Recent advancements have prompted the evaluation of laser-assisted bleaching as an adjunct to traditional methods. Laser technology has shown promise in enhancing the efficacy of bleaching agents by accelerating the chemical reactions involved. Various studies have explored the use of lasers to improve the speed and effectiveness of the whitening process. Additionally, lasers may help in achieving more uniform results across both natural teeth and restorative materials. When planning the teeth whitening process for patients, it is crucial to recognize that the aforementioned bleaching agents will interact not only with the natural tissues of the tooth but also with various restorative materials commonly used in modern dentistry [8]. One of the most frequently used restorative materials is composite resin, which is a popular choice due to its esthetic properties and ease of application. It is important to assess how exposure to bleaching agents will influence the physical and chemical properties of these materials. Recent research has highlighted the impact of bleaching agents on the color and stability of composite resins, as achieving a brighter shade is a primary goal of whitening treatments. While hydrogen peroxide (HP) and carbamide peroxide (CP) are effective at whitening natural tooth tissues, their interaction with resin composites can be problematic. Studies have shown that these materials often do not respond to bleaching agents in the same manner as natural tooth tissues [8].