Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch-a randomized clinical controlled trial.

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Decrowding of lower anterior segment with and without photobiomodulation: a single center, randomized clinical trial.

The aim of this study was to evaluate the effect of low-level light therapy using light-emitting diodes (LEDs) on the speed of tooth movements that were required for the leveling and aligning of the lower anterior segment during non-extraction orthodontic treatment. The sample was comprised of patients (n = 40) with lower anterior crowding who were treated with self-ligating orthodontic brackets and a standardized wire sequence. A test group of patients (n = 20) who were treated with extraoral infrared light therapy for 20 min daily with at least 80 % compliance was compared to a control group (n = 20). The date of the first arch wire placement was recorded as T1, and the date of the completion of the lower anterior segment decrowding was recorded as T2. A final impression was also taken at T2. The time between T1 and T2 was significantly reduced by 22 % in the test group compared to the control group (68.3 vs. 87.8 days, respectively, p < 0.043). The use of photobiomodulation for 20 min daily at a wavelength of 850 nm might reduce the time required to resolve lower anterior crowding. This trial and its protocol were not registered on a publicly accessible registry.

The effectiveness of low-level laser therapy in accelerating orthodontic tooth movement: a meta-analysis.

Low-level laser therapy is claimed to accelerate bone remodeling. The aim of this meta-analysis was to critically appraise current evidence and to determine the effectiveness of low-level laser therapy in accelerating orthodontic tooth movement. PubMed, Web of Knowledge, Embase, CENTRAL, ProQuest Dissertations &Theses, and SIGLE were electronically searched from Jan 1990 to Jun 2013. Article screening, data extraction, assessment of risk of bias and evaluation of evidence quality through GRADE were conducted independently and in duplicate by two reviewer authors. Outcome of interest in this meta-analysis was accumulative moved distance (AMD). Meta-analyses were performed in Comprehensive Meta-Analysis Version 2.2.064 (Biostat, Englewood, NJ, USA). Finally, five studies were included in this meta-analysis. The meta-analysis revealed that the pooled difference in mean (DM) was 0.33 [95 % CI: (0.03-0.64)], 0.76 [95 % CI: (-0.14, 1.65)] and 0.43 [95 % CI: (-0.05, 0.91)] for AMD within 1 month, AMD within 2 months and AMD within 3 months, respectively. However, significant heterogeneities and instability of the pooled results were detected. Moreover, publication bias was found for AMD within 3 months. The subgroup analysis on the wavelength of 780 nm revealed that the pooled DM of AMD were 0.54 (95 % CI = 0.18-0.91), 1.11 (95 % CI = 0.91-1.31) and 1.25 (95 % CI = 0.68-1.82) for 1, 2, and 3 months, respectively. For the output power of 20 mW, the subgroup analysis showed that the pooled DM of AMD was 0.45 (95 % CI = 0.26-0.64), 1.11 (95 % CI = 0.91-1.31), and 1.25 (95 % CI = 0.68-1.82) for 1, 2, and 3 months, respectively. Weak evidence suggests that low-level laser irradiations at the wavelength of 780 nm, at the fluence of 5 J/cm(2) and/or the output power of 20 mW could accelerate orthodontic tooth movement within 2 months and 3 months. However, we cannot determine its effectiveness within 1 month due to potential measurement errors.

Effectiveness of Er:YAG laser-aided fiberotomy and low-level laser therapy in alleviating relapse of rotated incisors.

INTRODUCTION: In this study, we compared the effectiveness of laser-aided circumferential supracrestal fiberotomy (CSF) and low-level laser therapy (LLLT) with conventional CSF in reducing relapse of corrected rotations. METHODS: The study included 24 patients who were at the finishing stage of orthodontic treatment and had at least 1 maxillary incisor with 30° to 70° of rotation before starting therapy. The subjects were divided into 4 groups by treatment: conventional CSF, Er:YAG laser-aided CSF, LLLT, and control. After alginate impressions were taken, the archwire was sectioned from the experimental incisors, and they were allowed to relapse. The second impression was taken 1 month later, and the degree and percentage of relapse were calculated in photographs taken from the dental models. Gingival recession, pocket depth, and pain were also measured in the CSF groups. RESULTS: The mean percentages of relapse were 9.7% in the conventional CSF, 12.7% in the Er:YAG laser-aided CSF, 11.7% in the LLLT, and 27.8% in the control groups. Relapse was significantly greater in the control than the experimental groups (P <0.05), which were not statistically different from each other. The changes in sulcus depth and gingival recession were small and not significantly different among the CSF groups (P >0.05), but pain intensity was greater in subjects who underwent conventional CSF (P = 0.003). CONCLUSIONS: Er:YAG laser-aided CSF proved to be an effective alternative to conventional CSF in reducing rotational relapse. LLLT with excessively high energy density was also as effective as the CSF procedures in alleviating relapse, at least in the short term.

Effects of a low level laser on periodontal tissue in hypofunctional teeth.

Malocclusions, such as an open bite and high canines, are often encountered in orthodontic practice. Teeth without occlusal stimuli are known as hypofunctional teeth, and numerous atrophic changes have been reported in the periodontal tissue, including reductions in blood vessels in the periodontal ligament (PDL), heavy root resorption, and reduced bone mineral density (BMD) in the alveolar bone. Low Level Laser (LLL) has been shown to have a positive effect on bone formation and the vasculature. Although the recovery of hypofunctional teeth remains unclear, LLL is expected to have a positive influence on periodontal tissue in occlusal hypofunction. The aim of the present study was to elucidate the relationship between LLL and periodontal tissue in occlusal hypofunction. Twenty-four male rats aged 5 weeks were randomly divided into control and hypofunctional groups. An anterior metal cap and bite plate were attached to the maxillary and mandibular incisors in the hypofunctional group to simulate occlusal hypofunction in the molars. LLL irradiation was applied to the maxillary first molar through the gingival sulcus in half of the rats. Rats were divided into four groups; control, control+LLL, hypofunctional, and hypofunctional+LLL. Exposure to LLL irradiation was performed for 3 minutes every other day for 2 weeks. Animals were examined by Micro-CT at 5 and 7 weeks and were subsequently sacrificed. Heads were resected and examined histologically and immunohistologically. The hypofunctional group had obvious stricture of the PDL. However, no significant differences were observed in the PDL and alveolar bone between the hypofunctional+LLL and the control groups. In addition, the expression of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF)-positive cells were higher in the hypofunctional + LLL group than in the hypofunctional group. These results indicated that LLL enhanced the production of bFGF and VEGF in the periodontal tissue of hypofunctional teeth.