Aim: This systematic review compared erbium lasers (Er:YAG/Er,Cr:YSGG) with conventional rotary instruments (dental turbine/high-speed handpiece) for caries removal and cavity preparation in pediatric dentistry, focusing on patient-centered outcomes and short-term restorative performance. Methods: Following PRISMA guidance, PubMed, Scopus, and Web of Science were searched for studies published between January 2010 and November 2025. Eligible studies were in vivo/human investigations in children with carious primary teeth comparing erbium laser versus rotary instrumentation. Results: Eleven studies met the inclusion criteria. Across the included trials, erbium laser treatment was consistently associated with reduced intraoperative pain and improved comfort, often accompanied by lower anxiety indicators and higher child acceptance compared with rotary preparation. Several studies also reported a reduced need for local anesthesia in the laser group. In contrast, operative time was generally longer with erbium lasers than with turbines. When restorations were evaluated, clinical performance and short-term success (up to 12 months) were comparable between laser- and bur-prepared cavities, with no consistent disadvantages observed for laser preparation. Conclusions: Overall, erbium lasers appear to be a clinically effective and child-friendly alternative to conventional turbines, offering superior patient comfort while maintaining comparable short-term restorative outcomes, albeit at the cost of longer procedure duration.
DIPALMA et al. (2026) studied this question.