1
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Shimada E, Kanetaka H, Hihara H, Kanno A, Kawashima R, Nakasato N, Igarashi K. Effects of pain associated with orthodontic tooth movement on tactile sensation of periodontal ligaments. Clin Oral Investig 2023; 28:36. [PMID: 38147159 PMCID: PMC10751255 DOI: 10.1007/s00784-023-05469-2] [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: 09/13/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES Pain associated with orthodontic tooth movement reportedly reduces periodontal ligament tactile sensation. However, the mechanism associated with the central nervous system remains unclear. This study was conducted by measuring somatosensory evoked magnetic fields (SEFs) during mechanical stimulation of teeth as they were being moved by separator elastics. Findings clarified the effects of pain on periodontal ligament tactile sensation during orthodontic tooth movement. MATERIALS AND METHODS Using magnetoencephalography, SEFs were measured during the application of mechanical stimuli to the mandibular right first molars of 23 right-handed healthy participants (0 h). Separator elastics were subsequently inserted into the mesial and distal interdental portions of the mandibular right first molars. The same mechanical stimuli were applied again 24 h later while the SEFs were measured (24 h). After each SEF measurements, pain was also evaluated using the Visual Analog Scale (VAS). RESULTS The VAS values were significantly higher at 24 h than at 0 h (p < 0.05). No significant difference in the peak latencies was found between those obtained at 0 h and 24 h, but the intensities around 40.0 ms in the contralateral hemisphere were significantly lower at 24 h than at 0 h (p < 0.01). CONCLUSIONS Pain associated with orthodontic tooth movement might suppress periodontal ligament tactile sensation in the primary somatosensory cortex. CLINICAL RELEVANCE Pain associated with orthodontic tooth movement might affect periodontal ligament sensation, consequently causing discomfort during occlusion.
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Affiliation(s)
- Eriya Shimada
- Division of Craniofacial Anomalies, Tohoku University Graduate School of Dentistry, Sendai, Japan.
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Japan.
| | - Hiroyasu Kanetaka
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Japan
- Division of Interdisciplinary Integration, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hiroki Hihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Akitake Kanno
- Department of Advanced Spintronics Medical Engineering, Tohoku University Graduate School of Engineering, Sendai, Japan
| | - Ryuta Kawashima
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Nobukazu Nakasato
- Department of Advanced Spintronics Medical Engineering, Tohoku University Graduate School of Engineering, Sendai, Japan
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kaoru Igarashi
- Division of Craniofacial Anomalies, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Japan
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2
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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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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 '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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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 '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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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'"] [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: 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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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/s10103-023-03870-7jypboind] [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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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/s10103-023-03870-7����%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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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'||'] [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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Clear Aligner Treatments in Orthoperio Patients. Case Rep Dent 2022; 2022:8932770. [PMID: 35198252 PMCID: PMC8860530 DOI: 10.1155/2022/8932770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/08/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction. Orthodontic treatment is a recognized approach to support specific periodontal issues thanks to its capability to manipulate periodontal tissues. This concept is certainly not new, but the use of aligners in certain clinical conditions can be considered as being innovative when a multidisciplinary treatment is necessary. Moreover, aligners enable to plan 3D tooth movements, root placement, staging, and range of dental movements, alongside the improvement of oral hygiene. Thus, aligners can be suitable for the treatment of periodontal issues. In this article, the authors present two clinical cases with different periodontal issues: one with superficial periodontal problems and the other with a deep one. Both cases were successfully treated with aligners, highlighting how this invisible and comfortable tool can simplify the management of complex adult treatments. Conclusion. Digital workflow is the key for success in the aligner technique. The possibility to design a virtual plan of treatment and to transfer it in the real clinical world represents a way to limit errors and to reduce the time of orthodontic therapy.
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11
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Zaniboni E, Bagne L, Camargo T, do Amaral MEC, Felonato M, de Andrade TAM, Dos Santos GMT, Caetano GF, Esquisatto MAM, Santamaria M, Mendonça FAS. Do electrical current and laser therapies improve bone remodeling during an orthodontic treatment with corticotomy? Clin Oral Investig 2019; 23:4083-4097. [PMID: 30771000 DOI: 10.1007/s00784-019-02845-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 02/07/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Evaluate the bone remodeling during orthodontic movement with corticotomy when submitted to low-intensity electrical stimulation application (microcurrent-MC) and low-level laser therapy (LLLT). MATERIAL AND METHODS One hundred and fifty Wistar rats were divided into the following 5 groups: (C) submitted to tooth movement; (Cort) tooth movement/corticotomy; (Cort-L) tooth movement/corticotomy/laser AsGaAl 808 nm (4.96J/50s); (Cort-Mc) tooth movement/corticotomy/microcurrent (10 μA/5 min); (Cort-L-Mc) tooth movement/corticotomy and laser/microcurrent alternated. Inflammation, angiogenesis, and osteogenesis were evaluated in the periodontal ligament (PDL) and alveolar bone on the 7th, 14th, and 21st days of orthodontic movement. RESULTS The quantification of inflammatory infiltrate, angiogenesis and expression of TGF-β1, VEGF, and collagen type I were favorably modulated by the application of therapies such as low-level laser therapy (LLLT), MC, or both combined. However, electrical stimulation increased fibroblasts, osteoclasts and RANK numbers, birefringent collagen fiber organization, and BMP-7 and IL-6 expression. CONCLUSIONS Low-level laser therapy (LLLT) and MC application both improved the process of bone remodeling during orthodontic treatment with corticotomy. Still, electrical current therapy promoted a more effective tooth displacement but presented expected root resorption similar to all experimental treatments. CLINICAL RELEVANCE It is important to know the effects of minimally invasive therapies on cellular and molecular elements involved in the bone remodeling of orthodontic treatment associated with corticotomy surgery, in order to reduce the adverse effects in the use of this technique and to establish a safer clinical routine.
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Affiliation(s)
- Ewerton Zaniboni
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Leonardo Bagne
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Thaís Camargo
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Maria Esméria Corezola do Amaral
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Maira Felonato
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Thiago Antônio Moretti de Andrade
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Gláucia Maria Tech Dos Santos
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Guilherme Ferreira Caetano
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Marcelo Augusto Marreto Esquisatto
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
| | - Milton Santamaria
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil. .,Graduate Program of Orthodontics, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil.
| | - Fernanda Aparecida Sampaio Mendonça
- Graduate Program of Biomedical Sciences, Herminio Ometto University Center, UNIARARAS, Dr. Maximiliano Baruto, 500, Araras, SP, 13607-339, Brazil
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Kouskoura T, Katsaros C, von Gunten S. The Potential Use of Pharmacological Agents to Modulate Orthodontic Tooth Movement (OTM). Front Physiol 2017; 8:67. [PMID: 28228735 PMCID: PMC5296343 DOI: 10.3389/fphys.2017.00067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/24/2017] [Indexed: 11/13/2022] Open
Abstract
The biological processes that come into play during orthodontic tooth movement (OTM) have been shown to be influenced by a variety of pharmacological agents. The effects of such agents are of particular relevance to the clinician as the rate of tooth movement can be accelerated or reduced as a result. This review aims to provide an overview of recent insights into drug-mediated effects and the potential use of drugs to influence the rate of tooth movement during orthodontic treatment. The limitations of current experimental models and the need for well-designed clinical and pre-clinical studies are also discussed.
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Affiliation(s)
- Thaleia Kouskoura
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern Bern, Switzerland
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern Bern, Switzerland
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13
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Long H, Wang Y, Jian F, Liao LN, Yang X, Lai WL. Current advances in orthodontic pain. Int J Oral Sci 2016; 8:67-75. [PMID: 27341389 PMCID: PMC4932774 DOI: 10.1038/ijos.2016.24] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 02/05/2023] Open
Abstract
Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons: the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway—periaqueductal grey and dorsal raphe—has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti-inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviating orthodontic pain in the future.
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Affiliation(s)
- Hu Long
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li-Na Liao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Yang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen-Li Lai
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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14
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Biological Events in Periodontal Ligament and Alveolar Bone Associated with Application of Orthodontic Forces. ScientificWorldJournal 2015; 2015:876509. [PMID: 26421314 PMCID: PMC4572431 DOI: 10.1155/2015/876509] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/20/2015] [Accepted: 08/24/2015] [Indexed: 01/08/2023] Open
Abstract
Orthodontic force-induced stresses cause dynamic alterations within the extracellular matrix and within the cytoskeleton of cells in the periodontal ligament and alveolar bone, mediating bone remodelling, ultimately enabling orthodontic tooth movement. In the periodontal ligament and alveolar bone, the mechanically induced tensile strains upregulate the expression of osteogenic genes resulting in bone formation, while mechanically induced compressive strains mediate predominantly catabolic tissue changes and bone resorption. In this review article we summarize some of the currently known biological events occurring in the periodontal ligament and in the alveolar bone in response to application of orthodontic forces and how these facilitate tooth movement.
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15
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Han J, He H. Expression and function of osteogenic genes runt-related transcription factor 2 and osterix in orthodontic tooth movement in rats. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:11895-11900. [PMID: 26617945 PMCID: PMC4637761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the expression and function of osteogenic genes osterix (OSX) and runt-related transcription factor 2 (RUNX2) in the rat periodontal tissues under orthodontic force for the remodeling of the periodontal tissues. METHODS 24 Wistar rats were randomly divided into 4 groups of orthodontic tooth movements for 1, 3, and 7 days (experimental groups) and control group (without orthodontic force). The expression of RUNX2 and OSX in the periodontal tissues was analyzed using real time PCR for mRNA and Western blot analysis for protein. The data were also analyzed for involvement of the two genes in signal pathways using bioinformatics tools. RESULTS The mRNA levels of RUNX2 and OSX increased in the periodontal tissues after subjected to the orthodontic force for 1 to 7 days, with the highest level occurring at day 7. The relative expression levels of RUNX2 and OSX mRNA were 1.85 ± 0.12, 304 ± 0.06 and 4.16 ± 0.068, and 1.52 ± 0.09, 1.83 ± 0.03 and 2.56 ± 0.06 at day 1, 3 and 7, respectively. The results of Western blot analysis were consistent with the mRNA results. CONCLUSION In orthodontic tooth movement, the expression of RUNX2 and OSX was upregulated as a result of external stimulation, suggesting that the two genes is involved in periodontal tissue remodeling and plays an important role in periodontal tissue remodeling.
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Affiliation(s)
- Jinyou Han
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan UniversityHubei Province, Wuhan 430079, China
- Liaocheng People’s HospitalShandong Province, China
| | - Hong He
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan UniversityHubei Province, Wuhan 430079, China
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Dalaie K, Hamedi R, Kharazifard MJ, Mahdian M, Bayat M. Effect of Low-Level Laser Therapy on Orthodontic Tooth Movement: A Clinical Investigation. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2015; 12:249-56. [PMID: 26622279 PMCID: PMC4662762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVES One major drawback of orthodontic treatment is its long duration due to slow tooth movement and the pain at the onset of treatment following application of forces. There is controversy regarding the efficacy of laser for decreasing the treatment time and pain of orthodontic treatment. The purpose of this study was to investigate the effect of low level diode laser on the rate of orthodontic tooth movement and the associated pain. MATERIALS AND METHODS In this double blind randomized controlled clinical trial, 12 orthodontic patients referring to Shahid Beheshti School of Dentistry for first premolar extraction were randomly selected and allocated to gallium aluminum-arsenide laser (GA-AL-AS diode laser, 880 nm, 100 mW, 5 j/cm(2), 8 points, 80 seconds, continuous mode) or control group. The patients initially underwent leveling and alignment using the sectional system. Force (150 gr) was applied to each canine tooth via sectional closing loops. The loops were activated every month. The rate of tooth movement and pain were monitored over the treatment period and recorded on days 1, 3, 7, 30, 33, 37, 60, 63 and 67. Two-way ANOVA was used for comparison of groups. RESULTS There was no significant difference in terms of tooth movement and pain scores between the irradiated and non-irradiated sides at any time point (P>0.05). CONCLUSION Although laser enhanced orthodontic tooth movement in the upper jaw, we failed to provide solid evidence to support the efficacy of laser for expediting tooth movement or reducing the associated pain.
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Affiliation(s)
- Kazem Dalaie
- Assistant Professor, Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Hamedi
- Postgraduate Student, Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: R. Hamedi, Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
| | - Mohammad Javad Kharazifard
- Epidemiologist, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Seifi M, Arayesh A, Shamloo N, Hamedi R. Effect of nanocrystalline hydroxyapatite socket preservation on orthodontically induced inflammatory root resorption. CELL JOURNAL 2015; 16:514-27. [PMID: 25685742 PMCID: PMC4297490 DOI: 10.22074/cellj.2015.496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 12/01/2013] [Indexed: 11/07/2022]
Abstract
Objective Orthodontically induced inflammatory root resorption (OIIRR) is considered to be
an important sequel associated with orthodontic tooth movement (OTM). OTM after Socket
preservation enhances the periodontal condition before orthodontic space closure. The purpose of this study is to investigate the histologic effects of NanoBone®, a new highly nonsintered porous nano-crystalline hydroxyapatite bone on root resorption following OTM.
Materials and Methods This experimental study was conducted on four male dogs. In
each dog, four defects were created at the mesial aspects of the maxillary and mandibular
first premolars. The defects were filled with NanoBone®. We used the NiTi closed coil for
mesial movement of the first premolar tooth. When the experimental teeth moved approximately halfway into the defects, after two months, the animals were sacrificed and we harvested the area of interest. The first premolar root and adjacent tissues were histologically
evaluated. The three-way ANOVA statistical test was used for comparison.
Results The mean root resorption in the synthetic bone substitute group was 22.87 ±
11.25×10-4mm2 in the maxilla and 21.41 ± 11.25×10-4mm2 in the mandible. Statistically,
there was no significant difference compared to the control group (p>0.05).
Conclusion The use of a substitution graft in the nano particle has some positive effects
in accessing healthy periodontal tissue following orthodontic procedures without significant influence on root resorption (RR). Histological evaluation in the present study showed
osteoblastic activity and remodeling environment of nanoparticles in NanoBone®.
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Affiliation(s)
- Massoud Seifi
- Department of Orthodontic, Dentofacial Deformities Research Center, Research Institute of Dental Sciences of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Arayesh
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nafise Shamloo
- Department of Oral and Maxillofacial Pathology, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Hamedi
- Department of Orthodontic, Dentofacial Deformity Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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