Accelerated Canine Retraction by Using Mini Implant With Low-Intensity Laser Therapy

Abstract

BackgroundThe continuous increase in demand for reduced treatment times has led researchers to think in terms of "accelerated orthodontics." Generally, the duration for fixed orthodontic treatment is around two to three years. Prolonged use of braces leads to external root resorption, a high risk of caries, and decreased patient compliance. Therefore, finding an optimal supplementary approach to achieve faster tooth movement is still considered a subject of interest. Low-intensity laser therapy (LILT) is one of the non-invasive surgical techniques in the field of accelerated orthodontics. Low-level laser therapy (LLLT) has demonstrated faster healing, less bleeding, and biostimulation and anti-inflammatory effects. According to all studies, it accelerates tooth movement, thereby reducing braces treatment time. It is simple, safe, and minimally invasive. Despite these pieces of evidence, studies have shown variable findings in low-level laser therapy. This study evaluates the effect of LLLT on accelerated orthodontics in comparison with conventional canine retraction. An aluminum gallium arsenide-type diode laser with a wavelength of 940 nm has been used in this study. MethodologyThis study was conducted using the split-mouth method, which included 20 patients with permanent dentition who required first premolar extractions. A miniscrew implant was placed on both the right and left sides for maximum anchorage. Irradiation doses were applied on days 0, 3, 7, and 14 of the first month. Subsequently, irradiations were given every 15 days until the canine's retraction was complete in the test group. ResultsThe study results three months after the canine retraction in the test and control groups (M1) were 0.81 ± 0.03 mm/month and 0.74 ± 0.04 mm/month, respectively, indicating a significantly higher rate of canine retraction in the test group than in the control group (P < 0.0001). The average increase in the amount of tooth movement at three months was 40.1% and 36.3% in the test and control groups, respectively. However, the average increase in the amount of movement of teeth following canine retraction was 100% in the test group and 68.2% in the control group. There were significant variations in the pain score between Day 1 and Day 3 (P = 0.003) in the test group; however, there was no analytic variation in the pain score between Day 1 and Day 30 in the test group (P = 0.18). The pain score between Day 3 and Day 30 was significantly lower. ConclusionsIt was concluded that the rate of canine retraction increases when it is combined with LILT-assisted accelerated orthodontics in comparison to conventional canine retraction. Although LLLT does not provide immediate pain relief, it relieves the sensation of pain after 24-72 hours. LILT is an innovative, non-invasive technique that allows rapid orthodontic tooth movement. The rate of canine retraction increases when it is combined with LILT-assisted accelerated orthodontics in comparison to conventional canine retraction using mini-implants.

Acceleration of Orthodontic Tooth Movement Overview

“…Other phagocytic cells pass via capillaries with developing osteoclasts and help in tissue modeling and remodeling in addition to bone modeling. In comparison with controls, histological sections after 7 days after healing on the laser experimental sides showed faster deposition of bone matrix as well as nascent vascularization [102,103].…”

“…From day one, LLLT groups showed increased fibronectin expression and collagen type 1 turnover as compared to controls. This may be the case because fibronectin stimulates RANKL overexpression, which causes osteoclast differentiation [95,102].…”

“…Many studies adopted Ga-Al-As diode laser emitting a wavelength of 610-960 nm of infrared light application in extraction cases during canine retraction with retraction force at least 150 g. Most of studies demonstrated that the application of the laser accelerated the velocity of tooth movement. However other studies conducted results appeared to have no significant difference between the laser and the control group in the studies conducted [29,79,80,88,98,102,103,[106][107][108][109][110][111].…”

Efectos de la fotobiomodulación en el tratamiento de ortodoncia. Revisión bibliográfica

“…Donde se observó una mayor velocidad, con respecto al desplazamiento de los dientes en el grupo tratado con FBM, pues en el plazo de un mes, se observa un desplazamiento promedio de 1,35 mm para el grupo no irradiado y 1,98 mm para el grupo irradiado, demostrando una diferencia estadísticamente significativa (p < 0.05) entre la velocidad promedio de los caninos irradiados y los caninos de control (10). A la par, en el estudio publicado por Kharat DS llamado "Retracción canina acelerada mediante el uso de mini implantes con terapia láser de baja intensidad" que duró tres meses se evidenció que después de la retracción canina en los grupos de prueba y control (M1) fueron de 0,81 ± 0,03 mm/mes y 0,74 ± 0,04 mm/mes, respectivamente, indicando que existe significativamente una mayor de retracción canina en el grupo de control (2). Otros resultados publicados por el autor Alain Manuel Chaple Gil en su artículo "Láser de baja intensidad acelerando los movimientos dentales en ortodoncia.…”

“…Es por ello por lo que, la temporalidad juega un papel importante, debido a que, actualmente los pacientes requieren tratamientos más rápidos debido a sus actividades sociales en el medio en el que medio en el que se desenvuelven, razón por la cual el especialista en ortodoncia debe buscar alternativas que permitan la aceleración del tratamiento, pero manteniendo la eficacia y eficiencia de estos, mediante el cumplimiento de los objetivos propuestos en base al diagnóstico del paciente. (2).…”