|Year : 2018 | Volume
| Issue : 1 | Page : 42-45
Evaluation of the effects of laser irradiation on the rate of tooth movement: A split-mouth study
Urvi Harish Mal, Manjunath Malagan
Department of Orthodontics and Dentofacial Orthopaedics, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
|Date of Web Publication||17-Jan-2018|
Dr. Urvi Harish Mal
Department of Orthodontics and Dentofacial Orthopaedics, KAHE's KLE University, Belagavi, Karnataka
Source of Support: None, Conflict of Interest: None
AIM AND OBJECTIVE: The aim of this study is to evaluate the rate of tooth movement caused by laser during individual canine retraction in the maxillary arch.
MATERIALS AND METHODS: The study was done on 10 patients requiring upper first premolar extraction on both the sides and individual canine retraction using closed NiTi coil spring with high anchorage. A split-mouth technique was carried out where the right quadrant was the experimental side and left quadrant was the control side. On experimental side, canine was irradiated with Ga-As semiconductor laser (wavelength – 940 nm, output – 0.2 mW for 25 s, energy density – 5 J/cm2). Amount of retraction was measured using digital caliper on the cast. A palatal plug was used as a reference to ascertain retraction of canine.
RESULTS: Results showed statistically significant difference in tooth movement on the experimental sides compared to control side.
CONCLUSION: Hence, it can be concluded that laser effectively accelerates the tooth movement and reduce the treatment duration in clinical practice.
Keywords: Acceleration, laser, noninvasive
|How to cite this article:|
Mal UH, Malagan M. Evaluation of the effects of laser irradiation on the rate of tooth movement: A split-mouth study. Indian J Health Sci Biomed Res 2018;11:42-5
|How to cite this URL:|
Mal UH, Malagan M. Evaluation of the effects of laser irradiation on the rate of tooth movement: A split-mouth study. Indian J Health Sci Biomed Res [serial online] 2018 [cited 2019 Aug 24];11:42-5. Available from: http://www.ijournalhs.org/text.asp?2018/11/1/42/223428
| Introduction|| |
Orthodontics has been developing greatly in achieving the desired results both clinically and technically. This is especially so using new technologies, such as simulation software that can assist in treatment planning and the outcomes.Orthodontic tooth movement is accompanied by site-specific bone remodeling with inflammatory nature. Alveolar bone remodeling is essential for tooth movement and is characterized by tandem periods of osteoclastic recruitment, bone resorption, reversal, and bone formation. This process involves the periodontal ligament and is dependent on the magnitude and consistency of the force being applied. In the area of periodontal ligament compression, osteoclasts proliferate and initial resorption of superficial bone occurs. In the region of periodontal ligament tension, the periodontal fibers unwind, fibroblasts appear, and osteoblasts form a nonmineralized collagenous matrix called osteoid. The osteoid is later mineralized, trapping some osteocytes in lacunae within the bone.
Since orthodontic treatment usually takes place over a long period of time, the problems of caries and periodontal disease are burdensome for the patient. Furthermore, it has been reported that total treatment duration proves to be highly correlated with discomfort, pain, external apical root resorption, suboptimal oral hygiene, white spot lesions, and dental caries.
An increasing number of patients are demanding orthodontic treatment nowadays for improved esthetics as it is affecting their professional and social life. Accelerating the rate of orthodontic tooth movement would be beneficial to the shortening of treatment time and to diminish adverse effects in orthodontic treatment. Low-level laser therapy (LLLT) is a nonsurgical approach, which has gained a lot of interest in last few years in accelerating the tooth movement.
Hence, this study aims to evaluate the application of laser on the rate of tooth movement on individual tooth so that this technique can be applied clinically for reducing the treatment duration.
| Materials and Methods|| |
The study included 10 patients, who reported to the Department of Orthodontics and Dentofacial Orthopedics, K. L. E V. K Institute of Dental Sciences, Belagavi, Karnataka, India. Patients needing first premolar extraction in the maxillary arch as a part of orthodontic treatment, patients with permanent dentition, no history of previous orthodontic treatment, and both male and female patients were included in the study. Periodontally compromised patients, medically compromised patients, patients on any kind of long-term medication, participants needing extractions other than all first premolar extractions, patients with unilateral chewing/parafunctional habits, crossbites, and occlusal interferences, and impacted canine or canine with dilacerated roots are excluded from the study. A split-mouth technique was carried out where the quadrant for the experimental side and the control side was randomly selected, i.e., Group laser – one-quadrant was irradiated with laser [Figure 1] along with NiTi coil spring and other quadrant was control having NiTi coil spring only.
Irradiations with a semiconductor laser at 940 nm for 25 s at 0.2 mW with energy density of 5 J/cm2 and total dose of 7 J (power density = power/unit area) laser were applied on days 0, 3, 7, and 14 in the 1st month and thereafter on every 15th day for 4 months [Figure 2]. A fiber-optic tip of 3-mm diameter was used (area irradiated –0.7 cm2). Alginate impressions and intraoral photographs were taken on day 0, before the placement of NiTi coil spring and application of toothbrush vibrations, and every 30 days.
Distribution of laser irradiation dosage
Five irradiations were given on buccal side and palatal side of canine:
- two on cervical third – one on mesial and one on distal
- two on apical third – one on mesial and one on distal
- one on middle third.
Amount of tooth movement was measured using a palatal plug. Each initial model was used for making a palatal plug, with reference wires pointing at the mesial contact of the canines. The plug was then transferred to the consecutive models to measure displacement of the mesial contact of the canines relative to the reference wire using a digital caliper.
| Results|| |
The findings of the study were analyzed using Wilcoxon test. Statistically significant tooth movement was seen in both the experimental and control side over a period of 4 months [Table 1] and [Figure 3]. Comparing tooth movement in laser group, it was seen that the tooth movement was faster in laser side than in control side and it was statistically significant during the 1st, 2nd, and 4th month [Table 2]. Experimental side showed an increase by 0.3-fold and by 30% compared to control side.
|Figure 3: Comparison of tooth movement per month in laser and control sides|
Click here to view
|Table 1: Changes in tooth position in both groups and both experimental and control sides of laser group over 1st to 4th month analyzed by Friedman's test|
Click here to view
|Table 2: Comparison of tooth movement* (mms/month) between test and control sides for the laser group|
Click here to view
| Discussion|| |
The currently available studies demonstrate a various methods of acceleration of tooth movement which includes both invasive and noninvasive techniques. In this study, we have used a semiconductor diode laser of wavelength 940 nm, a continuous mode, an output of 0.2 mW, and exposure time of 25 s because the results obtained by Doshi-Mehta and Bhad-Patil  and Takeda  had shown significant biostimulatory effects around this dosage. Doshi-Mehta and Bhad-Patil  conducted a study where the patients were called on day 0, 3, 7, 14, and after every 15 days for laser application and they showed a positive result. Hence, the similar regimen was followed in our study. The rate of tooth movement after 3 months in our study on experimental side was increased up to 0.3-fold compared to control group. In other words, there was 37% increase in tooth movement on experimental side which was statistically significant. Doshi-Mehta and Bhad-Patil  found an increase of 1.3-fold and by 56% more on experimental side than on control side after 3 months, but after 4.5 months, the tooth movement increase was only 30%. A 1.5-fold increase in tooth movement was demonstrated by Yoshida et al. in their experimental group over a period of 7 days using a Ga-Al-As of 810-nm wavelength and total dose of 54 J. In our study, the wavelength used was higher (940 nm), and thus, we obtained a lesser fold increase on the experimental side. Kim et al. in their study on dogs reported an increase in the experimental side by 2.08-fold over a period of 2 months where they had used a pulsed mode rather than a continuous mode that we used in our study. A study done by Cruz et al. using a Ga-Al-As diode laser of 830 nm with the energy dose of 5 J/cm2 at each of the 10 different points around the tooth to cover the periodontal fibers and alveolar process around the canine teeth showed an increase in tooth movement. In our study, we used similar energy density of 5 J/cm2 and 10 points around the tooth were irradiated. Mohamed Youssef et al. used a Ga-Al-As diode laser of 830 nm with the energy dose of 8 J/cm2 at each of the 6 different points around the tooth. This distribution of energy into different points surrounding the canine teeth could be more adequate due to a more homogeneous distribution of the energy and accelerating the tooth movement. LLLT is a type of irradiation therapy that does not induce an increase in temperature in treated tissues. The best evidence regarding LLLT, which is of low quality, indicated that low-energy LLLT promotes tooth movement, whereas high-energy LLLT could not. Our study used the energy density of 5 J/cm2 and total dose of 7 J. Lower energy density of 5–8 J/cm2 is more effective than higher energy density of 20–25 J/cm2 or more was found by studies done by Yi et al. and Ge et al. A split-mouth study done by Goulart et al. with 2 experimental and 1 control groups showed an increase by 50% in the tooth movement in the first experimental group which was irradiated using Ga-Al-As diode laser of 780 nm, energy density of 5 J per square centimeter, and a total dose of 1.89 J. In the second experimental group, a decrease by 90% was seen in the experimental group which was irradiated using energy density of 35 J/cm2 and total dose of 12.6 J.
| Conclusion|| |
The laser parameters used in this study did show an increased tooth movement on experimental side. Studies with a larger sample size can be done to get better results. Further studies are required to be carried out as to know which wavelength is more beneficial to accelerate the tooth movement and reduce the treatment duration.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Nimeri G, Kau CH, Abou-Kheir NS, Corona R. Acceleration of tooth movement during orthodontic treatment – A frontier in orthodontics. Prog Orthod 2013;14:42.
Darendeliler MA, Zea A, Shen G, Zoellner H. Effects of pulsed electromagnetic field vibration on tooth movement induced by magnetic and mechanical forces: A preliminary study. Aust Dent J 2007;52:282-7.
Doshi-Mehta G, Bhad-Patil WA. Efficacy of low-intensity laser therapy in reducing treatment time and orthodontic pain: A clinical investigation. Am J Orthod Dentofacial Orthop 2012;141:289-97.
Takeda Y. Irradiation effect of low-energy laser on alveolar bone after tooth extraction. Experimental study in rats. Int J Oral Maxillofac Surg 1988;17:388-91.
Yoshida T, Yamaguchi M, Utsunomiya T, Kato M, Arai Y, Kaneda T, et al.
Low-energy laser irradiation accelerates the velocity of tooth movement via stimulation of the alveolar bone remodeling. Orthod Craniofac Res 2009;12:289-98.
Kim SJ, Moon SU, Kang SG, Park YG. Effects of low-level laser therapy after corticision on tooth movement and paradental remodeling. Lasers Surg Med 2009;41:524-33.
Cruz DR, Kohara EK, Ribeiro MS, Wetter NU. Effects of low-intensity laser therapy on the orthodontic movement velocity of human teeth: A preliminary study. Lasers Surg Med 2004;35:117-20.
Youssef M, Ashkar S, Hamade E, Gutknecht N, Lampert F, Mir M. The effect of low-level laser therapy during orthodontic movement: a preliminary study. Lasers Med Sci 2008;23:27–33.
Yi J, Xiao J, Li H, Li Y, Li X, Zhao Z. Effectiveness of adjunctive interventions for accelerating orthodontic tooth movement: a systematic review of systematic reviews. J Oral Rehabil 2017.
Ge MK, He WL, Chen J, Wen C, Yin X, Hu ZA, Liu ZP, Zou SJ. Efficacy of low-level laser therapy for accelerating tooth movement during orthodontic treatment: a systematic review and meta-analysis. Lasers Med Sci February 2014.
Goulart CS, Nouer PR, Mouramartins L, Garbin IU, de Fatima Zanirato Lizarelli R. Photoradiation and orthodontic movement: experimental study with canines. Photomed Laser Surg 2006;24:192-6.
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]