Effectiveness of Low-Level Laser Therapy during Tooth Movement: A Randomized Clinical Trial

Evaluation of Patient-Reported Outcome Measures (PROMs) Associated With the Acceleration of Canine Retraction by Piezosurgery in Comparison With Low-Level Laser Therapy: A Three-Arm Randomized Controlled Clinical Trial

Background and objectives Recently, both surgical and non-surgical interventions have gained popularity in accelerating orthodontic tooth movement, but there is no randomized controlled trial (RCT) comparing both modalities in terms of patient-reported outcome measures (PROMs) during maxillary canine retraction. Therefore, this trial aimed to assess the PROMs associated with either low-level laser therapy (LLLT) or piezocision-assisted acceleration in the context of maxillary canine retraction. Materials and methods This was a single-blinded, single-center, three-arm RCT. A total of 54 patients (12 males, 42 females, mean age 20.65 ± 2.85) whose treatment needed upper-first-premolar extraction to facilitate canine retraction were enrolled and randomly divided into three groups: piezocision group (PG), LLLT group (LLLTG), and the control group (CG). Standardized questionnaires using a visual analog scale were distributed to patients at five assessment times: 1 (T1), 3 (T2), 7 (T3), 14 (T4), and 28 days following the canine retraction initiation (T5). The patients' pain, discomfort, swelling, chewing difficulty, satisfaction, and acceptance were recorded. Results Regarding pain and discomfort, the levels were significantly lower in the LLLTG during the first two weeks of canine retraction compared to the other two groups (p<0.017). At the same time, these levels were significantly greater in the PG than the CG in the first week of canine retraction (p<0.017). Patients in the PG had a "mild to moderate" perception of swelling at T1 and T2, which was significantly different than that of the other two groups (p<0.001). Regarding chewing difficulty, the levels in the LLLTG were significantly lower than those in PG at the first three assessment times (p<0.017). Patients' satisfaction with canine speed was significantly greater in the intervention groups compared to the CG (p<0.001). In contrast, no statistically significant differences were found between the three groups regarding satisfaction with gum appearance surrounding the canine (p=0.061) and acceptance (p=0.125). Conclusion The LLLT-assisted canine retraction was associated with significantly lower negative patient-reported outcomes during the first two weeks of retraction than piezocision-assisted retraction. However, the levels of pain and discomfort were significantly greater in the piezocision-assisted retraction group than those in the conventional canine retraction group, which in turn were greater than those with the LLLT-assisted canine retraction group during the first week of retraction. Patient satisfaction and acceptance were high with both piezocision and LLLT interventions.

Effect of low-level laser therapy on orthodontic dental alignment: a systematic review and meta-analysis

The aim of this study is to systematically summarize the available evidence regarding low-level laser therapy (LLLT) speed-up effect on dental alignment in comprehensive orthodontic treatment. An extensive electronic search was conducted in PubMed, ScienceDirect, Cochrane, Web of Science, and Scopus up to February 20, 2023. The Cochrane risk of bias tool and the Newcastle-Ottawa Quality Assessment Form were used by two authors independently to assess the risk of bias (RoB). Statistical analysis was performed by Review Manager 5.3. The eight eligible trials were reviewed and included in qualitative synthesis. Four studies reported the overall time of leveling and alignment (OLAT, days), enabling a synthesizing of the data. The meta-analysis results showed that LLLT significantly reduced the overall time of leveling and alignment compared to control group (MD=-30.36, 95% CI range -41.50 to -19.22, P<0.0001), with moderate heterogeneity (χ2=4.10, P=0.25, I2=27%). Based on the data available, statistically significant evidence with moderate risk of bias suggests that LLLT may have a positive effect on accelerating dental alignment. However, due to the differences in intervention strategy and evaluating method, the conclusions should be interpreted with caution.

Comparing Circumferential Supracrestal Fiberotomy with Surgical Scalpel Versus Photobiomodulation in Orthodontic Relapse Reduction: A Clinical Trial

Objective: This investigation aimed to compare the efficacy of circumferential supracrestal fiberotomy (CSF) with surgical scalpel, laser CSF, and photobiomodulation for reduction of relapse after orthodontic tooth rotation. Background: Relapse is the tendency of teeth to move back to their preoperative position after removal of orthodontic appliances. Materials and methods: This randomized controlled clinical trial was conducted on 90 rotated teeth at the final stages of fixed orthodontic treatment. The teeth were randomly divided into six groups (n = 15) of (1) control (no intervention), (2) photobiomodulation alone (wavelength of 940 nm, 0.2 W, and 4 J/cm2), (3) conventional CSF, (4) laser CSF (wavelength of 940 nm, 1.5 W, and 4 J/cm2, and power density of 160 mW/cm2), (5) conventional CSF plus photobiomodulation, and (6) laser CSF plus photobiomodulation. Measurements were made on clinical photographs and dental casts using the AutoCAD software. Level of pain of patients was measured within the first 24 h after fiberotomy using a visual analog scale. Data were analyzed by ANOVA and Kruskal-Wallis test (α = 0.05). Results: The magnitude (p = 0.014) and percentage (p = 0.035) of relapse were significantly different among the six groups, and they were the highest in the control group followed by photobiomodulation alone, laser CSF, conventional CSF, conventional CSF plus photobiomodulation, and finally, laser CSF plus photobiomodulation. Moreover, photobiomodulation plus laser CSF and photobiomodulation plus conventional CSF had significantly different results from the other groups. The six groups had no significant difference in sulcus depth changes, gingival recession (difference in primary and secondary crown height), or pain score (p > 0.05). Conclusions: This study suggests that utilizing photobiomodulation combined with laser CSF or conventional CSF can be effective in reducing relapse. However, further clinical trials are required to support this idea. Iranian Registry of Clinical Trials (IRCT20210621051653N1).

Impact of Low-Level Laser Therapy on Orthodontic Tooth Movement and Various Cytokines in Gingival Crevicular Fluid: A Split-Mouth Randomized Study

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.

Non-surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic treatment

BACKGROUND

Deviation from a normal bite can be defined as malocclusion. Orthodontic treatment takes 20 months on average to correct malocclusion. Accelerating the rate of tooth movement may help to reduce the duration of orthodontic treatment and associated unwanted effects including orthodontically induced inflammatory root resorption (OIIRR), demineralisation and reduced patient motivation and compliance. Several non-surgical adjuncts have been advocated with the aim of accelerating the rate of orthodontic tooth movement (OTM).         OBJECTIVES: To assess the effect of non-surgical adjunctive interventions on the rate of orthodontic tooth movement and the overall duration of treatment.

SEARCH METHODS

An information specialist searched five bibliographic databases up to 6 September 2022 and used additional search methods to identify published, unpublished and ongoing studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) of people receiving orthodontic treatment using fixed or removable appliances along with non-surgical adjunctive interventions to accelerate tooth movement. We excluded split-mouth studies and studies that involved people who were treated with orthognathic surgery, or who had cleft lip or palate, or other craniofacial syndromes or deformities.

DATA COLLECTION AND ANALYSIS

Two review authors were responsible for study selection, risk of bias assessment and data extraction; they carried out these tasks independently. Disagreements were resolved by discussion amongst the review team to reach consensus.  MAIN RESULTS: We included 23 studies, none of which were rated as low risk of bias overall. We categorised the included studies as testing light vibrational forces or photobiomodulation, the latter including low level laser therapy and light emitting diode. The studies assessed non-surgical interventions added to fixed or removable orthodontic appliances compared to treatment without the adjunct. A total of 1027 participants (children and adults) were recruited with loss to follow-up ranging from 0% to 27% of the original samples.  Certainty of the evidence For all comparisons and outcomes presented below, the certainty of the evidence is low to very low. Light vibrational forces  Eleven studies assessed how applying light vibrational forces (LVF) affected orthodontic tooth movement (OTM). There was no evidence of a difference between the intervention and control groups for duration of orthodontic treatment (MD -0.61 months, 95% confidence interval (CI) -2.44 to 1.22; 2 studies, 77 participants); total number of orthodontic appliance adjustment visits (MD -0.32 visits, 95% CI -1.69 to 1.05; 2 studies, 77 participants); orthodontic tooth movement during the early alignment stage (reduction of lower incisor irregularity (LII)) at 4-6 weeks (MD 0.12 mm, 95% CI -1.77 to 2.01; 3 studies, 144 participants), or 10-16 weeks (MD -0.18 mm, 95% CI -1.20 to 0.83; 4 studies, 175 participants); rate of canine distalisation (MD -0.01 mm/month, 95% CI -0.20 to 0.18; 2 studies, 40 participants); or rate of OTM during en masse space closure (MD 0.10 mm per month, 95% CI -0.08 to 0.29; 2 studies, 81 participants). No evidence of a difference was found between LVF and control groups in rate of OTM when using removable orthodontic aligners. Nor did the studies show evidence of a difference between groups for our secondary outcomes, including patient perception of pain, patient-reported need for analgesics at different stages of treatment and harms or side effects.  Photobiomodulation Ten studies assessed the effect of applying low level laser therapy (LLLT) on rate of OTM. We found that participants in the LLLT group had a statistically significantly shorter length of time for the teeth to align in the early stages of treatment (MD -50 days, 95% CI -58 to -42; 2 studies, 62 participants) and required fewer appointments (-2.3, 95% CI -2.5 to -2.0; 2 studies, 125 participants). There was no evidence of a difference between the LLLT and control groups in OTM when assessed as percentage reduction in LII in the first month of alignment (1.63%, 95% CI -2.60 to 5.86; 2 studies, 56 participants) or in the second month (percentage reduction MD 3.75%, 95% CI -1.74 to 9.24; 2 studies, 56 participants). However, LLLT resulted in an increase in OTM during the space closure stage in the maxillary arch (MD 0.18 mm/month, 95% CI 0.05 to 0.33; 1 study; 65 participants; very low level of certainty) and the mandibular arch (right side MD 0.16 mm/month, 95% CI 0.12 to 0.19; 1 study; 65 participants). In addition, LLLT resulted in an increased  rate of OTM during maxillary canine retraction (MD 0.01 mm/month, 95% CI 0 to 0.02; 1 study, 37 participants). These  findings were not clinically significant. The studies showed no evidence of a difference between groups for our secondary outcomes, including OIIRR, periodontal health and patient perception of pain at early stages of treatment. Two studies assessed the influence of applying light-emitting diode (LED) on OTM. Participants in the LED group required a significantly shorter time to align the mandibular arch compared to the control group (MD -24.50 days, 95% CI -42.45 to -6.55, 1 study, 34 participants). There is no evidence that LED application increased the rate of OTM during maxillary canine retraction (MD 0.01 mm/month, 95% CI 0 to 0.02; P = 0.28; 1 study, 39 participants ). In terms of secondary outcomes, one study assessed patient perception of pain and found no evidence of a difference between groups.   AUTHORS' CONCLUSIONS: The evidence from randomised controlled trials concerning the effectiveness of non-surgical interventions to accelerate orthodontic treatment is of low to very low certainty. It suggests that there is no additional benefit of light vibrational forces or photobiomodulation for reducing the duration of orthodontic treatment. Although there may be a limited benefit from photobiomodulation application for accelerating discrete treatment phases, these results have to be interpreted with caution due to their questionable clinical significance. Further well-designed, rigorous RCTs with longer follow-up periods spanning from start to completion of orthodontic treatment are required to determine whether non-surgical interventions may reduce the duration of orthodontic treatment by a clinically significant amount, with minimal adverse effects.

Human Interleukin-1β Profile and Self-Reported Pain Monitoring Using Clear Aligners with or without Acceleration Techniques: A Case Report and Investigational Study

Introduction. There is a growing demand for more aesthetic, comfortable, and faster orthodontic treatments, and clear aligners emerged as a solution to fulfill this need. However, the effectiveness of clear aligners to treat complex malocclusions is yet contentious. The use of acceleration methods could improve the efficacy of clear aligners by stimulating cells' mechanobiology through numerous pathways, but this hypothesis is still poorly explored. Objective. We aimed to monitor the release profile of an inflammatory marker-the interleukin-1β-and to evaluate its relationship with self-reported pain scores with and without the use of acceleration techniques during an orthodontic treatment requiring difficult tooth movements with clear aligners. Case Report. Here, we report a case of a 46-year-old female patient who presented functional and aesthetic complaints. Intraoral examination revealed a diminished overjet and overbite, rotation of teeth 45 and 24, absence of teeth 25, 35, and 36, buccolingual dislocation of tooth 21, a tendency to a Class III malocclusion, and a 2 mm left deviation of the lower midline. This study is divided into three stimulation phases: no stimulation, mechanical vibration stimulation, and photobiomodulation. Interleukin-1β levels in gingival crevicular fluid samples from the pressure side of six selected teeth were evaluated at four time points after the orthodontic treatment onset. Pain monitoring in those teeth was performed using a visual analogue scale at the same time points. Results. Interleukin-1β protein production peaked 24 h after treatment onset. Complex movements were associated with increased self-reported pain. Conclusion. Clear aligners show limitations in solving complex tooth movements, even when combined with acceleration. The development of customized and programmable stimulation microdevices integrated into “smart aligners,” which could be designed to specifically stimulate the direction of movement and stimulation parameters and could constitute a solution to optimize the orthodontic tooth movement with clear aligners.

Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report

Implantology represents the gold standard in oral rehabilitation. Unfortunately, a new pathology begins to show itself to clinicians that no longer affects only and solely the supporting tissues of the tooth but also dental implants and peri-implantitis. In this study, we present a case report regarding a tissue regeneration maneuver involving dental implants. The clinical and radiographic results are encouraging, regarding the use of these techniques on implant surfaces. Surely, the advent of new biomaterials and surgical techniques will make this practice safe and predictable.

Use of Hydrogels to Regulate Orthodontic Tooth Movement in Animal Models: A Systematic Review

The objective of this article is to conduct a systematic review of the literature to contrast the existing evidence regarding the use of hydrogels during and after experimental orthodontic treatment in animals. An extensive search was performed through the electronic databases, Medline, Web of Science and Scopus, from December 2020 to April 2021 for in vivo animal studies. A total of 282 studies were reviewed. Eight studies were included for final revision; four studies were conducted in rats, two in rabbits, one study in mice and one study in guinea pigs. The quality assessment of the eight included studies was performed according to the ARRIVE guidelines and the risk of bias was assessed using the Center for Systematic Review of Laboratory Animal Experimentation tool; in four of the eight articles evaluated, a high risk-of-bias rating was obtained in 40% of the criteria evaluated. In the studies reviewed, the hydrogel acted as a carrier, and inhibition (post-treatment retention) or acceleration of orthodontic tooth movement was assessed according to the active substance used in each of the articles. The uses of hydrogels for transporting active substances to regulate the rate of orthodontic tooth movement remains debatable. Future studies are suggested to evaluate the feasibility of hydrogel as a transport method in humans.

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

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

The influence of two photobiomodulation protocols on orthodontically induced inflammatory root resorption (a randomized controlled clinical trial)

Background

Controversial results have been reported regarding the impact of photobiomodulation (PBM) on orthodontically induced inflammatory root resorption (OIIRR). The aim of this study was to evaluate the influence of two PBM protocols, one of them requiring a high application frequency (on days 0, 3, 7, 14, then every 2 weeks), while the second requires less frequent applications (every 3 weeks), on OIIRR accompanying orthodontic treatment.

Methods

Twenty female patients were recruited for this randomized controlled trial, requiring the therapeutic extraction of maxillary first premolars, and they were randomly divided into 2 equal groups. In Group A, one side of the maxillary arch randomly received PBM on days 0, 3, 7, 14, and every 2 weeks thereafter, while in Group B, one side was randomly chosen to receive PBM every 3 weeks. The laser applied was a Diode laser with a wavelength of 980 nm, in a continuous mode. Canine retraction in both groups was carried out using closed-coil springs, delivering 150 g of force, and the force level was checked every 3 weeks, over a 12-week study period. Pre-retraction and post-retraction cone-beam computed tomography (CBCT) was done for the evaluation of OIIRR.

Results

No significant differences in the amount of OIIRR have been reported between the laser and control sides in both groups A and B. Also, no significant differences have been reported between the laser sides in both groups.

Conclusions

Photobiomodulation does not affect OIIRR, whether by increasing or decreasing its occurrence, with both laser application protocols. Therefore, it can be stated that PBM does not result in root resorption less than the commonly observed range elicited with conventional orthodontic treatment, and that it has no effect on OIIRR.

Trial registration Two Low-level Laser Irradiation Protocols on the Rate of Canine Retraction (NCT04926389), 15/06/2021—retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04926389.

The Effects of Periodontal Laser Therapy on Pain in Adult Patients with Orthodontic Treatment: A Randomized Clinical Trial

(1) Background: Pain is the most common complaint of patients with fixed orthodontic treatment, especially when applying and activating the orthodontic device. The effectiveness of low-level laser therapy (LLLT) in reducing pain caused by the orthodontic treatment has been frequently studied over the last few years. In this study, we aim to evaluate the influence of laser therapy on pain caused by orthodontic forces acting on periodontal tissues during fixed orthodontic treatment. (2) Methods: A total of 36 patients who met the inclusion criteria were submitted to laser therapy after beginning a fixed orthodontic treatment. For each patient, one half-arch was treated with laser (HL), the opposite one being the control half-arch (HC). The evaluation of pain was conducted by asking the patients to rate their pain on a VAS scale from 0 to 10. (3) Results: Analyzing the VAS score values reported after applying the orthodontic device, we noticed that the pain increased in the first few hours, it was the highest 24 h after application, and it decreased towards the 7th day. The pain reported by most patients was significantly reduced in the HL compared to the HC, in all three moments that were evaluated (p < 0.0001). (4) Conclusions: Repeated LLLT in patients with orthodontic treatment leads to a significant decrease in pain levels, as the comparison between the laser half-arch and the control half-arch showed.

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

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

The Optimal Energy Density of Photobiomodulation Therapy in Decreasing Orthodontic-Related Pain: A Systematic Review and Network Meta-Analysis

Objective: The aim of this network meta-analysis (NMA) was to explore the optimal energy density (ED) for relief of orthodontic-related pain by photobiomodulation therapy. Background: Orthodontic treatment corrects the deformity of teeth, dental arch, jaw, and face using various orthodontic devices under the action of biomechanics. Materials and methods: A computerized literature search was conducted within the MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM databases to identify randomized controlled trials (RCTs) that used photobiomodulation therapy to relieve pain during orthodontic treatment. Particular inclusion and exclusion criteria were connected to recognize relevant articles. The information was extricated autonomously by two reviewers, and a quality assessment was carried out by utilizing the Cochrane Collaboration "risk of bias" tool. The RevMan 5.4 software and STATA 15.0 were utilized for data analysis. Also, the NMA was performed with mvmeta commands in Stata (StataCorp, TX). Results: Of the 1024 recognized articles, 21 RCTs were at long last included. Within the risk-of-bias assessments, 2 studies displayed a high risk, 17 an unclear risk, and 2 a low risk. The global and local inconsistency of the NMA in 1 and 2 days was not significant; however, the NMA in 3 days showed a significant inconsistency. Laser with lower ED (0-10 J/cm²) appeared to be the most noteworthy possibility to become the optimal intervention, and it also had the highest mean rank in the rankogram and the biggest value of surface under the cumulative ranking in all three NMA structures. Conclusions: On account of the limited evidence of included trials, laser with lower ED (0-10 J/cm²) appeared to be more valid than the remaining treatment modalities (laser with higher ED, placebo, and control) for pain reduction in 1, 2, and 3 days after orthodontic procedures were applied. In the future, more high-quality research with consistency in research design is needed for further evaluation.

Effects of Photobiomodulation on the Upper First Molar Intrusion Movement Using Mini-Screws Anchorage: A Randomized Controlled Trial

Objective: The aim of this study was to quantify the changes obtained when the molar intrusion movement is complemented by photobiomodulation (PBM). Background: A common problem in adult patients is the super-eruption of maxillary molars caused by the loss of the antagonist tooth. Super-erupted molars impair oral rehabilitation and can cause both occlusal and functional problems. There is increasing research confirming the benefits of adjunctive PBM during orthodontic treatment. Methods: Twenty patients with indication of a maxillary first molar intrusion for oral rehabilitation were selected. Patients were randomized into two groups to receive orthodontic intrusion (control group) or the same treatment complemented by PBM (PBM group) in repeated doses (days 0, 1, 2, 3, 4, and 7 from the start of the intrusion and in each monthly follow-up) by using a low-power red laser diode (670 nm, 150 mW, 12 min around the molar). Plaque index (PI), probing depth (PD), and bleeding of probing (BOP) were assessed at 0, 1, 2, 3, and 6 months. Stereolithography models generated from an intraoral scanner were taken at 0, 3, and 6 months and cone beam computed tomography (CBCT) records were taken at 0 and 6 months. Mean intrusion distance, mean intrusion velocity, and volumetric resorption were calculated. Results: Periodontal clinical assessments (PI, PD, and BOP) and mean intrusion distance or mean intrusion velocity yielded no differences (p > 0.05) between groups. However, PBM group showed lower values of all these scores during the first 3 months. Intraoral scanner and CBCT were equally effective in accurately monitoring the intrusion distance (p > 0.05). CBCT records allowed volumetric evaluation of the root resorption process, being lesser in the PBM group, but not significantly (p > 0.05). Conclusions: During orthodontic intrusion process, the adjunctive application of PBM may provide better periodontal records and lower progression of root resorption at the expense of a little lower intrusion distance and velocity.

Viability of Photobiomodulaton Therapy in Decreasing Orthodontic-Related Pain: A Systematic Review and Meta-Analysis

Objective: To assess the viability of photobiomodulation therapy (PBMT) in decreasing orthodontic-related pain after different orthodontic procedures. Methods: A computerized literature search was conducted within the MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and CBM databases to identify randomized controlled trials (RCTs), which used PBMT to relieve pain during orthodontic treatment. Particular inclusion and exclusion criteria were connected to recognize relevant articles. The information was extricated autonomously by two reviewers, and a quality assessment was carried out by utilizing the Cochrane Collaboration "risk of bias" tool. Meta-analysis was conducted with fixed- or random-effects models as suitable. Statistical heterogeneity was also examined. The RevMan 5.4 software was utilized for data analysis. Results: Of 1024 recognized articles, 25 RCT were at long last included. Within the risk-of-bias assessments, 1 study displayed a high risk, 22 an unclear risk, and 2 a low risk. The meta-analysis appeared that in patients treated with photobiomodulation (PBM) versus control there was a distinction in support of PBMT in placement of elastomeric separators, canine retraction, and archwire placement during 1 week. Conclusions: PBMT demonstrated to be effective in advancing a reduction pain after elastomeric separators placement, canine retraction, and archwire placement within 1 week. In the future, more high-quality research with consistency in research design is needed for further evaluation.

Clinical Features and Physical Properties of Gummetal Orthodontic Wire in Comparison with Dissimilar Archwires: A Critical Review

Objective

Gummetal is a novel multifunctional alloy which possesses distinctive properties with the potential to refine and amend the efficacy of orthodontic treatment. The objective of this critical literature review was to investigate scientific evidence concerning the mechanical and clinical features of this recently manufactured beta-titanium orthodontic wire.

Materials and Methods

Electronic databases: PubMed, PMC, Google Scholar, Ovid, and Cochrane Library were searched. Studies investigating the properties of Gummetal orthodontic wire including in vitro and clinical studies were selected, validity was assessed, and data was extracted. The risk of bias was assessed by the Cochrane risk of bias Tool 2.0 in a randomized clinical trial. Results and Discussion. Among 322 papers, 13 papers were selected and divided into two groups: prospective double-blinded randomized clinical trial and in vitro studies.

Conclusions

The results of this review should be interpreted with caution because of the heterogeneity of the studies. Only single clinical trial paper was found in the literature. The studies reported different characteristics obtained by various methods; thus, it was difficult to objectively compare the results. Low bending strength, low fatigue limit, and high resilience have been confirmed. Gummetal provides lower force than Nitinol and TMA but higher than Supercable wire. Plastic deformation of Gummetal questions its superelasticity. Friction of Gummetal wire is comparable to SS and CoCr wires. Because of its nontoxic chemical composition, Gummetal might be useful in the initial phase of orthodontic treatment for patients suffering from nickel allergy. Further studies are necessary to assess the usefulness of Gummetal in the clinical practice.

Orthodontic Treatment of Periodontally Compromised Teeth After Laser Periodontal Therapy: A Case Report

Objective: To assess stability of laser periodontal therapy (LPT) results after orthodontic tooth movement. Background: Periodontitis and malocclusion each exhibit high global prevalence. Thus, dentists inevitably face increasing demand for orthodontic treatment in patients with reduced periodontal support. Many of these patients benefit from orthodontic treatment, provided that periodontal inflammation is controlled. Materials and methods: We present a case demonstrating successful orthodontic treatment of periodontally compromised teeth after LPT. A patient with severe attachment and alveolar bone loss received orthodontic treatment 13 months after neodymium-doped: yttrium aluminum garnet LPT (1064 nm). We utilized three laser parameter sets for various purposes during the procedure-ablation of the periodontal pocket epithelium (2.8 W, 20 Hz, 100 μs), clot stabilization (2.8 W, 20 Hz, 550 μs), and photobiomodulation (2.8 W, 20 Hz, 100 μs, noncontact). Results: Treatment resulted in improved radiographic bone levels, clinical parameters consistent with periodontal health, and favorable occlusal relationships. Conclusions: In the presented case, we successfully treated a patient presenting with malocclusion and reduced periodontal support while avoiding the risk and morbidity of conventional periodontal surgery. Controlled clinical research to establish the predictability of the described approach appears warranted.

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

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

AIM AND BACKGROUND

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL SIGNIFICANCE

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

HOW TO CITE THIS ARTICLE

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

Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating)

Background: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study was to assess the orthodontic treatment outcomes in an Italian postgraduate School of Orthodontics using Peer Assessment Rating (PAR) Index. Methods: A sample of 50 patients treated in a postgraduate program was randomly selected. PAR index was used to assess pre-treatment and post-treatment study casts by two different examiners. The influence of different variables such as gender, treatment method, and need for extraction was statistically analyzed. Results: The average numerical reduction of PAR between the beginning and the end of the treatment was 18.74 (CI 95% 16.53–20.95), while the percentage reduction was 94.8% (CI 95% 91.91–97.68). All cases improved: 8% of patients resulted in the improved category, while 92% of them were in the greatly improved group. Conclusions: According to PAR index, the results showed that patients received a high-standard therapy. None of the factors studied influenced significantly the treatment outcomes.

Evaluation of the Effect of Various Powers of the Diode Laser in Microcrack Formation in the Wall of the Dental Root Canal by Scanning Electron Microscope (SEM)

Background:

The laser is utilized for the removal of the smear layer, cleaning and disinfecting the dental canal. Recently, diode laser has been offered with a wavelength of (635-980nm) for cleaning and disinfecting the dental root canal.

Objective:

There is not adequate evidence for microcrack formation when using diode lasers with different powers. Therefore, the present study was conducted in order to analyze various powers of a diode laser in microcrack formation in dental root canals.

Methods:

In this experimental study, 100 mandibular incisor teeth that were extracted because of periodontal disease were selected. Using stereo-microscope, the presence of crack and fracture of the root was evaluated before and after canal instrumentation. Then, samples were randomly divided into 10 groups (10 samples in any group) based on different powers of laser and canal to be humid or dry under laser radiation. The laser was utilized for 10s puls within three iterated times. The samples were cross-sectioned after disinfection with a diode laser at 3 and 6mm length from the dental apex. Sections were observed under a scanning electron microscope and images were taken.

Results:

The frequency of microcracks is increased at the distance of (3-6mm) from the dental apex by an increase in laser power level from 2 to 4w (P<0.05). Similarly, results showed that the probability of microcrack formation under dry condition than the humid condition at the distance of 3mm from the dental apex might increase to 6.606 times and at the distance of 6mm from the dental apex increase to 4.978 times more.

Conclusion:

The optimal power of diode laser in the wavelength of (980nm) for cleaning and disinfecting of the root canal with the minimum damage on hard periodontium tissue is 1.5w.

Gomes MG, Amaral FLB, G. França FM, Basting RT, Bandeca MC, Diniz RS, Gonçalves LM, de J. Tavarez RR, Turssi CP. Aging Protocols and Their Effects on Bond Strength of Total-Etch and Self-Etch Adhesive Systems to Dentin

Objective:

This study investigated whether different aging protocols have effects on the bond strength of total-etch and self-etch adhesive systems to dentin substrate.

Methods:

Molars were sectioned exposing the dentin, which was submitted to restorative procedures using two-step total-etch (ASB, Adper SingleBond2), two-step self-etch (CLF, Clearfil SEBond), or one-step self-etch (OPT, Optibond All-in-One) system and resin composite. The obtained blocks were sectioned to result in sticks to be submitted to bond strength and failure mode tests after 24h storage in distilled water (DW), or 180-day aging protocols in DW, artificial saliva (AS), citric acid (CA), or thermal cycling (TC). The types of failures were classified as adhesive, cohesive in dentin, cohesive in composite resin, and mixed. Data were analyzed using ANOVA followed by Tukey’s test (α=5%). The failure modes were descriptive under the relative frequencies form.

Results:

It was observed that ASB presented the higher bond strength(p<0.05), while CLF and OPT did not demonstrate differences between them(p>0.05) after 24h. The bond strength obtained with ASB significantly overcame that of OPT when stored in DW or AS for 180 days (p<0.001). In these storing mediums, ASB did not differ from CLF(p>0.05), while in CA or TC the values of CLF were significantly lower (p<0.001). In TC aging, the values presented by OPT did not differ from ASB(p>0.05), both of which had higher values than CLF(p<0.05). The predominant failure mode was adhesive.

Conclusion:

For the two-step total-etch and two-step self-etch adhesives, the influence of aging in AS and TC was equivalent to that of storage in DW. The most deleterious effects occurred in CA, a situation in which self-etch adhesives displayed worse performance than the conventional type.

Comparison of the Effects of Photobiomodulation with Different Lasers on Orthodontic Movement and Reduction of the Treatment Time with Fixed Appliances in Novel Scientific Reports: A Systematic Review with Meta-Analysis

Background: The duration of orthodontic treatment is one of the most important aspects considered by patients. Photobiomodulation (PBM) depends upon the exposure of the tissue to particular, therapeutic wavelengths of light in the "therapeutic window" (from 600 to 1200 nm). PBM increases cell metabolism, which leads to higher ATP production. Increasing the amount of ATP in well-vascularized bone cells promotes cell proliferation and differentiation, creating a favorable environment for tooth movement. Objective: The aim of the study is to discuss and compare the use of PBM in accelerating the orthodontic movement and reducing the time of treatment. Materials and methods: A systematic review was conducted. Literature searches were performed using Medline (PubMed), Web of Science, and Scopus (from September 13 to September 20, 2019). The quality assessment was performed using the Jadad scale for reporting randomized controlled trials for randomized clinical trial and randomized control clinical trial studies, and the Newcastle/Ottawa Quality Assessment Form for case/control studies. Results: Thirty-three articles from PubMed, 46 from Scopus, 5 from Web of Science were selected. After removal of duplicates, 82 articles were analyzed. Subsequently, 74 articles were excluded because they did not meet the inclusion criteria. The remaining eight articles were included in the qualitative synthesis. Conclusions and summary: PBM is an efficient, effective, and noninvasive method to accelerate orthodontic tooth movement. PBM should be introduced into the daily practice of treating various malocclusions as an additional procedure. Intraoral application gives better results and its introduction to treatment seems more reasonable.

Craniomandibular Disorders in Pregnant Women: An Epidemiological Survey

Temporomandibular joint (TMJ) disorder has been reported to be 1.5 to two times more common in women than men. Such a gender-based difference could be attributed to behavioral, hormonal, anatomical, and psychological characteristics. Physiological hormonal differences between genders could be one of the possible explanations for the higher incidence of temporomandibular disorder (TMD) in women. As the plasma level of certain female hormones increases during gestation, it could be assumed that there is a higher prevalence of dysfunctional signs and symptoms in pregnant women. We performed an epidemiological survey based on screening for TMD in a group of 108 pregnant women and found that 72% of young women reported significant signs of TMJ disorders, 9% of the young women reported mild signs of TMJ disorders, and 19% of the included subjects reported no signs or symptoms of TMD. The presence of estrogen receptors in the temporomandibular joint of female baboons could be the basis of an explanation for the increased prevalence of dysfunction in young women reported in the literature and the high feedback we have seen of joint noises in pregnant women. On the basis of the present findings, it could be assumed that gestation period could represent a risk factor for craniomandibular dysfunctions.

A Full Diagnostic Process for the Orthodontic Treatment Strategy: A Documented Case Report

The need for extractions in orthodontic treatment has always been a controversial topic. However, to date there is not a specific clinical guideline that can help the clinicians deciding to plan an extractive or a non-extractive orthodontic treatment. In this respect, clinicians must deal with patients’ occlusal, functional, periodontal and aesthetics characteristics before planning an orthodontic treatment including extraction. Considering the absence of specific guidelines, the choice to extract teeth or not is complicated, particularly in borderline cases. In this case report, we present a borderline case of a patient with the skeletal Class III pattern and significant crowding in both arches that could be treated with or without extraction, illustrating the diagnostic and decision-making processes that were conducted for the orthodontic treatment strategy.

The Efficacy of Retention Appliances after Fixed Orthodontic Treatment: A Systematic Review and Meta-Analysis

The purpose of this article is to evaluate the amount of the relapse of anterior crowding and the efficacy of retention appliances by reviewing the best available scientific evidence. A survey of articles published up to November 2019 about the stability of dental alignment and retention after fixed orthodontic treatment was performed using seven electronic databases. Study Selection: Only randomized clinical trials investigating patients previously treated with multi-bracket appliances with a follow-up period longer than 6 months were included. Data Extraction: Two authors independently performed the study selection, data extraction, and risk of bias assessment. All pooled data analyses were performed using a random-effects model. Statistical heterogeneity was evaluated. In total, eight randomized clinical trials (RCTs) were included, grouping data from 987 patients. The ages of the patients varied across the studies, ranging between 13 and 17 years. The observation period ranged between 6 and 24 months. The data showed no significant intercanine width modifications during the retention period with both fixed and removable retainers. A significant modification of Little’s Index was found for the mandibular removable retainers with a mean difference of 0.72 mm (95% Cl, 0.47 to 0.98) and for the maxillary removable retainers with a mean difference of 0.48 mm (95% Cl, 0.27 to 0.68). No significant changes were found by evaluating Little’s Index modification for the mandibular fixed retainers. The results of this meta-analysis showed that all the considered retainers were effective in maintaining dental alignment after fixed orthodontic treatment. However, fixed retainers showed greater efficacy compared to removable retainers.

A Comparative Assessment of Pain Caused by the Placement of Banded Orthodontic Appliances with and without Low-Level Laser Therapy: A Randomized Controlled Prospective Study

Patients still refuse or discontinue orthodontic treatment due to related pain and discomfort. In this study, we investigate if low-level laser therapy (LLLT) can reduce pain caused by orthodontic bands. Sixty subjects who needed bands placed on the upper permanent first molars were assigned randomly to the LLLT group, placebo, and control groups. Inclusion criteria were: age range 10–14 years, fully erupted upper first molars in healthy condition, presence of tight mesial proximal contact. Exclusion criteria were: systemic or metabolic diseases, chronic pain or neurological or psychiatric disorders, use of pharmacological agents interfering with pain perception, previous orthodontic treatment or the simultaneous presence of other devices in the patient’s mouth. The assessment of pain was performed by using a numeric rating scale (NRS) considering different time intervals, i.e., immediately after bands placement, 6 h, 24 h, and from day 2 to day 5. Differences in the maximum pain and in pain experienced at each time-point, among the three groups, was assessed by using the Kruskal–Wallis H. The final sample included 56 patients, 29 males, and 27 females, with a mean age of 12.03 ± 1.3 years. Patients were randomly allocated into three groups (tested, control, and placebo group) with each group consisting respectively of 19, 20, and 17 individuals. Subjects in the LLLT experienced less pain at each time interval as well as the maximum pain score being lower in the LLLT compared to control and placebo groups. These findings were all statistically significant (p < 0.05). LLLT can alleviate the intensity of pain after the placement of orthodontic bands.