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Ubuzima P, Nshimiyimana E, Mukeshimana C, Mazimpaka P, Mugabo E, Mbyayingabo D, Mohamed AS, Habumugisha J. Exploring biological mechanisms in orthodontic tooth movement: Bridging the gap between basic research experiments and clinical applications - A comprehensive review. Ann Anat 2024; 255:152286. [PMID: 38810763 DOI: 10.1016/j.aanat.2024.152286] [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] [Received: 02/28/2024] [Revised: 04/21/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES The molecular mechanisms behind orthodontic tooth movements (OTM) were investigated by clarifying the role of chemical messengers released by cells. METHODS Using the Cochrane library, Google scholar, and PubMed databases, a literature search was conducted, and studies published from 1984 to 2024 were considered. RESULTS Both bone growth and remodeling may occur when a tooth is subjected to mechanical stress. These chemicals have a significant effect on the stimulation and regulation of osteoblasts, osteoclasts, and osteocytes during alveolar bone remodeling. This regulation can take place in pathological conditions, such as periodontal diseases, or during OTM alone. This comprehensive review outlines key molecular mechanisms underlying OTM and explores various clinical assumptions associated with specific molecules and their functional domains during this process. Furthermore, clinical applications of certain molecules such as relaxin, prostaglandin E (PGE), and interleukin-1β (IL-1β) in accelerating OTM have been reported. Our findings underscore the existing gap between OTM clinical applications and basic research investigations. CONCLUSION A comprehensive understanding of orthodontic treatment is enriched by insights into biological systems. We reported the activation of osteoblasts, osteoclast precursor cells, osteoclasts, and osteocytes in response to mechanical stress, leading to targeted cellular and molecular interventions and facilitating rapid and regulated alveolar bone remodeling during tooth movement. Despite the shortcomings of clinical studies in accelerating OTM, this review highlights the crucial role of biological agents in this process and advocates for prioritizing high-quality human studies in future research to gain further insights from clinical trials.
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Affiliation(s)
- Pascal Ubuzima
- Department of Orthodontics, Affliated Hospital of Stomatology, Anhui Medical University Hefei, 69 Meishan Road, Hefei, Anhui, China; School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Rwanda
| | - Eugene Nshimiyimana
- Department of Orthodontics, Affliated Hospital of Stomatology, Anhui Medical University Hefei, 69 Meishan Road, Hefei, Anhui, China
| | - Christelle Mukeshimana
- Department of Orthodontics, Affliated Hospital of Stomatology, Anhui Medical University Hefei, 69 Meishan Road, Hefei, Anhui, China
| | - Patrick Mazimpaka
- School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Rwanda
| | - Eric Mugabo
- Department of Orthodontics, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 72 Xiangya Road, Changsha, Hunan 410000, China
| | - Dieudonne Mbyayingabo
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, Xi'an, Shaanxi 710004, China
| | | | - Janvier Habumugisha
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kitaku, Okayama 700-8525, Japan; Department of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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2
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Zhang J, Zhang X, Han K, Wang X, Guo Z, Deng Q, Li J, Lv S, Yu W. Effects of low level laser on periodontal tissue remodeling in hPDLCs under tensile stress. Lasers Med Sci 2023; 38:232. [PMID: 37819407 PMCID: PMC10567958 DOI: 10.1007/s10103-023-03885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/13/2023] [Indexed: 10/13/2023]
Abstract
This study aimed to investigate the effect of Low-Level Laser Therapy (LLLT) on human Periodontal Ligament Cells (hPDLCs) under tension stress. Primary hPDLCs were obtained using the tissue culture method, and P3 cells were utilized for the subsequent experiments. The study comprised four groups: a blank control group (Group B), a laser irradiation group (Group L), a tension stress group (Group T), and a laser + tension stress group (Group LT). Mechanical loading was applied using an in-vitro cell stress loading device at a frequency of 0.5 Hz and deformation of 2% for two hours per day for two days. Laser irradiation at 808 nm GaAlAs laser was administered 1 h after force loading. Cell samples were collected after the experiment. Bone and fiber remodeling factors were analyzed using PCR and Western blot. Flow cytometry was employed to assess the cell cycle, while ROS and Ca2+ levels were measured using a multifunctional enzyme labeling instrument. The results revealed that laser intervention under tension stress inhibited the expression of osteogenic differentiation factors, promoted the expression of osteoclast differentiation factors, and significantly increased the production of collagen factors, MMPs, and TIMPs. The LT group exhibited the most active cell cycle (P < 0.05). LLLT not only enhanced Ca2+ expression in hPDLCs under tension stress, but also stimulated the production of ROS. Overall, our findings demonstrate that LLLT effectively accelerated the proliferation of hPDLCs and the remodeling of periodontal tissue, possibly through the regulation of ROS and Ca2+ levels in hPDLCs.
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Affiliation(s)
- Jiaxi Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Xizhong Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Kaifang Han
- Department of Stomatology, Tianjin Beichen Hospital, Tianjin, 300400, China
| | - Xuan Wang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Ziyuan Guo
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Qi Deng
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Jiahui Li
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Shuxin Lv
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Wenwen Yu
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, 300041, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China.
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3
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7" and 2*3*8=6*8 and "9dhl"="9dhl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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4
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7%' and 2*3*8=6*8 and '6o48'!='6o48%] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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5
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7' and 2*3*8=6*8 and 'rz5y'='rz5y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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6
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7'"] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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7
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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8
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7jypboind] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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9
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7����%2527%2522\'\"] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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10
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Grajales M, Ríos-Osorio N, Jimenez-Peña O, Mendez-Sanchez J, Sanchez-Fajardo K, García-Perdomo HA. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials. Lasers Med Sci 2023; 38:200. [PMID: 37667064 DOI: 10.1007/s10103-023-03870-7'||'] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 01/29/2024]
Abstract
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm2 were associated with faster orthodontic tooth movement.
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Affiliation(s)
- Marggie Grajales
- Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain
| | - Nestor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.
| | - Oscar Jimenez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Juan Mendez-Sanchez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia
| | - Kelly Sanchez-Fajardo
- Department of Bio-Clinical Research, Faculty of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Herney Andrés García-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
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11
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Prathapan Santhakumari P, Varma Raja V, Joseph J, Devaraj A, John E, Oommen Thomas N. Impact of Low-Level Laser Therapy on Orthodontic Tooth Movement and Various Cytokines in Gingival Crevicular Fluid: A Split-Mouth Randomized Study. Cureus 2023; 15:e42809. [PMID: 37664315 PMCID: PMC10469857 DOI: 10.7759/cureus.42809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A few investigations have detailed the influence of low-level laser therapy (LLLT) on orthodontic tooth movement (OTM), with varying results. The objectives of this study were twofold: to assess the impact of LLLT on OTM and various cytokine levels in gingival crevicular fluid and to contrast the pain levels experienced by patients receiving orthodontic treatment with and without LLLT. MATERIALS AND METHODS This split-mouth randomized controlled prospective study comprised 40 patients with an average age of 19.7±2.4 years with Angle Class I malocclusion combined with bimaxillary protrusion who were advised for extraction of the maxillary first premolar and bilateral canine distalization. The control-side canine was distalized solely by the coil spring. On the test arm, a low-level gallium-aluminum-arsenide semiconductor diode laser operating at 980 nm and 100 mW with a continuous-wave energy of 8 J/cm2 was used. The canine distalization on either side was measured with a digital caliper following the first premolar extraction (TO), one month after treatment (TOTM1), two months later (TOTM2), and three months later (TOTM3). The gingival index and the level of various cytokines were determined by an enzyme-linked immunosorbent assay at the beginning of the study, on the third and seventh days, and at four, eight, and 12 weeks following the canine distalization. The intra-group and inter-group comparisons were carried out using one-way analysis of variance (ANOVA) and t-tests, respectively, at a 5% significance level. RESULTS The results show a highly statistically significant difference in the extent of canine distalization in the test group (TOTM1=2.92±0.44; TOTM2=1.04±0.1; TOTM3=0.62±0.21 mm) in contrast to the control group (TOTM1=3.23±0.8; TOTM2=2.65±0.2; TOTM3=2.11±0.24 mm) (p<0.01). After three months of canine distalization, the laser and control group had 34 and 27 patients with mild gingivitis, respectively. Interleukin-1β and interleukin-6 concentrations surged with values of 0.74±0.13 and 0.049±0.001 pg/g at seven days following treatment in the laser group, respectively. The difference in tumor necrosis factor concentration between the groups was shown to be highly statistically significant in all treatment phases (p<0.001). The differences in the epidermal growth factor and microglobulin levels were found to be statistically significant within both groups from T0 to T5. The average visual analog scale (VAS) scores at several subsequent evaluations of the laser and control groups were found to be highly statistically significant. CONCLUSION The findings imply that when the periodontal microenvironment is stimulated by orthodontic force, several paramount cytokines are released, triggering an ordered sequence of biological processes that appear to expedite OTM with reduced associated pain.
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Affiliation(s)
| | - Vighnesh Varma Raja
- Department of Orthodontics and Dentofacial Orthopedics, Indira Gandhi Institute of Dental Sciences, Kothamangalam, IND
| | - Jacob Joseph
- Department of Orthodontics and Dentofacial Orthopedics, Indira Gandhi Institute of Dental Sciences, Kothamangalam, IND
| | - Anjitha Devaraj
- Department of Orthodontics and Dentofacial Orthopedics, Indira Gandhi Institute of Dental Sciences, Kothamangalam, IND
| | - Eunice John
- Department of Orthodontics and Dentofacial Orthopedics, Indira Gandhi Institute of Dental Sciences, Kothamangalam, IND
| | - Navin Oommen Thomas
- Department of Orthodontics and Dentofacial Orthopedics, Pushpagiri College of Dental Sciences, Thiruvalla, IND
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Wang X, Liu Q, Peng J, Song W, Zhao J, Chen L. The Effects and Mechanisms of PBM Therapy in Accelerating Orthodontic Tooth Movement. Biomolecules 2023; 13:1140. [PMID: 37509176 PMCID: PMC10377711 DOI: 10.3390/biom13071140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
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.
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Affiliation(s)
- Xinyuan Wang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Qian Liu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Jinfeng Peng
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Jiajia Zhao
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
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13
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Wazwaz F, Seehra J, Carpenter GH, Papageorgiou SN, Cobourne MT. Duration of canine retraction with fixed appliances: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 163:154-172. [PMID: 36464569 DOI: 10.1016/j.ajodo.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Space closure is a challenging and time-consuming phase of orthodontic treatment with fixed appliances. This systematic review evaluated canine retraction duration using fixed appliances after maxillary first premolar extraction. METHODS Unrestricted systematic literature searches were conducted in 8 databases for randomized clinical trials, assessing the duration and rate of maxillary canine retraction using fixed appliances with or without treatment adjuncts published up to July 2021. Study selection, data extraction, and risk of bias evaluation were conducted independently and in duplicate. Random-effects meta-analyses of average rates or mean differences (MD) and 95% confidence intervals (CI) were conducted at α = 5%, followed by sensitivity and Grading of Recommendations Assessment, Development, and Evaluation analysis. RESULTS Fifty randomized clinical trials (6 parallel and 44 split-mouth designs) covering 811 participants (mean age 19.9 years; 34% male) were included. The estimated average pooled duration to achieve complete canine retraction was 4.98 months (2 trials; 95% CI, -2.9 to 12.88 months). Pooled average canine retraction was 0.97 mm at months 0-1 (23 trials; 95% CI, 0.79-1.16), 1.83 mm at months 0-2 (20 trials; 95% CI, 1.52-2.14), 2.44 mm at months 0-3 (23 trials; 95% CI, 2.10-2.79), 3.49 mm at months 0-4 (6 trials; 95% CI, 1.81-5.17) and 4.25 mm at months 0-5 (2 trials; 95% CI, 0.36-8.14). Surgically-assisted orthodontics was associated with greater canine retraction at all time points: months 0-1 (10 trials; MD, 0.52 mm; P = 0.004), months 0-2 (8 trials; MD, 0.53 mm; P = 0.04), months 0-3 (8 trials; MD, 0.67 mm; P = 0.01), and months 0-4 (3 trials; MD, 1.13 mm; P = 0.01), whereas subgroup analyses indicated significant effects of anchorage reinforcement method and bracket slot size on canine retraction. CONCLUSIONS The average time to achieve complete retraction of the maxillary canine using fixed appliances was around 5.0 months. Most studies used split-mouth randomization to investigate canine retraction for around 1-3 months, with substantial heterogeneity across studies. At 3 months of treatment, high-quality evidence supported greater canine retraction with surgically-assisted orthodontics.
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Affiliation(s)
- Fidaa Wazwaz
- Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial Development & Regeneration, King's College London, London, United Kingdom
| | - Jadbinder Seehra
- Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial Development & Regeneration, King's College London, London, United Kingdom
| | - Guy H Carpenter
- Department of Mucosal Biology, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Disease, King's College London, London, United Kingdom
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Martyn T Cobourne
- Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial Development & Regeneration, King's College London, London, United Kingdom.
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14
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Yan L, Liao L, Su X. Role of mechano-sensitive non-coding RNAs in bone remodeling of orthodontic tooth movement: recent advances. Prog Orthod 2022; 23:55. [PMID: 36581789 PMCID: PMC9800683 DOI: 10.1186/s40510-022-00450-3] [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] [Received: 07/22/2022] [Accepted: 11/15/2022] [Indexed: 12/31/2022] Open
Abstract
Orthodontic tooth movement relies on bone remodeling and periodontal tissue regeneration in response to the complicated mechanical cues on the compressive and tensive side. In general, mechanical stimulus regulates the expression of mechano-sensitive coding and non-coding genes, which in turn affects how cells are involved in bone remodeling. Growing numbers of non-coding RNAs, particularly mechano-sensitive non-coding RNA, have been verified to be essential for the regulation of osteogenesis and osteoclastogenesis and have revealed how they interact with signaling molecules to do so. This review summarizes recent findings of non-coding RNAs, including microRNAs and long non-coding RNAs, as crucial regulators of gene expression responding to mechanical stimulation, and outlines their roles in bone deposition and resorption. We focused on multiple mechano-sensitive miRNAs such as miR-21, - 29, -34, -103, -494-3p, -1246, -138-5p, -503-5p, and -3198 that play a critical role in osteogenesis function and bone resorption. The emerging roles of force-dependent regulation of lncRNAs in bone remodeling are also discussed extensively. We summarized mechano-sensitive lncRNA XIST, H19, and MALAT1 along with other lncRNAs involved in osteogenesis and osteoclastogenesis. Ultimately, we look forward to the prospects of the novel application of non-coding RNAs as potential therapeutics for tooth movement and periodontal tissue regeneration.
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Affiliation(s)
- Lichao Yan
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry and Engineering Research Center of Oral Translational Medicine and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Li Liao
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry and Engineering Research Center of Oral Translational Medicine and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Xiaoxia Su
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry and Engineering Research Center of Oral Translational Medicine and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
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15
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A randomized controlled trial evaluating the effect of two low-level laser irradiation protocols on the rate of canine retraction. Sci Rep 2022; 12:10074. [PMID: 35710926 PMCID: PMC9203565 DOI: 10.1038/s41598-022-14280-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/03/2022] [Indexed: 12/02/2022] Open
Abstract
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.
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16
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Effect of the photobiomodulation for acceleration of the orthodontic tooth movement: a systematic review and meta-analysis. Lasers Med Sci 2022; 37:2323-2341. [PMID: 35304644 DOI: 10.1007/s10103-022-03538-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/25/2022] [Indexed: 01/02/2023]
Abstract
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.
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17
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An Y, Zhao J, Xu H, An L, Wang J, Wu Y, Liu Q. Effect of humic acid as a photosensitizer combined with low-energy laser on orthodontic tooth movement in rats. J Dent Sci 2022; 17:407-414. [PMID: 35028064 PMCID: PMC8740398 DOI: 10.1016/j.jds.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Humic acid (HA) could promote light conversion reaction, and lasers accelerate orthodontic tooth movement. We investigated the effect of HA, as a photosensitizer, combined with low-energy laser on orthodontic tooth movement in rats. Materials and methods An orthodontic tooth movement model was established, and the upper left first molar was moved mesially by a nickel-titanium tension spring with a 50-g force. HA was injected into the rats’ abdominal cavity (80 mg/kg once daily). The periodontal tissue of the upper left upper first molar on the pressure side was irradiated (50 s once every 2 days) using a semiconductor laser (wavelength, 650 nm; power, 50 mV). Distance moved by the upper left first molar was measured at different time points, and the tissue of the first molar was sectioned and scanned by micro-computed tomography to evaluate the alveolar bone density. Tartrate-resistant acidic phosphatase staining was used to observe the osteoclast number, alveolar bone, and periodontal tissue. Results HA alone did not significantly affect orthodontic tooth movement, alveolar structure density, or periodontal tissue remodeling (P > 0.05). HA combined with a low-energy laser accelerated orthodontic tooth movement. The number of bone absorption lacunae and osteoclasts on the alveolar bone's pressure side increased significantly (P < 0.05), while the density decreased significantly (P < 0.05); however, no root absorption was observed. Conclusion HA can improve the conversion rate of low-energy lasers, enhance the low-energy laser effect, and promote orthodontic tooth movement and periodontal tissue reconstruction on the pressure side in rats, without causing root resorption.
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Affiliation(s)
- Yang An
- Department of Stomatology, Shanxi Bethune Ηospital, Taiyuan, Shanxi, China
| | - Jianmei Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Hang Xu
- Department of General Stomatology, Hangzhou YaBoyi Dental Clinic, Hangzhou, Zhejiang, China
| | - Li An
- Department of Operation, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | - Jun Wang
- Department of Stomatology, Shanxi Bethune Ηospital, Taiyuan, Shanxi, China
| | - Yang Wu
- Department of Stomatology, Shanxi Bethune Ηospital, Taiyuan, Shanxi, China
| | - Qingmei Liu
- Department of Stomatology, Shanxi Bethune Ηospital, Taiyuan, Shanxi, China
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18
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MacDonald L, Zanjir M, Laghapour Lighvan N, da Costa BR, Suri S, Azarpazhooh A. Efficacy and safety of different interventions to accelerate maxillary canine retraction following premolar extraction: A systematic review and network meta-analysis. Orthod Craniofac Res 2021; 24:17-38. [PMID: 34643019 DOI: 10.1111/ocr.12409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 01/03/2023]
Abstract
Decreasing orthodontic treatment duration is at the forefront of innovation for clinical orthodontics. This network meta-analysis aimed to determine the relative efficacy and safety of treatments for accelerated orthodontic tooth movement (OTM) in patients undergoing extraction of maxillary first premolars followed by canine retraction in any orthodontic setting. MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL and SCOPUS were searched (from inception to 20 April 2020). Study selection and data extraction were performed in duplicate. Eligible randomized controlled trials (RCTs) were meta-analysed to estimate the rate of tooth movement, 95% credible interval and surface under the cumulative ranking curve (SUCRA) in the first 3 months following the application of the adjunctive accelerative method. Eligible RCTs were assessed by Cochrane risk of bias tool, and quality of evidence was assessed by GRADE approach, obtained from CINeMA web application. Interventions were ranked for efficacy and reviewed for safety. Nineteen studies pertaining to eight interventions, with data from 415 patients were included. Quality of evidence was very low to moderate. Very low-to low-quality evidence suggests that corticotomy is an efficacious and safe adjunctive treatment to accelerate OTM in comparison with conventional treatment in the first 2 months of treatment. Low-quality evidence suggests that piezocision and micro-osteoperforations (MOP) are efficacious and safe adjunctive treatments only in the first month of treatment. Frequent MOP in conjunction with low-level laser therapy appeared to be an efficacious and safe adjunctive treatment only in the first month following its initial application but not thereafter.
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Affiliation(s)
- Laura MacDonald
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Maryam Zanjir
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Bruno R da Costa
- Clinical Epidemiology & Health Care Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sunjay Suri
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Clinical Epidemiology & Health Care Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
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19
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Photobiomodulation impacts the levels of inflammatory mediators during orthodontic tooth movement? A systematic review with meta-analysis. Lasers Med Sci 2021; 37:771-787. [PMID: 34599400 DOI: 10.1007/s10103-021-03425-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
During orthodontic tooth movement (OTM), there is the release of cytokines in the gingival crevicular fluid (GCF) that are supposed to participate in the bone remodeling. This systematic review aimed at assessing the effects of photobiomodulation (PBM) on the levels of these cytokines during OTM. This systematic review according to Cochrane Collaboration guidelines aimed to answer the clinical question following the PICOS strategy. The broad search in the literature was performed before 05 April, 2021 in six electronic databases (Pubmed, Web of Science, Scopus, Embase, Cochrane, Biblioteca Virtual de Saúde) and supplemented by the grey literature. The risk of bias of randomized and non-randomized clinical trials was evaluated by two tools: RoB 2 and ROBINS-I. Mean and standard deviation of cytokine levels was extracted to meta-analysis, and the GRADE system was applied to assess the quality of the evidence. Nine studies were included in this review. Low-level laser therapy (LLLT) was the photobiomodulation type used in most of the studies (n = 8). The wavelengths used varied from 618 to 980 nm and also differed concerning the light emission pattern. LLLT increased the levels of IL-1β, IL-8, OPN, and PGE2, but not TNF-α1, TGF-β1. The levels of IL6, RANKL, and OPG presented conflicting results. LLLT was statistically associated with an increase of IL-1β levels (standard mean difference [SMD] = 1.99; 95% confidence interval = 0.66 to 3.33; p < 0.001) with low certainty of evidence. LLLT may increase the levels of IL-1β and other cytokines; however, the results should be interpreted with caution due to protocol variations between studies, and the few studies added in the meta-analysis.
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Li Y, Zhan Q, Bao M, Yi J, Li Y. Biomechanical and biological responses of periodontium in orthodontic tooth movement: up-date in a new decade. Int J Oral Sci 2021; 13:20. [PMID: 34183652 PMCID: PMC8239047 DOI: 10.1038/s41368-021-00125-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023] Open
Abstract
Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated. We were aiming to summarize the evidences regarding the mechanisms of OTM. Firstly, we introduced the research models as a basis for further discussion of mechanisms. Secondly, we proposed a new hypothesis regarding the primary roles of periodontal ligament cells (PDLCs) and osteocytes involved in OTM mechanisms and summarized the biomechanical and biological responses of the periodontium in OTM through four steps, basically in OTM temporal sequences, as follows: (1) Extracellular mechanobiology of periodontium: biological, mechanical, and material changes of acellular components in periodontium under orthodontic forces were introduced. (2) Cell strain: the sensing, transduction, and regulation of mechanical stimuli in PDLCs and osteocytes. (3) Cell activation and differentiation: the activation and differentiation mechanisms of osteoblast and osteoclast, the force-induced sterile inflammation, and the communication networks consisting of sensors and effectors. (4) Tissue remodeling: the remodeling of bone and periodontal ligament (PDL) in the compression side and tension side responding to mechanical stimuli and root resorption. Lastly, we talked about the clinical implications of the updated OTM mechanisms, regarding optimal orthodontic force (OOF), acceleration of OTM, and prevention of root resorption.
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Affiliation(s)
- Yuan Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Zhan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Minyue Bao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jianru Yi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Yu Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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21
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Zheng J, Yang K. Clinical research: low-level laser therapy in accelerating orthodontic tooth movement. BMC Oral Health 2021; 21:324. [PMID: 34182967 PMCID: PMC8237464 DOI: 10.1186/s12903-021-01684-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background The present study aimed to investigate the effects of low-level laser therapy (LLLT) on orthodontic tooth movement and its correlation with the levels of interleukin-1β (IL-1β), receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) in gingival crevicular fluid (GCF). Methods This split-mouth design study included 12 patients scheduled for the extraction of both upper first premolars. Patients were randomly selected for experimental group that received left- or right-side radiation with a diode laser (810 nm wavelength, 100 mW power output, 6.29 J/cm2 energy density). Laser treatment was applied on days 0, 7, 14, and 21, after loading the canine retraction forces. GCF concentrations of IL-1β, RANKL, and OPG were analyzed. The upper arch of each patient was scanned with an intraoral scanner to assess tooth movement. Results The cumulative tooth movement over 28 days was significantly higher in the laser group than in the control group. We observed significant reductions in OPG levels and increases in IL-1β and RANKL levels in GCF samples on the experimental sides. Conclusion With the parameter settings used in this study, LLLT could, to some extent, lead to changes in bone metabolism, which could accelerate orthodontic tooth movement. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000039594. Registered 2 November 2020—Retrospectively registered, www.chictr.org.cn/edit.aspx?pid=62465&htm=4.
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Affiliation(s)
- Junyi Zheng
- Department of Orthodontics, School of Stomatology, Capital Medical University, No. 4, Tiantanxili, Beijing, China
| | - Kai Yang
- Department of Orthodontics, School of Stomatology, Capital Medical University, No. 4, Tiantanxili, Beijing, China.
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22
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Al-Shafi S, Pandis N, Darendeliler MA, Papadopoulou AK. Effect of light-emitting diode-mediated photobiomodulation on extraction space closure in adolescents and young adults: A split-mouth, randomized controlled trial. Am J Orthod Dentofacial Orthop 2021; 160:19-28. [PMID: 33840531 DOI: 10.1016/j.ajodo.2020.12.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/01/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
- Safa Al-Shafi
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Department of Orthodontics, Sydney Dental Hospital, Sydney South Local Health District, Australia
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - M Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Department of Orthodontics, Sydney Dental Hospital, Sydney South Local Health District, Australia
| | - Alexandra K Papadopoulou
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Department of Orthodontics, Sydney Dental Hospital, Sydney South Local Health District, Australia.
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23
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Li J, Ge X, Guan H, Jia L, Chang W, Ma W. The Effectiveness of Photobiomodulation on Accelerating Tooth Movement in Orthodontics: A Systematic Review and Meta-Analysis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:232-244. [PMID: 33733872 DOI: 10.1089/photob.2020.4954] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
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.
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Affiliation(s)
- Jie Li
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Xiaolei Ge
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Huibo Guan
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Liying Jia
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Weiwei Chang
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Wensheng Ma
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, People's Republic of China
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Domínguez A, Payán X, Dipp FA, Castillo BE. Photobiomodulation with 940 nm laser diode: effect on the interleukin 6 expression after orthodontic initial archwire activation. LASERS IN DENTAL SCIENCE 2021; 5:35-41. [DOI: 10.1007/s41547-021-00115-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/19/2021] [Indexed: 11/27/2023]
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Conti ACDCF, Mota Rodrigues CF, Volpato GH, de Miranda Ladewig V, Almeida MRD, Almeida-Pedrin RRD. Orthodontists' and patients' perceptions regarding techniques to reduce the orthodontic treatment duration. J World Fed Orthod 2020; 9:155-158. [PMID: 33183991 DOI: 10.1016/j.ejwf.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate patients' and orthodontists' perspectives on knowledge of techniques for reducing orthodontic treatment time and acceptance of these techniques. METHODS A total of 200 individuals were interviewed and equally divided into two groups: orthodontist group (62 female and 38 male; mean age, 38.07 years) and patient group (52 female and 48 male; mean age, 22.61 years; in the active stage of fixed orthodontic treatment). One questionnaire for each group was administered, including questions about the duration of orthodontic treatment and techniques used for treatment optimization, such as corticotomy, distraction osteogenesis, vibration, and laser therapy. The associations between variables were analyzed by the χ2 test at a significance level of 5%. RESULTS Among orthodontists, 76% knew at least one technique to reduce the treatment duration, with corticotomy being the most frequently cited (66%); however, only 12% used one or more of these techniques. Laser therapy was the most frequently implemented technique (7%). Regarding the duration of orthodontic treatment, the mean time reported by orthodontists was 19 to 24 months, regardless of the technique or the experience of the orthodontist. Furthermore, 39% of patients expected their treatment to last for more than 24 months, with 50% accepting to undergo further procedures to reduce this duration. CONCLUSIONS Patients are willing to undergo additional procedures to reduce the treatment duration and to bear additional costs. However, despite their knowledge, orthodontists do not apply or offer these techniques to the patients.
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Compressive force strengthened the pro-inflammatory effect of zoledronic acid on il-1ß stimulated human periodontal fibroblasts. Clin Oral Investig 2020; 25:3453-3461. [PMID: 33169272 DOI: 10.1007/s00784-020-03667-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The number of patients in dentistry taking bisphosphonates (BP) increases every year. There are only little data about the influence of biomechanical stress due to orthodontic treatment and periodontal inflammation in BP patients. This study focused on the effects of the induced inflammation by IL-1ß in compressed human periodontal ligament fibroblasts (HPdLF) exposed to the nitrogen-containing BP zoledronate in vitro. MATERIALS AND METHODS HPdLF were incubated with 5 μmol/l zoledronate and 10 ng/ml IL-1ß for 48 h. In the last 3 h, cells were exposed to a compressive, centrifugal force of 34.9 g/cm2. Cell viability was analyzed directly after the compressive force by MTT assay. Gene expression of COX-2 and IL-6 was investigated using quantitative qRT-PCR. PGE-2 and IL-6 protein secretion were measured via ELISA. RESULTS The cell viability of HPdLF was not affected. Without inflammatory pre-stimulation, COX-2 expression was increased by compression and zoledronate. IL-6 expression was increased under compression. On secretion level, the combination of compression and zoledronate induced a slightly increase of IL-6 secretion. In contrast, inflammatory pre-stimulation strengthened the compressive upregulation of COX-2, as well as induced a higher PGE-2 secretion. Further addition of zoledronate to pre-stimulated cells additionally strengthened the compression-induced upregulation of COX-2 and IL-6 expression as well as protein secretion compared to all other groups. CONCLUSIONS Biomechanical stress might trigger a pro-inflammatory potential of BP further enhanced in the presence of an inflammatory pre-stimulation. CLINICAL RELEVANCE To prevent excessive host inflammatory responses, occlusal overloading and mechanical stress due to orthodontic treatment should be avoided in BP patients with untreated periodontitis.
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Domínguez Camacho A, Montoya Guzmán D, Velásquez Cujar SA. Effective Wavelength Range in Photobiomodulation for Tooth Movement Acceleration in Orthodontics: A Systematic Review. Photobiomodul Photomed Laser Surg 2020; 38:581-590. [PMID: 32609566 DOI: 10.1089/photob.2020.4814] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
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.
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Apalimova A, Roselló À, Jané-Salas E, Arranz-Obispo C, Marí-Roig A, López-López J. Corticotomy in orthodontic treatment: systematic review. Heliyon 2020; 6:e04013. [PMID: 32490239 PMCID: PMC7260439 DOI: 10.1016/j.heliyon.2020.e04013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/17/2019] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate corticotomies effects to accelerate or facilitate dental movements in different kind of orthodontic treatments. DATA This report followed the PRISMA Statement. A total of 9 articles were included in review. SOURCES Two reviewers performed a literature search up to December 2018 in four databases: PubMed, Web of Science, Scopus and SciELO. STUDY SELECTION Controlled clinical trials and randomized controlled clinical trials conducted in human patients and published during the last 10 years in English were eligible to be selected. The articles should give detailed information about the results and treatment parameters. There were no limitations established in terms of the type of malocclusion to be corrected or the type of orthodontic treatment performed. RESULTS The methodological quality and evidence of the selected studies was low. Most of the studies observed a statistically significant increase in the rate of dental movement, when performing alveolar corticotomies as coadjuvants of orthodontic treatment; either with the conventional technique or with piezocision. The effect of combining corticotomy with bone grafts was assessed. CONCLUSIONS High heterogeneity among studies made it difficult to draw clear conclusions. However, within the limitations of this review, the corticotomy procedures were able to statistically and clinically produce significant temporary decrease in orthodontic tooth movement rate. This technique does not seem to involve major complications compared to conventional orthodontic treatments. CLINICAL RELEVANCE The use of this technique can reduce treatment time and therefore the undesirable effects associated with prolonged treatments.
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Affiliation(s)
- Alina Apalimova
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - Àlvar Roselló
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
- Oral Surgery and Oral Implantology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - Enric Jané-Salas
- Medicine and Surgery, Oral Medicine at the School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carlos Arranz-Obispo
- Medicine and Surgery, Oral Medicine at the School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Oral and Maxillofacial Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Antonio Marí-Roig
- Medicine and Surgery, Oral Medicine at the School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Oral and Maxillofacial Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - José López-López
- Medicine and Surgery, Oral Medicine at the School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- Surgical Medical Service, Barcelona University Dental Hospital, Barcelona, Spain
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Mistry D, Dalci O, Papageorgiou SN, Darendeliler MA, Papadopoulou AK. The effects of a clinically feasible application of low-level laser therapy on the rate of orthodontic tooth movement: A triple-blind, split-mouth, randomized controlled trial. Am J Orthod Dentofacial Orthop 2020; 157:444-453. [DOI: 10.1016/j.ajodo.2019.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/01/2019] [Accepted: 12/01/2019] [Indexed: 01/18/2023]
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Baghizadeh Fini M, Olyaee P, Homayouni A. The Effect of Low-Level Laser Therapy on the Acceleration of Orthodontic Tooth Movement. J Lasers Med Sci 2020; 11:204-211. [PMID: 32273964 DOI: 10.34172/jlms.2020.34] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
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.
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Affiliation(s)
| | - Pooya Olyaee
- DDS, MSc in Orthodontics, MSc in Implantology, Faculty of Dentistry, Goethe University, Frankfurt, Germany
| | - Ahmadreza Homayouni
- Industrial Engineering and Management Department, Oklahoma State University, US
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Lo Giudice A, Nucera R, Leonardi R, Paiusco A, Baldoni M, Caccianiga G. A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:272-279. [PMID: 31944878 PMCID: PMC7249466 DOI: 10.1089/photob.2019.4747] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage. Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6–6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm2 of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)–T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups. Results: Treatment time was significantly shorter (p < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits (p < 0.001) were lower in the PBM group (7) compared with the control group (9). Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.
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Affiliation(s)
- Antonino Lo Giudice
- Section of Orthodontics, Department of Medical-Surgical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele," Catania, Italy
| | - Riccardo Nucera
- Section of Orthodontics, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, University of Messina, Policlinico Universitario "G. Martino," Messina, Italy
| | - Rosalia Leonardi
- Section of Orthodontics, Department of Medical-Surgical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele," Catania, Italy
| | - Alessio Paiusco
- Section of Orthodontics, Department of Surgery and Interdisciplinary Medicine, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Marco Baldoni
- Section of Orthodontics, Department of Surgery and Interdisciplinary Medicine, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Gianluigi Caccianiga
- Section of Orthodontics, Department of Surgery and Interdisciplinary Medicine, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Fernandes MRU, Suzuki SS, Suzuki H, Martinez EF, Garcez AS. Photobiomodulation increases intrusion tooth movement and modulates IL-6, IL-8 and IL-1β expression during orthodontically bone remodeling. JOURNAL OF BIOPHOTONICS 2019; 12:e201800311. [PMID: 31001928 DOI: 10.1002/jbio.201800311] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Marcella R U Fernandes
- Department of Orthodontics, São Leopoldo Mandic, R. Dr. José Rocha Junqueira, Campina, São Paulo, Brazil
| | - Selly S Suzuki
- Department of Orthodontics, São Leopoldo Mandic, R. Dr. José Rocha Junqueira, Campina, São Paulo, Brazil
| | - Hideo Suzuki
- Department of Orthodontics, São Leopoldo Mandic, R. Dr. José Rocha Junqueira, Campina, São Paulo, Brazil
| | - Elizabeth F Martinez
- Department of Orthodontics, São Leopoldo Mandic, R. Dr. José Rocha Junqueira, Campina, São Paulo, Brazil
| | - Aguinaldo S Garcez
- Department of Orthodontics, São Leopoldo Mandic, R. Dr. José Rocha Junqueira, Campina, São Paulo, Brazil
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Isola G, Matarese M, Briguglio F, Grassia V, Picciolo G, Fiorillo L, Matarese G. Effectiveness of Low-Level Laser Therapy during Tooth Movement: A Randomized Clinical Trial. MATERIALS 2019; 12:ma12132187. [PMID: 31288379 PMCID: PMC6651332 DOI: 10.3390/ma12132187] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/05/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023]
Abstract
The present study evaluated the effects of low-level laser therapy (LLLT) by means of a diode laser in accelerating orthodontic tooth movement (OTM). After extraction of the first upper premolars for orthodontic purpose, 82 maxillary canines which needed distalization were analyzed in 41 enrolled patients (21 males, 20 females, mean age 13.4 ± 2.1 years). On all experimental sites, an orthodontic force of 50/N was applied by a nickel-titanium (NiTi) closed coil spring (G&H, Franklin, IN, USA) in order to obtain the space closure. Using a split mouth randomized design, the test side was treated using a diode laser (Wiser Laser Doctor Smile, Brendola, Italy) operating at 810 nm wavelength in continuous wave mode at both the buccal and palatal side on three points/side (distal, medial and mesial) (1 W output power, continuous wave of 66.7 J/cm2, energy density of 8 J) at baseline and at 3, 7, and 14 days and every 15 days until the space closed. On the control side, the opposite selected canine was treated only using orthodontic traction. The primary outcome chosen was the overall time needed to complete the levelling and closing space, measured on a study cast. The secondary outcome chosen was the evaluation of pain levels related to tooth traction, using a Visual Analogue Scale (VAS), recorded at 3, 7, and 14 days after treatments. The mean space closures of the maxillary canines were comparable between groups [Test, 4.56 mm (95% CI 3.9-4.8); Control, 4.49 mm (95% CI 3.8-4.7), p = 0.456]. The laser group yielded less mean time [84.35 ± 12.34 days (95% CI 79.3-86)] to accomplish space closure compared to the control group [97.49 ± 11.44 days (91.7-102.3)] (p < 0.001). The test side showed a significant reduction in the average range of dental pain at 3 [Test, 5.41 (95% CI 5.1-5.6); Control, 7.23 (95% CI 6.9-7.6), p < 0.001], 7 [Test, 4.12 (95% CI 3.8-4.7); Control, 5.79 (95% CI 5.4-5.8), p < 0.001], and at 14 days [Test, 2.31 (95% CI 1.8-2.3); Control, 3.84 (95% CI 3.3-4.2), p < 0.001] after treatment (p < 0.001). This study demonstrates that the use of LLLT therapy was effective in accelerating tooth movement and reducing pain levels related to OTM.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Via Plebiscito 628, University of Catania, 95124 Catania, Italy.
| | - Marco Matarese
- Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, Via Consolare Valeria 1, University of Messina, 98125 Messina, Italy
| | - Francesco Briguglio
- Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, Via Consolare Valeria 1, University of Messina, 98125 Messina, Italy
| | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Via Luigi de Crecchio 6, 80138 Naples, Italy
| | - Giacomo Picciolo
- Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, Via Consolare Valeria 1, University of Messina, 98125 Messina, Italy
| | - Luca Fiorillo
- Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, Via Consolare Valeria 1, University of Messina, 98125 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Via Luigi de Crecchio 6, 80138 Naples, Italy
| | - Giovanni Matarese
- Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, Via Consolare Valeria 1, University of Messina, 98125 Messina, Italy.
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Isola G, Ferlito S, Rapisarda E. Low-level laser therapy increases interleukin-1β in gingival crevicular fluid and enhances the rate of orthodontic tooth movement. Am J Orthod Dentofacial Orthop 2019; 155:456-457. [PMID: 30935594 DOI: 10.1016/j.ajodo.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 11/15/2018] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
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Mulimani P. Updates Available!: Time for Orthodontics’ research approach to catch up with the rapidly evolving techniques and discoveries in Molecular Biology research ? APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_101_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Priti Mulimani
- APOS Trends in Orthodontics, Doctoral Student in Oral Biology, Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
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