Effect of low-level laser therapy (LLLT) on orthodontic tooth movement

Photobiomodulation in Orthodontics: Mechanisms and Clinical Efficacy for Faster Tooth Movement

Accelerated orthodontics has revolutionized traditional dental practices by employing innovative techniques to expedite tooth movement and enhance treatment outcomes. Among these advancements, low-level laser therapy (LLLT) has emerged as a promising adjunctive method that offers a non-invasive and efficient approach to accelerate orthodontic tooth movement. By harnessing the power of low-level lasers, LLLT aims to stimulate cellular activity, promote bone remodeling, and reduce treatment duration, thereby revolutionizing the landscape of orthodontic care. In this review, we discuss the mechanism of action, methods, efficacy, advantages, limitations, and future scope of LLLT, uncovering its transformative impact on the field of accelerated orthodontics.

Nociceptor mechanisms underlying pain and bone remodeling via orthodontic forces: toward no pain, big gain

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.

Effect of low-level laser therapy on pain reduction in orthodontic patients during molar distalization: A randomized controlled trial

Aim

To investigate the effects of low-level laser therapy (LLLT) on pain reduction in orthodontic patients during molar distalization.

Materials and methods

Twenty patients requiring bilateral maxillary first molar distalization were randomly assigned to two groups: the intervention group (mean age 15.61 ± 1.03 years) received multiple LLLT after every activation of the distalizing appliance (immediately and on the 3rd, 7th, and 14th days) and the control group (mean age 15.64 ± 1.08 years) who did not receive LLLT. Patients reported pain levels every day for 7 days following activation of the appliance using an 11-point numeric rating scale (NRS), then the pain experience of both the intervention and control groups was compared using Mann-Whitney U test.

Results

The mean pain scores on the 1st day were higher in the intervention group (9.27 ± 1.01) compared to that of the control group (8.80 ± 1.03). However, the mean pain scores of the intervention group (6.55 ± 1.29, 4.00 ± 1.26, 2.55 ± 1.29, 0.91 ± 1.04, 0.00 ± 0.00 and 0.00 ± 0.00, respectively) were lower than the control group (7.40 ± 1.90, 5.60 ± 2.07, 4.20 ± 1.99, 2.80 ± 1.93, 1.60 ± 1.58 and 0.40 ± 0.84, respectively) from the 2nd to the 7th day. All the differences were not statistically significant except on the 6th day (P-value = 0.003). The peak pain level was experienced by both groups on the 1st day, followed by a statistically significant gradual decrease in pain levels. Patients in the intervention group reported a shorter overall duration of pain.

Conclusion

Although LLLT, with the used parameters, reduced the overall duration of pain experience following maxillary first molar distalization, it was not effective during peak pain levels.

Accelerated Orthodontic Treatment Using Photobiomodulation: A Randomized Clinical Trial

Background

Orthodontic treatment (OT) aims to align and correct teeth positions. However, conventional treatment methods often require a considerable amount of time. Photobiomodulation (PBM) has emerged as a potential solution to OT.

Materials and Methods

The study included 60 patients, divided equally into two groups: the PBM group and the control group. Patients in the PBM group received light therapy sessions applied directly to the OT area during each visit. Both groups underwent regular orthodontic adjustments. Treatment duration, changes in tooth alignment, and patient discomfort were evaluated. Statistical analysis was performed to compare the outcomes between the groups.

Results

The results of the study indicated that the PBM group experienced a statistically significant reduction in treatment duration compared to the control group. Moreover, there were noticeable improvements in tooth alignment in both groups. Patients in the PBM group reported minimal discomfort during the treatment process. These findings suggest that PBM has the potential to expedite OT without compromising its effectiveness.

Conclusion

In conclusion, this randomized clinical trial demonstrates that PBM can be an effective approach to accelerate OT. The technique led to a significant reduction in treatment duration and was well-tolerated by patients.

Accelerated Orthodontics: Stepping Into the Future Orthodontics

Orthodontic treatment signifies a transformative journey for individuals seeking not only enhanced oral health but also a boost in aesthetics and self-confidence. Nonetheless, the protracted timeline associated with conventional orthodontic care has been a persistent concern for both patients and practitioners. In this comprehensive review, we embark on an exploration of innovative strategies aimed at expediting orthodontic tooth movement (OTM). By doing so, we aspire to curtail treatment duration and mitigate potential risks, ultimately culminating in an elevated and more fulfilling patient experience. Traditionally, orthodontists heavily leaned on surgical techniques to hasten tooth movement. However, the recent landscape of orthodontics has been profoundly shaped by technological advancements and groundbreaking research findings, ushering in an era characterized by the embrace of minimally invasive approaches. These progressive methodologies encompass procedures like Piezocision, Discision, and Microosteoperforation (Alveocentesis). Beyond the obvious benefits of reduced patient discomfort, these techniques significantly truncate treatment periods, a development that addresses a primary concern of many patients. Moreover, this review delves into non-invasive alternatives, including cyclic vibrations, photobiomodulation, direct light electric current, and static or pulsed magnetic fields, as well as systemic and local administration of biological substances and hormones, all of which hold substantial promise in optimizing OTM. Furthermore, our exploration extends to a diverse spectrum of medications that have demonstrated their efficacy in expediting OTM. These encompass NSAIDs, acetaminophen, corticosteroids, bisphosphonates, herbal medicine biomaterials, and synthetic biomaterials like graphene dioxide. Every technique and medication is subjected to meticulous evaluation, taking into account its indications, contraindications, advantages, disadvantages, clinical implications, and limitations. Through this review, we endeavor to equip orthodontic professionals with a profound understanding of these innovative strategies. By doing so, we enable them to make informed decisions, tailored meticulously to meet the unique needs of each patient. In an ever-evolving field like orthodontics, staying abreast of these advancements becomes paramount, ultimately contributing to heightened treatment efficacy and enhanced patient satisfaction. The adoption of these innovative strategies not only holds the potential for improved clinical outcomes but also champions a patient-centric approach that could fundamentally reshape the landscape of orthodontic care.

Effect of light-emitting photobiomodulation therapy on the rate of orthodontic tooth movement : A randomized controlled clinical trial

PURPOSE

The aim of this study was to evaluate the effect of light-emitting photobiomodulation therapy (LPT) on the rate of canine distalization.

METHODS

This study was performed on 60 extraction spaces formed by extraction of the upper first premolars of 30 patients (15 in the LPT group and 15 in the control group). Paul Gjessing (PG)-segmented canine retraction springs were used for canine distalization. In the LPT group, the Biolux OrthoPulse™ (Biolux Research Ltd, Vancouver, Canada) intraoral device (wavelength 850 nm LED light and an energy density of 63 mW/cm2 [±13 mW/cm2]) was used for 5 min per day over a period of 84 days. For each patient, the diagnosis was based on standard orthodontic documentation with photographs, digital model casts, and cephalometric and panoramic radiographs. The anchorage loss, canine rotations, canine inclinations, and molar inclinations were also evaluated on plaster models obtained on days 0, 21, 42, 63, and 84. The models were measured by using 3Shape OrthoAnalyzer software (3Shape, Copenhagen, Denmark). Measurements were made by a researcher and a blinded clinician. For statistical comparison, a paired-samples t‑test and one-way analysis of variance (ANOVA) were used at the p < 0.05 level.

RESULTS

The mean canine distalization rates were 1.36 mm/21 days and 1.02 mm/21 days in the LPT and control groups, respectively, and were statistically greater in the LPT group (p < 0.001). The amount of anchorage loss, canine rotations, canine inclinations and molar inclinations were not significantly different between the LPT and control groups at any of the timepoints.

CONCLUSION

LPT has the potential to accelerate orthodontic tooth movement by 33%.

Photobiomodulation therapy assisted orthodontic tooth movement: potential implications, challenges, and new perspectives

Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster. Additionally, photobiomodulation therapy (PBMT), a non-invasive treatment, when applied in orthodontics, contributes to alleviating pain and reducing inflammation induced by orthodontic forces, along with improving tissue healing processes. Moreover, PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption (OIIRR) during orthodontic treatment (OT) due to its capacity to modulate inflammatory, apoptotic, and anti-antioxidant responses. However, a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement (OTM) in relation to OIIRR, casting doubt on its beneficial effects. In PBMT-assisted orthodontics, delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues. The penetration of light to the root surface is another crucial unknown factor. Both the penetration depth and distribution of light in periodontal tissues are unknown. Thus, advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations. This review explores possibilities for improving the application and effectiveness of PBMT during OTM. The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells, with a special focus on immunomodulatory effects during OTM.

The Effects and Mechanisms of PBM Therapy in Accelerating Orthodontic Tooth Movement

Malocclusion is one of the three major diseases, the incidence of which could reach 56% of the imperiled oral and systemic health in the world today. Orthodontics is still the primary method to solve the problem. However, it is clear that many orthodontic complications are associated with courses of long-term therapy. Photobiomodulation (PBM) therapy could be used as a popular way to shorten the course of orthodontic treatment by nearly 26% to 40%. In this review, the efficacy in cells and animals, mechanisms, relevant cytokines and signaling, clinical trials and applications, and the future developments of PBM therapy in orthodontics were evaluated to demonstrate its validity. Simultaneously, based on orthodontic mechanisms and present findings, the mechanisms of acceleration of orthodontic tooth movement (OTM) caused by PBM therapy were explored in relation to four aspects, including blood vessels, inflammatory response, collagen and fibers, and mineralized tissues. Also, the cooperative effects and clinical translation of PBM therapy in orthodontics have been explored in a growing numbers of studies. Up to now, PBM therapy has been gaining popularity for its non-invasive nature, easy operation, and painless procedures. However, the validity and exact mechanism of PBM therapy as an adjuvant treatment in orthodontics have not been fully elucidated. Therefore, this review summarizes the efficacy of PBM therapy on the acceleration of OTM comprehensively from various aspects and was designed to provide an evidence-based platform for the research and development of light-related orthodontic tooth movement acceleration devices.

Effect of low-level laser therapy on orthodontic tooth movement during miniscrew-supported maxillary molar distalization in humans: a single-blind, randomized controlled clinical trial

To investigate the effect of low-level laser therapy (LLLT) on orthodontic tooth movement during maxillary molar distalization over a 12-week observation period. Twenty patients were enrolled in this clinical trial. On the 0th, 3rd, 7th, 14th, 21st, 42nd, and 63rd days following the initial activation of the distalization appliance, laser therapy was applied in a total of 16 different points of the first and second molars for 10 s per point to the randomly determined molar region of the individuals in the intervention group. The amount of molar distalization was measured using digital scans of the three-dimensional (3D) digital models obtained during the 3rd, 6th, 9th, and 12th weeks. The amount of tooth movement on the laser-applied side of subjects in the intervention group was significantly greater than those in the contralateral and control groups at all time intervals (p < 0.001). The amount of tooth movement between the contralateral side of the intervention group and the control group was determined to be statistically insignificant (p > 0.05) at all time intervals. The laser-treated molars of the subjects in the intervention group moved 1.22 times more than the molars in the contralateral side and in the control group in 12 weeks. The rate of tooth movement in the laser, contralateral, and control groups was 0.033, 0.027, and 0.027 mm/day, respectively. Although LLLT was found to be statistically significant in terms of accelerating tooth movement, the effect of LLLT is not considered to be clinically significant. This trial was retrospectively registered (September 22, 2022) at Clinical-Trials.gov (Ref no: NCT05550168).

Accelerated Canine Retraction by Using Mini Implant With Low-Intensity Laser Therapy

Background The continuous increase in demand for reduced treatment times has led researchers to think in terms of "accelerated orthodontics." Generally, the duration for fixed orthodontic treatment is around two to three years. Prolonged use of braces leads to external root resorption, a high risk of caries, and decreased patient compliance. Therefore, finding an optimal supplementary approach to achieve faster tooth movement is still considered a subject of interest. Low-intensity laser therapy (LILT) is one of the non-invasive surgical techniques in the field of accelerated orthodontics. Low-level laser therapy (LLLT) has demonstrated faster healing, less bleeding, and biostimulation and anti-inflammatory effects. According to all studies, it accelerates tooth movement, thereby reducing braces treatment time. It is simple, safe, and minimally invasive. Despite these pieces of evidence, studies have shown variable findings in low-level laser therapy. This study evaluates the effect of LLLT on accelerated orthodontics in comparison with conventional canine retraction. An aluminum gallium arsenide-type diode laser with a wavelength of 940 nm has been used in this study. Methodology This study was conducted using the split-mouth method, which included 20 patients with permanent dentition who required first premolar extractions. A miniscrew implant was placed on both the right and left sides for maximum anchorage. Irradiation doses were applied on days 0, 3, 7, and 14 of the first month. Subsequently, irradiations were given every 15 days until the canine's retraction was complete in the test group. Results The study results three months after the canine retraction in the test and control groups (M1) were 0.81 ± 0.03 mm/month and 0.74 ± 0.04 mm/month, respectively, indicating a significantly higher rate of canine retraction in the test group than in the control group (P < 0.0001). The average increase in the amount of tooth movement at three months was 40.1% and 36.3% in the test and control groups, respectively. However, the average increase in the amount of movement of teeth following canine retraction was 100% in the test group and 68.2% in the control group. There were significant variations in the pain score between Day 1 and Day 3 (P = 0.003) in the test group; however, there was no analytic variation in the pain score between Day 1 and Day 30 in the test group (P = 0.18). The pain score between Day 3 and Day 30 was significantly lower. Conclusions It was concluded that the rate of canine retraction increases when it is combined with LILT-assisted accelerated orthodontics in comparison to conventional canine retraction. Although LLLT does not provide immediate pain relief, it relieves the sensation of pain after 24-72 hours. LILT is an innovative, non-invasive technique that allows rapid orthodontic tooth movement. The rate of canine retraction increases when it is combined with LILT-assisted accelerated orthodontics in comparison to conventional canine retraction using mini-implants.

Predictability of Invisalign® Clear Aligners Using OrthoPulse®: A Retrospective Study

This preliminary retrospective study evaluates how effective the OrthoPulse^® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign^® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign^® orthodontic clear aligners in association with an OrthoPulse^®. The OrthoPulse^® was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse^® App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse^® led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse^® needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse^® would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements.

A randomized controlled trial evaluating the effect of two low-level laser irradiation protocols on the rate of canine retraction

The objective of this study was to evaluate the canine retraction rate with two low-level laser therapy (LLLT) irradiation protocols, involving both a high and a low application frequency. Twenty patients were randomly divided into two equal groups. In Group A, one side of the maxillary arch randomly received LLLT on days 0, 3, 7, 14, and every 2 weeks thereafter, whereas in Group B, one side received LLLT every 3 weeks. Tooth movement was checked every three weeks since the onset of canine retraction, over the 12-week study period. Moreover, Interleukin-1β (IL-1β) levels in the gingival crevicular fluid were assessed. Results revealed a significant increase in the canine retraction rate on the laser sides of groups A and B, in comparison with the control sides (p < 0.05), with no significant differences reported between the laser sides in both groups (p = 0.08–0.55). Also, IL-1β levels were significantly higher on the laser sides of both groups, in comparison with the control sides (p < 0.05). Therefore, LLLT can effectively accelerate tooth movement, with both frequent and less frequent applications, which is attributed to an enhanced biological response as reflected by the elevated IL-1β levels on the compression sides.

Effect of the photobiomodulation for acceleration of the orthodontic tooth movement: a systematic review and meta-analysis

To determine whether the application of photobiomodulation (PBM), as an adjunctive treatment for patients with orthodontic fixed appliances, decreased the total treatment time compared to conventional orthodontics. Studies were collected from four electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Eligibility criteria were full-text articles in English or Spanish with the design of randomized (RCT), non-randomized clinical trials (non-RCT), and retrospective cohort, without any restriction regarding the publication time, in which the effect of PBM using low-level laser irradiation (LLLI) and light-emitting diode (LED) for the acceleration of the orthodontic movement had been evaluated. Data collection and analysis: Two authors independently extracted data for the characteristics and outcomes of the studies selected for inclusion. The risk of bias (RoB 2 and Robins-I) and the quality assessments (GRADE) were performed. For the quantitative synthesis, the standardized mean difference was calculated for each individual study selected and then the data were combined using a random-effects meta-analysis. The total number of included studies was n = 22 (only RCT and non-RCT were found) with a total of 515 participants. The included studies exhibited high risk of bias and some concerns, though none of them presented a low risk of bias. The quality of the studies was very low. The meta-analysis showed that the means (mm) and 95% confidence intervals (95% CI) of acceleration of tooth movement at 1, 2, and 3 months were 0.50 (- 0.28, 1.28), 1.40 (0.27, 2.53), and 0.46 (- 0.33, 1.24), respectively. The analysis showed that there is no evidence to support the use of LLLI to accelerate the orthodontic movement. LED for the acceleration of orthodontic movement does not have sufficient evidence to generate conclusions about it.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I ² = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Comparison Between the Effect of Low-Energy Laser Application and Piezocision on Acceleration of Orthodontic Tooth Movement

 ABSTRACT the aim of the study was to study the effectiveness of Low Energy Laser Application or piezocisions in accelerating tooth movement, during canine retraction, compared to conventional canine retraction. Patients and Methods: A split mouth study design was done with two groups A and B. Each group confined 10 patients; in each patient one side was used as a control side and the contralateral side received either low-level laser therapy (LLLT) (group A) or piezocisions (group B). The evaluation data was gathered by Intra-oral measurements directly, every 2 weeks, over a 3 months retraction period. Results: Statistical analysis using Repeated measure ANOVA test was used to compare between more than two groups in related samples. Paired sample t-test was used to compare between two groups in related samples. Independent sample t-test was used to compare between two groups in non-related samples. direct intra-oral measurements from Group A illustrated that there was a statistically significant difference between the study and control sides (p<0.001) a total of 4.19 ± 0.5 mm canine retraction has been achieved in the low-level laser therapy (LLLT) assisted canine retraction side versus a 2.83 ± 0.2 mm total canine retraction in the control side. which was statistically significant. Group B illustrated that there was a statistically significant difference between the study and control sides ( p<0.001) that a total of 3.65± 0.4 mm canine retraction has been achieved in the piezocisions assisted canine retraction side versus a 2.79± 0.2 mm total canine retraction in the control side which was a highly statistically significant difference Conclusion: low-level laser therapy (LLLT) and Piezocisions techniques accelerated the rate of canine retraction during orthodontic treatment, with the low-level laser therapy (LLLT)  being slightly more effective.

The protocol of low-level laser therapy in orthodontic practice: A scoping review of literature

Low-level laser therapy (LLLT) has been widely investigated as an adjunct technique for orthodontic treatment due to photobiomodulation effect. LLLT appears to be supportive for an orthodontic practice in terms of tooth movement acceleration, pain relief, and root resorption management. The decrease in these adverse effects will enhance the compliance in orthodontic patients, which could positively impact treatment outcomes. However, there seemed to be inconsistency in the impact of LLLT as well as its laser and treatment parameters. This scoping review aimed to evaluate the impact of different irradiation parameters on tooth movement acceleration, pain relief, and root resorption as well as to construct a protocol of LLLT in orthodontic practice. The search was conducted across PubMed, Scopus, Web of Science, Embase, Google Scholar, and the reference lists of identified articles. The last search was conducted on October 10, 2021 to identify experiments in humans regarding the application of LLLT as noninvasive treatment in orthodontic practice published between 2010 and 2021. However, they were excluded if they were not clinical research, if they did not report the source of laser, or if they were not relevant to tooth movement, pain perception, and root resorption, or if they were not available in English or in full-text. Following the systematic search and selection process, 60 articles were included in this review. A majority of included articles were published in the past few years. The findings of this review supported the application of LLLT in orthodontic practice with purposes of tooth movement acceleration and pain reduction. The positive impact of LLLT on root resorption had not been clearly evident yet. As this review demonstrated heterogeneity of both laser and treatment parameters, further research should be required to ensure the effectiveness of its specific parameters in orthodontic practice.

Effect of 970 nm low-level laser therapy on orthodontic tooth movement during Class II intermaxillary elastics treatment: a RCT

This prospective randomized clinical trial aimed to evaluate the effect of low-level laser therapy on tooth movement during Class II intermaxillary elastics treatment. Forty-two patients with Class II malocclusion were included, and their maxillary quadrants were allocated into two groups: treatment with an active diode laser and a placebo group. In each group, the time taken to obtain Class I occlusion after 6 months, rate of movement, total displacement of the maxillary canine to Class I occlusion and pain were recorded. The time to reach Class I occlusion in the active laser group (2.46 ± 2.1 months) was not significantly different from that in the placebo group (2.48 ± 2.0 months) (p = 0.938). Interestingly, the total distance of movement on the active laser side (2.27 ± 1.5 mm) was significantly greater than that on the placebo side (1.64 ± 1.3 mm) (p = 0.009). The pain levels on days 1, 2 and 3 were not significantly different between the laser and placebo sections. The rate of distance change toward Class I occlusion in the laser group (1.1 ± 0.7 mm/month) was significantly higher than that in the placebo group (0.74 ± 0.6 mm/month) (p = 0.037). Low-level laser therapy (970 nm) did not reduce the time needed to obtain Class I occlusion, but a significant acceleration in tooth movement was observed in the irradiated group.

Trial registration: NCT02181439. Registered 04 July 2014—https://www.clinicaltrials.gov/ct2/results?term=cinelaser.

An Efficacy of Photobiomodulation of 850 nm on Pain Reduction in a Human Oral Capsaicin Pain Model

Objective: The aim of this clinical trial was to evaluate the efficacy of photobiomodulation (PBM) to reduce oral pain initiated by capsaicin. Background: PBM has been used for pain reduction in oral regions; however, its clinical efficacy to alleviate burning sensations is still unknown. Methods: This clinical study was divided into two phases. There were 10 subjects in each phase. In Phase I, the burning sensation was stimulated using 0.05% in 95% ethanol capsaicin (prepared by the Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand) on filter paper and recorded with a 10-cm horizontal visual analog scale (VAS) every 1 min until the subject experienced no more pain. The area under the curve (AUC) of the graph between VAS and time was calculated. The washout period was 24 h. In Phase II, a crossover clinical trial was conducted in subjects who received the pain model as stated. Four interventions were included: (1) PBM before & after pain stimulation, (2) PBM before pain stimulation, (3) PBM after pain stimulation, and (4) Placebo. For PBM intervention, a single exposure of 850 nm Laser (AsGaAl; TOP 250 Soft Laser, Berkmed Medikal, distributed by Medical Innovation-MI, Istanbul, Turkey) with 0.10 cm² spot size laser probe continuous wave at 1 W/cm² and 30 J/cm² for 30 sec was used. Results: In Phase I, there was no statistically significant difference (p = 0.09) between the average AUC of day 1 [55.63 (23.38)] and day 2 [48.99 (27.20)]. In phase II, there was no statistical difference (p = 0.20) of the average AUC among the interventions and the placebo; group 1 [56.24 (30.11)], group 2 [45.46 (45.46)], group 3 [64.15 (32.89)], and group 4 [58.59 (30.16)]. Conclusions: The human capsaicin model was suitable for a crossover design clinical trial. The PBM used in this study did not reduce oral burning sensations from capsaicin.

The effect of intra-oral LED device and low-level laser therapy on orthodontic tooth movement in young adults: A randomized controlled trial

INTRODUCTION

This randomized controlled clinical trial aimed to assess the effect of LED⁵ and LLLT⁶ in a three-arm parallel setting.

METHODS

Sixty patients who needed the maxillary first premolar extraction were allocated to three groups using the stratified block randomization method. In the LED group, a custom-made device with a wavelength of 640nm and a power density of 40 mW/cm² was used 5min/day. In the laser group, Ga Al As⁷ laser with a wavelength of 810nm and a power of 100 mW was used on days 0, 3, 30, and 60 each time for 18seconds. Patients in the control group received placebo treatment as the laser group protocol, using a coated light cure device. Models were made at baseline and monthly until the end of the retraction. The rate of canine retraction was the primary outcome, while canine rotation and pain were secondary outcomes. The final data were anonymous for the outcome assessor and statistical consultant. Data were analyzed per protocol using a linear mixed model.

RESULTS

The rate of canine retraction significantly increased by 60.8% in the laser group, while it increased not significantly by 26% in the LED group compared with the control group. There was no significant difference among the groups in terms of tooth rotation and pain.

CONCLUSIONS

LLLT can accelerate orthodontic tooth movement (OTM). LED with the present setting couldn't increase the rate of OTM. LLLT and LED did not affect canine rotation or pain.

TRIAL REGISTRATION

IRCT20120220009086N4. On 1 June 2019 was retrospectively registered.

Photobiostimulatory Effect of a Single Dose of Low-Level Laser on Orthodontic Tooth Movement and Pain

Objective

To assess the effect of low-level laser applied at 3 weeks intervals on orthodontic tooth movement (OTM) and pain using conventional brackets (CB).

Materials and Methods

Twenty patients with Angle's class II div 1 (10 males and 10 females; aged 20.25 ± 3.88 years) needing bilateral extractions of maxillary first bicuspids were recruited. Conventional brackets MBT of 0.022 in slot (McLaughlin Bennett Trevisi) prescription braces (Ortho Organizers, Carlsbad, Calif) were bonded. After alignment and levelling phase, cuspid retraction began with nitinol closed coil spring on 19 × 25 stainless steel archwire, wielding 150 gram force. 7.5 J/cm² energy was applied on 10 points (5 buccal and 5 palatal) on the canine roots on the investigational side using gallium-aluminum-arsenic diode laser (940 nm wavelength, iLase™ Biolase, Irvine, USA) in a continuous mode. Target tissues were irradiated once in three weeks for 9 weeks at a stretch (T0, T1, and T2). Patients were given a feedback form based on the numeric rating scale (NRS) to record the pain intensity for a week. Silicon impressions preceded the coil activation at each visit (T0, T1, T2, and T3), and the casts obtained were scanned with the Planmeca CAD/CAM™ (Helsinki, Finland) scanner.

Results

The regimen effectively accelerated (1.55 ± 0.25 mm) tooth movement with a significant reduction in distress on the investigational side as compared to the placebo side (94 ± 0.25 mm) (p < 0.05).

Conclusions

This study reveals that the thrice-weekly LLLT application can accelerate OTM and reduce the associated pain.

Effect of light-emitting diode-mediated photobiomodulation on extraction space closure in adolescents and young adults: A split-mouth, randomized controlled trial

INTRODUCTION

This split-mouth trial aimed to examine the effects of light-emitting diode (LED)-mediated photobiomodulation compared with no photobiomodulation on maxillary canine distalization.

METHODS

Twenty participants (10 males and 10 females; aged 11-20 years) requiring bilateral extraction of maxillary first premolars were included from the Sydney Dental Hospital waiting list. After premolar extractions, leveling, and alignment, canines were retracted on 0.020-in stainless steel wires with coil springs delivering 150 g of force to each side. Each patient's right side was randomly assigned to experimental or control using www.randomisation.com, and allocation concealment was performed with sequentially numbered, opaque, sealed envelopes. The experimental side received 850 nm wavelength, 60 mW/cm² power, continuous LED with OrthoPulse device (Biolux Research Ltd, Vancouver, British Columbia, Canada) for 5 min/d. For the control side, the device was blocked with opaque black film. Patients were reviewed at 4-week intervals for force reactivation and intraoral scanning over 12 weeks. The primary outcome was the amount of tooth movement, and secondary outcomes were anchorage loss and canine rotation, all measured digitally. Blinding for study participants and the treating clinician was not possible; however, blinding was done for the measurements by deidentifying the digital scans. Linear mixed models were implemented for the data analysis.

RESULTS

Nineteen participants concluded the study. Data analysis showed that the treatment × time interaction was not significant, suggesting no difference in space closure (unstandardized regression coefficient [b], 0.12; 95% confidence interval [CI], -0.05 to 0.29; P = 0.17), canine rotation (b, 0.21; 95% CI, -0.82 to 1.25; P = 0.69), and anchorage loss (b, -0.01, 95% CI, -0.28 to 0.26, P = 0.94). No harms were noted.

CONCLUSIONS

Daily 5-minute application of LED did not result in clinically meaningful differences during extraction space closure compared with no LED application.

REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12616000652471).

PROTOCOL

The protocol was not published before trial commencement.

FUNDING

This research was funded by the Australian Society of Orthodontists Foundation for Research and Education.

The Effectiveness of Photobiomodulation on Accelerating Tooth Movement in Orthodontics: A Systematic Review and Meta-Analysis

Objective: This meta-analysis evaluated the effectiveness of photobiomodulation therapy (PBMT) on accelerating orthodontic tooth movement (OTM) in clinical practice. Methods: Data from bilingual journals across seven different databases were compiled and analyzed. Randomized controlled trials (RCTs) and quasi-RCTs regarding the effect of PBMT on OTM in cases with four first premolar extractions in split-mouth design were selected. This study was conducted after approval from the IRB. The outcome variables were the cumulative tooth movement distances in 1, 2, and 3 months. Data extraction was performed by two authors independently and in duplicate. Risk of bias was assessed. Results: Eight RCTs and one quasi-RCT were ultimately included and analyzed in meta-analysis. This study revealed that the pooled mean difference (MD) among these trials was 0.30 [95% confidence interval (CI): -0.02 to 0.62], 0.69 (95% CI: 0.08 to 1.29), and 0.64 (95% CI: -0.01 to 1.29) for 1, 2, and 3 months, respectively. The results remained consistent after sensitivity analysis assessment. Conclusions: There is insufficient evidence to support that photobiomodulation accelerates tooth movement in orthodontic treatments. Our results suggest that the optimal parameters of PBMT on OTM in human might be about 20 mW, 5-8 J/cm², 0.5 W/cm², 0.2 J/point, and 2-10 J/tooth. More large-sample multicenter clinical trials carried out in similar settings are required to confirm and pinpoint treatment efficiency and optimal parameters. Registration: The review protocol was not registered prior to the study.

Do orthodontists aim to decrease the duration of fixed appliance treatment?

OBJECTIVES:

The aim of the present study was to investigate the trends in the use of fixed appliance and accelerated orthodontics to decrease the treatment duration. Further, this study aimed to assess the effect of demographic factors on the participant's choice of treatment modality.

METHODS:

This was a cross-sectional study in the form of questionnaire-based online survey especially designed and distributed to 265 orthodontists via email. The questions aimed to collect basic information about the participants and respondents’ choices for decreasing the treatment duration. The data were analyzed according to gender, level of academic education and years of clinical experience using Chi-square test.

RESULTS:

A response rate of 85.2% was reported. Most of the orthodontists aimed to reduce the treatment duration by the biomechanical (66.8%) and surgical approaches (27.4%). The use of sliding mechanics (69.4%) and one-step retraction was more common (66.3%). MBT bracket prescription was more prevalent (51.7%), followed by Roth (41.1%). Conventional brackets were used more than self-ligating brackets, and aesthetic brackets were avoided by one third of the respondents. NiTi wires were the most commonly used wires during the alignment stage (44.2%). However, the effect of gender, years of clinical experience and specialty level of education showed some effects on the use of certain techniques and clinical practice of the respondents.

CONCLUSIONS:

Most of the orthodontists aimed to decrease orthodontic treatment duration by using biomechanical and surgical approaches. Gender and clinical experience to a certain extent affected the participants’ choice during orthodontic treatment.

Effects of different wavelengths of low-level laser therapy on orthodontically induced inflammatory root resorption in rats investigated with micro-computerized tomography

INTRODUCTION

The objective of this research was to investigate the effects of different wavelengths low-level laser therapies on orthodontically induced inflammatory root resorption (OIIRR) during orthodontic tooth movement in rats by micro-computerized tomography.

METHODS

Forty Wistar albino rats were divided into 5 groups: control group (A), 405-nm laser group (B), 532-nm laser group (C), 650-nm laser group (D), and 940-nm laser group (E). The left side of group A was used as a positive control (A-PC), and the right side of group A was used as a negative control (A-NC) group. In all groups, the maxillary left first molars were moved mesially by 50 g of force for 14 days. The lasers were performed for 9 minutes on the maxillary left first molar tooth. At the end of the experimental period, OIIRR measurements were performed at the mesial and the distal sides along the mesial root of the maxillary first molars.

RESULTS

The root resorption volume was significantly lower in group A-NC than in groups A-PC, B, and D. The percentage of root resorption was significantly lower in group A-NC than in all other groups. The root resorption volume and the percentage of root resorption in groups C, D, and E were significantly lower than group A-PC. The depth and the width of the lacuna and even the number of mesial lacunae were similar between groups. The distal and the total lacunae were significantly lower in group A-NC than in all other groups except group C.

CONCLUSIONS

The 532-nm, 650-nm, and 940-nm lasers significantly reduced the volume of OIIRR. In addition, the 532-nm laser reduced the number of lacunae both distally and totally than all the other groups.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis

AIM AND BACKGROUND

This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM).

REVIEW METHODS

The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software.

RESULTS

A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %).

CONCLUSION

Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high.

CLINICAL SIGNIFICANCE

Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children.

HOW TO CITE THIS ARTICLE

Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Which method is more effective for accelerating canine distalization short term, low-level laser therapy or piezocision? A split-mouth study

OBJECTIVES

This study evaluated and compared the effects of low-level laser therapy (LLLT) and piezocision on the amount of orthodontic tooth movement.

MATERIALS AND METHODS

Forty maxillary canines from 20 patients (mean age, 16.35 ± 1.14 years) were evaluated in a split-mouth design study. Miniscrew-supported canine distalization was performed. Piezocision was applied in the right maxillary canine region, and the left maxillary canines were irradiated with a diode laser (940 nm, 5 J/cm²). LLLT was performed on day 0 and days 3, 7, 14, 21, and 28 after the start of canine distalization in the first 4‑week period. Data were evaluated at baseline (T0) and after 4 (T1), 8 (T2), and 12 (T3) weeks. The amount of canine movement was determined from three-dimensional models, and the angulation of canines and first molars was analyzed based on lateral cephalograms.

RESULTS

Intragroup and intergroup comparisons of canine distalization were performed for four different time intervals (T0-T1, T1-T2, T2-T3, T0-T3). The canine tooth movement in the T0-T1 period was significantly greater in the LLLT group compared to the piezocision group. No statistically significant differences were observed between the groups for the T1-T2, T2-T3, and T0-T3 periods. The amount of canine distalization in the T0-T1 period was significantly greater than that in the T1-T2 and T2-T3 periods in both groups. Tooth movement during the T1-T2 period was higher than that in the T2-T3 period in the LLLT group. Cephalometric evaluation revealed no statistically significant difference between the groups with respect to canine and first molar angulation.

CONCLUSION

Although laser application seems more effective during the first 4‑week period, considering the 12-week period, the effects of LLLT and piezocision on orthodontic tooth movement during canine distalization were similar.

Effective Wavelength Range in Photobiomodulation for Tooth Movement Acceleration in Orthodontics: A Systematic Review

Objective: The present systematic review aims to establish an effective range of low-level laser therapy wavelengths to accelerate tooth movement in orthodontic treatments. Materials and methods: The electronic literature search was carried out in the following databases: PubMed, ISI Web of Science, Scopus, and Cochrane randomized controlled trials (RCTs). The protocol (CRD42019117648) was registered in PROSPERO. Results: According to PRISMA guidelines and after applying the inclusion criteria, nine RCTs were included. Three blind reviewers independently assessed the methodological quality and evidence level of selected articles. Evidence level classification was established according to the recommendations of SIGN 50 (Scottish Intercollegiate Guidelines Network 2012) and was high quality being ++, acceptable +, low quality -, unacceptable -, reject 0. Conclusions: The majority of RCTs related to accelerating the tooth movement in orthodontic treatments are ideally between 780 and 830 nm wavelengths. The average increase in speed movement calculated as a percentage of the control group in nine studies is 24%. Further studies are necessary to establish the exact dosimeter in photobiomodulation during orthodontic movement.

Photobiomodulation-Underlying Mechanism and Clinical Applications

The purpose of this study is to explore the possibilities for the application of laser therapy in medicine and dentistry by analyzing lasers' underlying mechanism of action on different cells, with a special focus on stem cells and mechanisms of repair. The interest in the application of laser therapy in medicine and dentistry has remarkably increased in the last decade. There are different types of lasers available and their usage is well defined by different parameters, such as: wavelength, energy density, power output, and duration of radiation. Laser irradiation can induce a photobiomodulatory (PBM) effect on cells and tissues, contributing to a directed modulation of cell behaviors, enhancing the processes of tissue repair. Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), can induce cell proliferation and enhance stem cell differentiation. Laser therapy is a non-invasive method that contributes to pain relief and reduces inflammation, parallel to the enhanced healing and tissue repair processes. The application of these properties was employed and observed in the treatment of various diseases and conditions, such as diabetes, brain injury, spinal cord damage, dermatological conditions, oral irritation, and in different areas of dentistry.

Use of Laser Systems in Orthodontics

Laser systems have been used in the practice of dentistry for >35 years. Laser systems have so many advantages, such as increase patient cooperation, reduce the duration of treatment time, and help the orthodontists to enhance the design of a patient's smile to improve treatment efficacy, and the success of orthodontic treatments can also be improved by diminishing the orthodontic pain and the discomfort of the patients. Laser systems also have some disadvantages, such as cost, large space requirements for some types, and high-risk potential for physician and patient if not used at the appropriate wavelength and power density, that is why before incorporating lasers into clinical practice, the physician must fully understand the basic science, safety protocol, and risks associated with them. Lasers have many applications in orthodontics, including accelerating tooth movement, bonding and debonding processes, pain reduction, bone regeneration, etching procedures, increase mini-implant stability, soft tissue procedures (gingivectomy, frenectomy, operculectomy, papilla flattening, uncovering temporary anchorage devices, ablation of aphthous ulcerations, and exposure of impacted teeth), fiberotomy, scanning systems, and welding procedures. In reviewing the literature on the use of laser in orthodontics, many studies have been conducted. The purpose of the present study was to give information about the use of laser in the field of orthodontics, the effects of laser during the postoperative period, and its advantages and disadvantages and to provide general information about the requirements to be considered during the use of laser.

Low Intensity Laser Influence on Orthodontic Movement: A Randomized Clinical and Radiographic Trial

Introduction: Finding a method to decrease orthodontic treatment time has been a concern for several authors. This study evaluated, clinically and radiographically, the influence of low-level laser therapy on the rate of orthodontic movement and dental tissue integrity.

Methods: The sample included 11 individuals with class I malocclusion, requiring extraction of 4 first premolars. Gallium aluminum arsenide diode laser with a wavelength of 780 nm was used once a month during retraction mechanics, to irradiate the maxillary and mandibular canines on one side and compare them with the nonirradiated contralateral side, after spring activation, until canine retraction was completed. This was followed by movement measurement. Periapical radiographs were used to check for possible modifications in the supporting tissues and root surface of the displaced canines.

Results: No differences in the rate of tooth movement were found between the irradiated and nonirradiated side on both dental arches. There was no resorption of the root and/or alveolar bone crest, maintaining the integrity of these tissues.

Conclusions: Low-level laser therapy did not promote an increment on the rate of tooth movement and did not cause greater root and alveolar bone crest resorption than on the nonirradiated side with the used protocol.

The Effect of Low-Level Laser Therapy on the Acceleration of Orthodontic Tooth Movement

In clinical practice, low-level laser therapy (LLLT) is widely used. The main aim of this review is to assess the effectiveness of LLLT in accelerating tooth movement in human subjects. The PRISMA checklist was utilized as a guideline to carry out this systematic review. The electronic databases were searched from Google Scholar (2014-2018) and PubMed, and comprehensive research on this topic was also manually conducted. Therefore, 77 articles randomized clinical trials (RCTs) or controlled clinical trials (CCTs) were selected. After screening studies, consequently, eleven trials met the inclusion criteria. Eight out of 11 studies showed LLLT has a significant impact on the acceleration of orthodontic tooth movement, and there was no statistically significant difference in the rate of tooth movement between the laser group and the control group in the two remaining studies. Furthermore, five out of 11 articles showed that LLLT has no adverse effects. Although we have some degree of understanding from a cellular point of view to LLLT effects, we still do not know whether these cellular level changes have any effect on the clinical acceleration of orthodontic tooth movement. The results are inconclusive and cannot be generalized to the public community; therefore, well-structured studies are required.

Examination of the Effect of the Combined Use of Nd: YAG Laser Irradiation and Mechanical Force Loading on Bone Metabolism Using Cultured Human Osteoblasts

Introduction: In recent years, laser irradiation in the near-infrared ray (NIR) area has been reported to promote bone healing. There are also reports that laser irradiation accelerates orthodontic tooth movement. In this study, we investigated the effect of NIR laser irradiation and mechanical stimulation on osteoblasts. Methods: We seeded osteoblast-like cells and laser irradiation was performed 24 hours after cell seeding. In addition, a control group not receiving anything, a group receiving only Nd: YAG (neodymium-doped yttrium aluminum garnet) laser irradiation, a group receiving only centrifugal loading, and a group receiving both Nd: YAG laser irradiation and centrifugal force loading were set, and after 24 hours and after 48 hours, cells were collected and quantitative real-time polymerase chain reaction (PCR) was performed. Results: 24 hours after laser irradiation, the gene expression of alkaline phosphatase (ALP), the receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) was significantly higher in the 2.0 W group than in the control group. In addition, the RANKL/OPG ratio was higher in the 2.0 W group than in the control group. Also, in the group using laser irradiation and centrifugal loading in combination, 24 hours after laser irradiation, ALP and OPG showed significantly higher values than those in the centrifugal load only group. Furthermore, the RANKL/OPG ratio also showed high values. Conclusion: These results suggest that osteoblast-like cells activate genes related to bone metabolism by combining mechanical stimulation and laser irradiation. This helps to elucidate the influence of laser irradiation during tooth movement.

Evaluation of the effects of photobiomodulation on orthodontic movement of molar verticalization with mini-implant: A randomized double-blind protocol study

INTRODUCTION

Loss of a dental element can generate several repercussions in the stomatognathic system. According to the latest survey by the Ministry of Health, in 2010, Brazilian adults had, on average, 7 missing teeth. This loss may lead to movement of the adjacent teeth and the antagonist, which would make prosthetic rehabilitation harder to do. Anchoring systems, such as mini-implants, have been increasingly used as a treatment option because they act with heavy but controlled forces and without side effects. Recent studies have shown that photobiomodulation (PBM) can accelerate orthodontic movement in molar intrusion. The objective of this study will be to evaluate the effect of PBM on the acceleration of the orthodontic movement of molar verticalization and its effect on pain and inflammation of the periodontal tissues. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire.

DIAGNOSIS

verticalization will be evaluated by clinical and radiographic analysis.

INTERVENTIONS

Thirty four healthy patients aged 30 to 60 years, who need to recover the prosthetic space for oral rehabilitation after loss of the posterior inferior dental elements and inclination of the adjacent element, will be randomly divided into 2 groups: G1 (control group) - verticalization by mini-implant + PBM simulation (placebo); G2 (experimental group) - verticalization by mini-implant + PBM. The movements will occur with the aid of mini-implants and elastomeric chains ligatures. The PBM will occur with diode laser application, 808 nm, 100 mW, receiving 1J per point, 10 seconds, 10 points (5 per buccal and 5 per lingual) and radiant exposure of 25 J/cm. The orthodontic forces of verticalization (corresponding to any exchange of elastomeric ligation) will be applied every 30 days and the PBM will be applied immediately, 3 and 7 days of each month, for a period of 3 months. The crevicular gingival fluid (CGF) will be collected on the 1st, 3rd, and 7th days after the first activation, and then on the 3rd day of the following 2 months.

OUTCOMES

Interleukins IL1β, IL-6, IL-8, IL-10, and TNF-α will be analyzed by ELISA. Panoramic radiography will be performed at baseline and 90 afterwards to ascertain the amount (in degrees) of verticalization. To evaluate the pain, the Visual Analog Scale (VAS) will be used in all the consultations, and to evaluate the quality of life, the Oral Health Impact Profile (OHIP-14) questionnaire will be applied. Analgesics will be given and the quantity of drugs will be counted. If the data are normal, they will be submitted to Student t test. The data will be presented as means ± SD and the value of p will be defined as <0.05.

DISCUSSION

This protocol will determine the effectiveness of photobiomoduation regarding the orthodontic movement of molar verticalization.

ETHICS AND DISSEMINATION

This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3 533 219). The data will be published in a peer-reviewed periodical.

The effect of combined corticotomy and low level laser therapy on the rate of orthodontic tooth movement: split mouth randomized clinical trial

Purpose

The aim of this study was to evaluate the combined effect of corticotomy and Low-Level Laser Therapy(LLLT) on the rate of orthodontic tooth movement.

Methods

A randomized split-mouth design for 16 female patients compared the rate of maxillary canine retraction using corticotomy combined with LLLT versus corticotomy only. The device used in the present study was an In-Ga-As semiconductor diode laser emitting at 940 nm (IR) with these parameters: 0.5 W/ cm² power density, 5 J/cm² Fluence, CW, 240 sec time irradiation, weekly for the first month and twice monthly for the next three months. Assessment of the rate of canine retraction was carried out via a series of dental models.

Results

A non-significant statistical rate of canine retraction was achieved by LLLT combined to corticotomy compared with the corticotomy technique alone.

Conclusion

Low-Level Laser Therapy combined to corticotomy could not achieve a higher rate of canine retraction compared to the golden standard corticotomy technique alone. No long-term adverse effects on the alveolar mucosa were detected following both techniques.

Effect of photobiomodulation therapies on the root resorption associated with orthodontic forces: a pilot study using micro computed tomography

OBJECTIVES

The aim of this study is to investigate the effect of photobiomodulation therapies on root resorption compared with the placebo group.

MATERIALS AND METHODS

Thirty patients who were admitted to the Gaziantep University Faculty of Dentistry Orthodontics Department for treatment, with an indication of upper right first premolar tooth extraction were included. Before the individuals' orthodontic treatment, 0.022 slot MBT brackets and tubes were placed on the maxillary first premolar and molar. A 150-g buccal tipping force was applied to the first premolar. Cantilever spring with 0.017 × 0.025 Beta Titanium wire was used for force application. Individuals were then randomly divided into three groups. For the first group, laser application was performed with an 810-nm GaAlAs laser device at 0, 3, 7, 14, 21, and 28 days to 8 J/cm². For the second group, an LED application according to the manufacturer's instructions with an 850-nm wavelength and 20 mW/cm² output power for 10 min per day during the experiment. For the third group, a placebo therapy was completed whereby a laser device that did not make active pulses was used. At the end of 4 weeks, the amount of root surface resorption was compared using micro-CT imaging after the extraction of the teeth.

RESULTS

No significant difference was found between the groups in terms of regional and total crater volumes. It was observed that photobiomodulation therapies were not different from the control group in terms of forming root resorption.

CONCLUSIONS

It is seen that laser and LED photobiomodulation therapies used for accelerate orthodontic tooth movement do not differ from the control group in terms of forming root resorption.

CLINICAL RELEVANCE

According to the results of this pilot study on this subject, which needs to be clarified with new findings in the future, LED and laser applications may not increase the risk for root resorption.

Photobiomodulation increases intrusion tooth movement and modulates IL-6, IL-8 and IL-1β expression during orthodontically bone remodeling

This study investigated the effects of photobiomodulation (PBM) on upper molar intrusion movement, regarding acceleration of orthodontic movement and its molecular effects. The sample consisted of 30 patients with indication of tooth intrusion for oral rehabilitation. Teeth were divided into three different groups: G1 (n = 10) pre-molars without force or laser application (control); G2 (n = 10) upper molar intrusion; and G3 (n = 10) upper molar intrusion and PBM. On PBM treated molars, the teeth were irradiated with a low-power diode laser (808 nm, 100 mW), receiving 1 J per point, density of 25 J/cm² , with application of 10 s per point, 10 points (5 per vestibular and 5 per palatal region). Orthodontic force of intrusion applied every 30 days and PBM was performed immediately, 3 and 7 days after force application for 3 months. Gingival crevicular fluid was collected at the same time periods as the laser applications and interleukins (IL) 1-β, -6 and -8 were evaluated by enzyme-linked immunosorbent assay. Clinical measures were performed monthly to verify the amount of intrusion. The levels of IL-6, IL-8 and IL-1β increased under orthodontic force (G2 and G3) when compared to control group (G1), however, the cytokines levels were significantly higher after PBM (G3). The mean intrusion velocity was 0.26 mm/month in the irradiated group (G3), average duration of 8 months vs 0.17 mm/month for the non-irradiated group (G2), average duration of 12 months. This study suggests that PBM accelerates tooth movement during molar intrusion, due to modulation of IL-6, IL-8 and IL-1β during bone remodeling.

Infrared Light-Emitting Diode (LED) Effects on Orthodontic Tooth Movement

The present study aimed to analyze the effect of LED phototherapy on the presence of hyalinization and root resorption during orthodontic tooth movement (OTM) in rats and to measure the amount of tooth movement. Eighty rats were allocated into two groups: LED and control (CON), where the LED rats were irradiated with infrared LED (850 nm, 30 mW) for 5 min during the first five days of OTM and where controls were not irradiated. Both groups were subdivided into four subgroups (n=10) according to the date of euthanasia (4, 7, 14 and 21 days). Five out of ten LED21 and five of ten CON21 rats were submitted to micro-computed tomography (μCT); μCT scans were taken on days 0, 7, 14 and 21. For histological study, maxillae were processed to light microscopy using Hematoxylin-Eosin (HE) and Tartrate-Resistant Acid Phosphatase (TRAP) histochemistry. The amount of tooth movement did not differ between LED and CON. Hyalinization was observed at the pressure areas in both groups, and it did not show a statistically significant difference between the groups. Root resorption was also observed in both groups after 7 days and it did not represent any differences between the two groups. LED phototherapy was not able to increase the amount of OTM. Similar characteristics of hyalinization and root resorption were observed in both groups.

The Role of Low-Intensity Biostimulation Laser Therapy in Transforming Growth Factor β1, Bone Alkaline Phosphatase and Osteocalcin Expression during Orthodontic Tooth Movement in Cavia porcellus

Objective The aim of this study is to analyze the low-intensity laser therapy (LILT) biostimulation mechanism as adjuvant therapy within orthodontic treatment as a means of accelerating bone remodeling by transforming growth factor β1 (TGF-β1), bone alkaline phosphatase (BALP), and osteocalcin (OSC) expression.

Materials and Methods An analytical experimental method incorporating a posttest only randomized the control group design. The sample consisted of 24 3- to 4-month-old male Cavia porcellus weighing between 300 and 500 g divided into three groups (group 1: control, group 2: received orthodontic treatment, and group 3: received orthodontic treatment with irradiation LILT). LILT biostimulation at a dose of 4 joule/cm ² was performed daily for 3 min on the mesial-distal labial-palatal of the first dextra and sinistra incisor for 2 weeks. The TGF-β1, BALP, and OSC expression was subjected to immunohistochemical analysis. An analysis of variance with multiple comparison, a Tukey's honestly significant difference test, a Kruskal–Wallis test, and a Wilcoxon–Mann–Whitney test were all performed ( p < 0.05).

Results TGF-β1 expression was significantly different ( p = 0.047; p < 0.05) in the tension area, but not in the compression side ( p = 0.154; p > 0.05). BALP expression was significantly different in both the tension ( p = 0.009) and compression areas ( p = 0.005; p < 0.05). OSC expression was significantly different ( p = 0.034; p < 0.05) in the tension side, but not in the compression area ( p = 1.194; p > 0.05).

Conclusion LILT biostimulation can increase TGF-β1, BALP, and OSC expression during orthodontic tooth movement.

Molecular biological and histological effects of Er:YAG laser irradiation on tooth movement

The aim of this study was to evaluate the effects of a fiberotomy-like procedure using Er:YAG laser irradiation on the velocity of orthodontic tooth movement. To produce experimental tooth movement in rats, orthodontic force was applied to the upper first molars with a nickel-titanium closed coil. The right molars were irradiated with an Er:YAG laser while the non-irradiated left molars were used as controls. The rats were sacrificed at 4 weeks after the start of tooth movement and the distance between the mesial side of the second molar and the distal side of the upper first molar was measured on CT images. The amount of tooth movement was significantly greater in the irradiation group than in the control group. The TRAP-positive nuclei count at the pressure site was higher in the laser-irradiation group than in the control group. Expression of RANKL and ALP was higher at the mesial-coronal pressure site in the laser-irradiation group than in the control group. In addition, expression of OPG was higher at the pressure site in the control group than in the laser-irradiation group. These results suggest that a fiberotomy-like procedure using an Er:YAG laser stimulates osteoclasts and osteoblasts and may promote bone metabolism in the context of experimental tooth movement.