Introduction

Often, people struggle with dental health issues such as tooth decay, breakages, or individuals that have previously filed their teeth [1, 2]. Such instances require ceramic restoration of the tooth. All-ceramic restoration refers to an approach used to repair various dental health issues such as the ones outlined above using a crown or veneer. The crown is also commonly referred to as dental porcelain. An all-ceramic restoration is a preferred approach because it is characterized by several benefits such as its effectiveness when used for both anterior and posterior restorations. Furthermore, since the crowns are aesthetic, multiple strategies can be used in improving their appearance to fit the specific preferences of the customer. For instance, the crown can be discolored, flourished, and hypo-calcified. Nevertheless, the benefits associated with this process have a limitation due to the life span constraint associated with it. Consequently, it becomes inevitable to remove the all-ceramic restorations from the patient’s teeth after a given period. The traditional methods used to remove the crown from the tooth’s surface are inefficient and inconvenient because they destroy the ceramic, which damages the integrity of the material. Moreover, the procedure is time-consuming because underlying dentin and bonding cement share the same color, thus making it is extremely difficult for the dentist to distinguish between the two.

The laser-assisted procedure is the new invention utilized in the removal of all-ceramic restorations. The procedure is considered to be efficient because it reduces the shear strength that the ceramic crown uses to hold onto the tooth’s surface. Moreover, the time is taken to complete the process significantly reduces. However, it is essential to note that even though laser-aided rebounding of all-ceramic restorations is popular, multiple factors influence its effectiveness such as the thickness of the crown, chemical composition in the ceramic, laser frequency, and radiation. Hence, depending on the type of laser used, the time taken could differ. However, despite the existing shortcomings, laser-assisted rebounding of all-ceramic restoration is considered a more effective process compared to the conventional methods used in the past.   

Materials and Methods

The researcher considered different databases as the source of the research articles included in the systematic review. These databases include PubMed, Google Scholar, Z-Library, and PMC. Different terms were used as the keywords that guided the search for the resources considered in this study including “laser-assisted,” “laser-aided,” “crown removal,” “all-ceramic restorations,” and “ceramic rebounding.” Below are some factors considered for the inclusion or exclusion procedure after the search in various databases to ensure that only relevant articles are featured.

1. The search result would be considered for inclusion in the study if it is either a report within the healthcare field or a scholarly article.
2. The report or the scholarly article must be published in the period between 2011 and 2021.
3. The report or the article must be available in full to ensure that the conclusion made is not a judgment from partial details.

Moreover, the search process aimed at ensuring that the articles chosen to make conclusions in the current systematic review answered some questions that are relevant to the topic of study. For instance, either the report or scholarly article had to address the efficiency in using laser-aided removal of all-ceramic restorations from a patient’s teeth. Furthermore, the article should help to answer whether laser-assisted rebounding of all-ceramic restorations was a more efficient strategy compared to other conventional processes. Another critical question that the resources considered should answer is whether a laser-assisted procedure is capable of minimizing the rebounding process compared to the conventional approaches. Finally, the resource should outline the features or qualities that made the laser-assisted rebounding method more effective compared to other conventional methods. It is essential to note that a single resource may not necessarily answer all the intended questions. Hence, a resource qualifies to be included in the study if it responded to only one of the above questions. Additionally, it is essential to note that the resources included in the study were classified depending on the question that was answered, namely efficiency, time-taken to rebound, and features. Accordingly, it would be possible to deduce conclusions for the present systematic review demonstrating aspects that make laser aided rebounding of all-ceramic restorations a more effective process.

The PRISMA Chart below will illustrate the process involved in narrowing down the research to 15 studies from a total of 124 results acquired in various databases. Additionally, this section will conduct a Cochrane risk of bias assessment aimed at illustrating the factors that would influence the inclusion of the study in the systematic review.

Study selection

The PRISMA chart and the Cochrane risk of bias assessment illustrate the procedure followed in selecting studies featured and factors that influence the inclusion of an article or a report in the systematic review.

PRISMA chart

The PRISMA chart below helps to demonstrate the methodology procedure used to correct information used to conclude the current study (Figure 1). The diagram will feature the identification phase where all the articles from each of the databases will be noted. Additionally, it will show the number of articles that remained after the screening process and eventually accounting for the studies that will be considered to deduce the results as illustrated below. Importantly, in each section, the PRISMA chart will demonstrate the reason why the resource was excluded from the study.

Cochrane risk of bias assessment

The studies will be categorized into three types of bias, namely low risk, some concerns, and high-risk bias. The low-risk bias is articles that lacked any factor that would trigger biases, while the high risk has factors that trigger a lot of bias. Below is Table 1, demonstrating the bias assessment for various studies used in the systematic review.

Table 1. Cochrane Risk of Bias Assessment

Study characteristics

The studies featured in the systematic review were published in the period between 2011 and 2021. It is vital to note that both reports and research studies relevant to the topic of a study published within the period were considered for inclusion in the systematic review. Hence, the profile of the participants is diverse since each study or report had a unique research population. The studies and reports considered to compile the findings of the systematic review needed to have their full version accessible.

Results and Discussion

Below is Table 2, outlining a summary considered to derive the results discussed in the systematic review.

Table 2. Summary of Studies included in the systematic review