Long-term evaluation of the effect of low-level laser therapy on orthodontic miniscrew stability and peri-implant gingival condition: A randomized clinical trial

Effect of photobiomodulation therapy on mini-implant stability: a systematic review and meta-analysis

The study aimed to assess trials investigating the effect of PBMT on mini-implant stability. Electronic searches of seven databases and manual search were conducted up to May 2020. Randomized controlled trials and controlled clinical trials evaluating the effect of PBMT on mini-implant stability were included. The risks of bias of individual studies were performed using ROB 2.0 and ROBINS-I-tool based on different study design. Meta-analysis was conducted to compare mini-implant stability exposed to PBMT with control ones at different time points after implantation. Among the 518 records initially identified, seven studies were included in this study. Six studies investigated low-level laser therapy (LLLT) and one study evaluated light-emitting diode (LED) therapy. Two studies were eligible for meta-analysis, which showed that LLLT significantly improved mini-implant stability 60 days after initial implantation (MD - 3.01, 95% CI range [- 4.68, - 1.35], p = 0.0004). High energy density of LLLT began to show beneficial effect on mini-implant stability as early as 3 days after implantation, while the significant effect of low energy density displayed later than 30 days after insertion. LED therapy could improve mini-implant stability after 2 months post-insertion. In conclusion, PBMT appears to be beneficial in ameliorating mini-implant stability. High energy density of LLLT might exert more rapid effect than low energy density. More high-quality clinical trials are needed to further demonstrate PBMT' effects on orthodontic mini-implants.

Effects of low-level laser therapy on the orthodontic mini-implants stability: a systematic review and meta-analysis

Objectives

The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability.

Materials and methods

An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted.

Results

Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement.

Conclusions

LLLT shows positive effects on the OMI stability.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40510-021-00350-y.

Effect of 808 nm Semiconductor Laser on the Stability of Orthodontic Micro-Implants: A Split-Mouth Study

BACKGROUND

To evaluate the effect of photobiomodulation (PBM) on orthodontic micro-implants (n = 44; 14 women, 8 men).

METHODS

PBM with 808 nm diode laser was applied immediately, 3, 6, 9, 12, 15, and 30 days post the implantation. Results were assessed within same time frames and additionally after 60 days to check for implants stability using the Periotest device. Patients pain experiences following the first day post-treatment and potential loss of micro-implants after 60 days were recorded. The procedure involved insertion of mini-implants in the maxilla for the laser group (L, n = 22) and negative control group (C, n = 22). Irradiation was carried buccally and palatally with respect to the maxillary ridge (2 points). The energy per point was 4 J (8 J/cm2), total dose was 56 J.

RESULTS

Patients did not report significant differences in terms of pain experiences comparing the L and C groups (p = 0.499). At 30 days post-treatment, higher secondary stability of implants was observed in the laser group (Periotest Test Value, PTV 6.32 ± 3.62), in contrast to the controls (PTV 11.34 ± 5.76) (p = 0.004). At 60 days post-treatment, significantly higher stability was recorded in the laser group (PTV 6.55 ± 4.66) compared with the controls, PTV (10.95 ± 4.77) (p = 0.009). Conclusions: Application of the 808 nm diode laser increased secondary micro-implant stability.

Photobiomodulation in Periodontology and Implant Dentistry: Part 2

(Part 1 of this article can be located at www.liebertpub.com/doi/10.1089/photob.2019.4710.) Objective: Finding evidence-based treatment strategies for low-level light therapy and the correct incorporation of these treatment methods in the clinical practice of periodontics. Background: Photobiomodulation has been shown to have biostimulatory, anti-inflammatory, and analgesic effects that can be beneficial in periodontal and dental implant treatment procedures. Methods: In this review, we have addressed some clinical questions regarding the potential clinical application of low-level light irradiation and its photobobiomodulatory effects in periodontology and implantology. The literature was searched for in vivo (animal or clinical) articles written in English in four electronic databases of PubMed, Scopus, Google Scholar, and Cochrane Library until April 2019. Only studies with low irradiation doses without any thermal effects used only for their photobiomodulatory purposes were included. Results: We were able to find relevant studies for all of our questions, and positive effects for the application of light therapy were reported in most of the studies. However, there is still a great deal of heterogeneity in terms of study designs and most importantly in light irradiation devices and the parameters used. Due to this issue, it was not possible to reach specific evidence-based irradiation protocols for the questions addressed in this review. Conclusions: Based on our search results, an obvious positive effect of low-level light therapy on stimulation of healing of periodontal soft and hard tissues and reduction of inflammation can be seen. Future well-designed randomized control studies with the same irradiation settings and systematic reviews evaluating the studies found on the questions mentioned are necessary to reach evidence-based recommendations.

Effect of photobiomodulation on the stability and displacement of orthodontic mini-implants submitted to immediate and delayed loading: a clinical study

The aim of this study was to evaluate the effect of photobiomodulation (PBM) on the stability and displacement of orthodontic mini-implants (MIs) submitted to loading. Forty-eight and 35 mini-implants (1.5 × 8 × 1 mm) were assessed for stability and displacement, respectively (19 patients). MIs were allocated according to the intervention in 1-PBM + immediate loading (IL), 2-PBM + delayed loading (DL) (four weeks after implantation), 3-IL only, and 4-DL only. PBM (Therapy XT, DCM) was implemented using a red emission (660 nm, 4 J/cm², 0.1 W, 20 s) immediately after implantation (day 0) and infrared emissions (808 nm; 8 J/cm², 0.1 W, 40 s) in the following appointments every 48-72 h during two weeks (days 2, 4, 7, 9, 11, and 14). Loading of 150 gF was applied during three months for all MIs. The stability was assessed by resonance frequency analysis (Osstell ISQ), and images from Cone beam computed tomography were evaluated to determine the amount of the displacement of the MI's head. MIs from the PBM groups presented lower loss of stability (P = 0.0372). When the analysis considered the loading protocol as an additional variable, group two showed the lowest loss of stability, being significantly different from groups that did not receive PBM (P = 0.0161). There was no difference between groups two and four during the period without loading (P > 0.05). DL groups presented lower loss when the effective period of loading was assessed, independently of the application of PBM (P < 0.0001). All groups showed displacement of the MIs head without significant differences (P > 0.05). DL potentiated the effect of PBM, decreasing the loss of stability.

Effects of low-intensity laser therapy on the stability of orthodontic mini-implants: a randomised controlled clinical trial

OBJECTIVE

To investigate the effect of low-intensity laser therapy on mini-implant stability using resonance frequency analysis during canine retraction with fixed appliances.

DESIGN

A split-mouth randomised clinical trial.

SETTING

Subjects were recruited and treated in the outpatient clinic, Department of Orthodontics, Faculty of Dentistry, Cairo University.

PARTICIPANTS

Fifteen subjects with mean age 20.9 (±3.4) years who required extraction of maxillary first premolar teeth and mini-implant-supported canine retraction.

METHODS

Thirty orthodontic mini-implants were inserted bilaterally in the maxillary arches of recruited subjects following alignment and levelling. Mini-implants were immediately loaded with a force of 150 g using nickel titanium coil springs with split-mouth randomisation to a low-intensity laser-treated side and control side. The experimental sides were exposed to low-intensity laser therapy from a diode laser with a wavelength of 940 nm at (0, 7, 14, 21 days) after mini-implant placement. Mini-implant stability was measured using resonance frequency analysis at (0, 1, 2, 3, 4, 6, 8, 10 weeks) after implant placement.

RESULTS

A total sample of 28 mini-implants were investigated with 14 in each group. Clinically, both mini-implant groups had the same overall success rate of 78.5%. There were no significant differences in resonance frequency scores between low-intensity laser and control sides from baseline to week 2. However, from week 3 to 10, the low-intensity laser sides showed significantly increased mean resonance frequency values compared to control (P > 0.05).

CONCLUSIONS

Despite evidence of some significant differences in resonance frequency between mini-implants exposed to low-intensity laser light over a 10 weeks period there were no differences in mini-implant stability. Low-intensity laser light cannot be recommended as a clinically useful adjunct to promoting mini-implant stability during canine retraction.