Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 613
  • Home
  • Print this page
  • Email this page
Cover page of the Journal of Health Sciences


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 11  |  Issue : 1  |  Page : 42-45

Evaluation of the effects of laser irradiation on the rate of tooth movement: A split-mouth study


Department of Orthodontics and Dentofacial Orthopaedics, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India

Date of Web Publication17-Jan-2018

Correspondence Address:
Dr. Urvi Harish Mal
Department of Orthodontics and Dentofacial Orthopaedics, KAHE's KLE University, Belagavi, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_249_17

Rights and Permissions
  Abstract 


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 Jun 17];11:42-5. Available from: http://www.ijournalhs.org/text.asp?2018/11/1/42/223428




  Introduction Top


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.[1]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.[2]

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.[2]

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 Top


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.
Figure 1: Bar graph showing chonge in tooth position

Click here to view


Laser irradiations

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.
Figure 2: LASER application

Click here to view


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 Top


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 Top


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 [3] and Takeda [4] had shown significant biostimulatory effects around this dosage. Doshi-Mehta and Bhad-Patil [3] 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 [3] 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.[5] 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.[6] 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.[7] 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.[8] 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.[8] 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.[9] and Ge et al.[10] A split-mouth study done by Goulart et al.[11] 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 Top


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

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
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.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
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.  Back to cited text no. 3
    
4.
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.  Back to cited text no. 4
    
5.
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.  Back to cited text no. 5
    
6.
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.  Back to cited text no. 6
    
7.
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.  Back to cited text no. 7
    
8.
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.  Back to cited text no. 8
    
9.
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.  Back to cited text no. 9
    
10.
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.  Back to cited text no. 10
    
11.
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.  Back to cited text no. 11
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
   Abstract
  Introduction
   Materials and Me...
  Results
  Discussion
  Conclusion
   References
   Article Figures
   Article Tables

 Article Access Statistics
    Viewed539    
    Printed10    
    Emailed0    
    PDF Downloaded58    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]