Er:YAG laser in oral medicine: mechanisms, efficacy, and future perspectives

The erbium-doped yttrium aluminum garnet (Er:YAG) laser, characterized by high water absorption, precise ablation, antibacterial effects, and biostimulatory functions, represents a transformative technology in oral medicine. This review explores its diverse applications. In endodontics, it is used for caries removal, cavity preparation, hypersensitivity management, vital pulp therapy, and root canal treatment, offering reduced pain and improved adhesive performance. In periodontology, it facilitates debridement and tissue regeneration through both nonsurgical and surgical interventions. In implantology and prosthodontics, the Er:YAG laser provides novel strategies for peri-implantitis management, bone defect conditioning, and surface modification. In oral and maxillofacial surgery, it is applied in soft tissue resection, osseous surgery, and the management of medication-related osteonecrosis, ensuring precise ablation and faster recovery. Furthermore, it shows promise in orthodontics and pain management. Despite challenges, such as insufficient parameter standardization and the need for long-term evidence, future developments, including evidence-based guidelines and integration with artificial intelligence and real-time imaging, are expected to synergize with regenerative medicine. These advances will propel the Er:YAG laser toward increasingly precise, minimally invasive, and personalized dental diagnosis and treatment across clinical subspecialties.