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Domínguez A, Muñoz-Alvear HD, Oviedo-Toro D, Suárez-Quenguán X, Lopez-Portilla E. Effective Parameters for Orthodontic Tooth Movement Acceleration with Photobiomodulation: An Umbrella Review. Photobiomodul Photomed Laser Surg 2024; 42:449-462. [PMID: 38836768 DOI: 10.1089/pho.2024.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Objective: To answer this research question: What are the effective wavelength, power, and energy density parameters for achieving dental movement acceleration? Background Data: Photobiomodulation (PBM) has been clinically studied for its ability to accelerate dental movements in orthodontics. However, its effectiveness is dose dependent. Methods: The search was carried out in PubMed, SCOPUS, and ISI Web of Science. The quality of the included systematic reviews was performed using the AMSTAR 2 tool. The risk of bias was assessed using the ROBIS tool. Results: In total, 29 articles in PubMed, 75 in Scopus, and 61 in ISI Web of Science. Finally, only five systematic reviews were included. Conclusions: The results showed the range from 730 to 830 nm as the most effective range of wavelength to accelerate the orthodontic dental movement. A power range of 0.25-200 mW, with emphasis on the direct correlation between power, wavelength, and energy density. Energy density has not been adequately reported in the most randomized controlled clinical trials.
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Affiliation(s)
| | - Hernan Dario Muñoz-Alvear
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
| | - Daniela Oviedo-Toro
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
| | - Ximena Suárez-Quenguán
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
| | - Esteban Lopez-Portilla
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
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Zheng F, Wu T, Wang F, Li H, Tang H, Cui X, Li C, Wang Y, Jiang J. Low-intensity pulsed ultrasound promotes the osteogenesis of mechanical force-treated periodontal ligament cells via Piezo1. Front Bioeng Biotechnol 2024; 12:1347406. [PMID: 38694622 PMCID: PMC11061374 DOI: 10.3389/fbioe.2024.1347406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Background Low-intensity pulsed ultrasound (LIPUS) can accelerate tooth movement and preserve tooth and bone integrity during orthodontic treatment. However, the mechanisms by which LIPUS affects tissue remodeling during orthodontic tooth movement (OTM) remain unclear. Periodontal ligament cells (PDLCs) are pivotal in maintaining periodontal tissue equilibrium when subjected to mechanical stimuli. One notable mechano-sensitive ion channel, Piezo1, can modulate cellular function in response to mechanical cues. This study aimed to elucidate the involvement of Piezo1 in the osteogenic response of force-treated PDLCs when stimulated by LIPUS. Method After establishing rat OTM models, LIPUS was used to stimulate rats locally. OTM distance and alveolar bone density were assessed using micro-computed tomography, and histological analyses included hematoxylin and eosin staining, tartrate-resistant acid phosphatase staining and immunohistochemical staining. GsMTx4 and Yoda1 were respectively utilized for Piezo1 functional inhibition and activation experiments in rats. We isolated human PDLCs (hPDLCs) in vitro and evaluated the effects of LIPUS on the osteogenic differentiation of force-treated hPDLCs using real-time quantitative PCR, Western blot, alkaline phosphatase and alizarin red staining. Small interfering RNA and Yoda1 were employed to validate the role of Piezo1 in this process. Results LIPUS promoted osteoclast differentiation and accelerated OTM in rats. Furthermore, LIPUS alleviated alveolar bone resorption under pressure and enhanced osteogenesis of force-treated PDLCs both in vivo and in vitro by downregulating Piezo1 expression. Subsequent administration of GsMTx4 in rats and siPIEZO1 transfection in hPDLCs attenuated the inhibitory effect on osteogenic differentiation under pressure, whereas LIPUS efficacy was partially mitigated. Yoda1 treatment inhibited osteogenic differentiation of hPDLCs, resulting in reduced expression of Collagen Ⅰα1 and osteocalcin in the periodontal ligament. However, LIPUS administration was able to counteract these effects. Conclusion This research unveils that LIPUS promotes the osteogenesis of force-treated PDLCs via downregulating Piezo1.
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Affiliation(s)
- Fu Zheng
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
| | - Tong Wu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
| | - Feifei Wang
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
| | - Huazhi Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
| | - Hongyi Tang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
| | - Xinyu Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
| | - Cuiying Li
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
| | - Yixiang Wang
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
| | - Jiuhui Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Haidian, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Haidian, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Haidian, Beijing, China
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Wang S, Ko CC, Chung MK. Nociceptor mechanisms underlying pain and bone remodeling via orthodontic forces: toward no pain, big gain. FRONTIERS IN PAIN RESEARCH 2024; 5:1365194. [PMID: 38455874 PMCID: PMC10917994 DOI: 10.3389/fpain.2024.1365194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Orthodontic forces are strongly associated with pain, the primary complaint among patients wearing orthodontic braces. Compared to other side effects of orthodontic treatment, orthodontic pain is often overlooked, with limited clinical management. Orthodontic forces lead to inflammatory responses in the periodontium, which triggers bone remodeling and eventually induces tooth movement. Mechanical forces and subsequent inflammation in the periodontium activate and sensitize periodontal nociceptors and produce orthodontic pain. Nociceptive afferents expressing transient receptor potential vanilloid subtype 1 (TRPV1) play central roles in transducing nociceptive signals, leading to transcriptional changes in the trigeminal ganglia. Nociceptive molecules, such as TRPV1, transient receptor potential ankyrin subtype 1, acid-sensing ion channel 3, and the P2X3 receptor, are believed to mediate orthodontic pain. Neuropeptides such as calcitonin gene-related peptides and substance P can also regulate orthodontic pain. While periodontal nociceptors transmit nociceptive signals to the brain, they are also known to modulate alveolar bone remodeling in periodontitis. Therefore, periodontal nociceptors and nociceptive molecules may contribute to the modulation of orthodontic tooth movement, which currently remains undetermined. Future studies are needed to better understand the fundamental mechanisms underlying neuroskeletal interactions in orthodontics to improve orthodontic treatment by developing novel methods to reduce pain and accelerate orthodontic tooth movement-thereby achieving "big gains with no pain" in clinical orthodontics.
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Affiliation(s)
- Sheng Wang
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, United States
| | - Ching-Chang Ko
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, United States
| | - Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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Mohammed Bahaa El-Din A, Abd El Khaliq Hendy K, Elghetany Mohamed R, Abouelnour A, Mohamed Ali M, Akram El-Awady A, Ahmed Hussein F. Pain Intensity of Skeletally Anchored Maxillary Molar Distalization in Conjunction with Micro-osteoperforations: A Randomized Clinical Trial. Cureus 2024; 16:e53527. [PMID: 38445137 PMCID: PMC10912477 DOI: 10.7759/cureus.53527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/07/2024] Open
Abstract
Objective To assess pain intensity levels during orthodontic therapy of Class II malocclusion patients undergoing skeletally anchored maxillary molar distalization assisted with different micro-osteoperforation (MOP) approaches. Methods Twenty-seven patients (12 males and 18 females) with a mean age of 16.1 ± 0.3 years were randomized into three equal groups (n=9): Group 1 comprised MOPs on buccal surface, Group 2 comprised MOPs on buccal and palatal surface, and Group 3 comprised the control or no-MOP group. The patients underwent maxillary molar distalization using skeletally anchored distal jet appliance assisted with or without MOPs. The MOPs were applied repeatedly on the buccal and buccal and palatal sides, or no MOP (control). Pain intensity was assessed using a 10 cm visual analog scale after each device activation at 24, 48, 72 hours, and at seven days. Data were analyzed using one-way ANOVA and repeated measures ANOVA for non-paired and paired means. Results Both approaches of buccal and buccal and palatal application of MOPs showed statistically significant (p< 0.01) higher levels of pain intensity after the first activation at 24 hours. Nevertheless, pain intensity levels decreased significantly in both MOP groups and between the two activations. Conclusion The repeated application of MOPs on either the buccal side only or on both buccal and palatal sides during maxillary molar distalization did not affect the levels of pain experienced; however, these levels were reported to be higher than that obtained in the control group. Moreover, it is observed that these pain levels tend to gradually reduce to mild levels over the subsequent days.
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Affiliation(s)
| | | | | | - Ahmed Abouelnour
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
| | - Mohamed Mohamed Ali
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
| | - Ahmed Akram El-Awady
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
| | - Farouk Ahmed Hussein
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
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Alfailany DT, Hajeer MY, Awawdeh MA, Khursheed Alam M, Darwich KMA, Aljabban O, Latifeh Y, Alhaffar JB, Almasri IA. Evaluation of Patient-Reported Outcome Measures (PROMs) Associated With the Acceleration of Canine Retraction by Piezosurgery in Comparison With Low-Level Laser Therapy: A Three-Arm Randomized Controlled Clinical Trial. Cureus 2024; 16:e51779. [PMID: 38192530 PMCID: PMC10772303 DOI: 10.7759/cureus.51779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 01/10/2024] Open
Abstract
Background and objectives Recently, both surgical and non-surgical interventions have gained popularity in accelerating orthodontic tooth movement, but there is no randomized controlled trial (RCT) comparing both modalities in terms of patient-reported outcome measures (PROMs) during maxillary canine retraction. Therefore, this trial aimed to assess the PROMs associated with either low-level laser therapy (LLLT) or piezocision-assisted acceleration in the context of maxillary canine retraction. Materials and methods This was a single-blinded, single-center, three-arm RCT. A total of 54 patients (12 males, 42 females, mean age 20.65 ± 2.85) whose treatment needed upper-first-premolar extraction to facilitate canine retraction were enrolled and randomly divided into three groups: piezocision group (PG), LLLT group (LLLTG), and the control group (CG). Standardized questionnaires using a visual analog scale were distributed to patients at five assessment times: 1 (T1), 3 (T2), 7 (T3), 14 (T4), and 28 days following the canine retraction initiation (T5). The patients' pain, discomfort, swelling, chewing difficulty, satisfaction, and acceptance were recorded. Results Regarding pain and discomfort, the levels were significantly lower in the LLLTG during the first two weeks of canine retraction compared to the other two groups (p<0.017). At the same time, these levels were significantly greater in the PG than the CG in the first week of canine retraction (p<0.017). Patients in the PG had a "mild to moderate" perception of swelling at T1 and T2, which was significantly different than that of the other two groups (p<0.001). Regarding chewing difficulty, the levels in the LLLTG were significantly lower than those in PG at the first three assessment times (p<0.017). Patients' satisfaction with canine speed was significantly greater in the intervention groups compared to the CG (p<0.001). In contrast, no statistically significant differences were found between the three groups regarding satisfaction with gum appearance surrounding the canine (p=0.061) and acceptance (p=0.125). Conclusion The LLLT-assisted canine retraction was associated with significantly lower negative patient-reported outcomes during the first two weeks of retraction than piezocision-assisted retraction. However, the levels of pain and discomfort were significantly greater in the piezocision-assisted retraction group than those in the conventional canine retraction group, which in turn were greater than those with the LLLT-assisted canine retraction group during the first week of retraction. Patient satisfaction and acceptance were high with both piezocision and LLLT interventions.
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Affiliation(s)
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Mohammed A Awawdeh
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | - Khaldoun M A Darwich
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Ossama Aljabban
- Department of Endodontics and Restorative Dentistry, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Youssef Latifeh
- Department of Internal Medicine, Faculty of Medicine, University of Damascus, Damascus, SYR
| | - Jacqueline Bashar Alhaffar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Imad Addin Almasri
- Department of Applied Statistics, Faculty of Economics, University of Damascus, Damascus, SYR
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