Effect of Low Level Laser Therapy on Local Bone Resorption During Orthodontic Treatment: A Randomized Controlled Trial

Abstract

DOMINGUEZ, Á.; LEÓN, P.; ARISTIZABAL. J. F. Effect of low level laser therapy on local bone resorption during orthodontic treatment. A randomized controlled trial. Int. J. Odontostomat., 10(3):483-490, 2016. ABSTRACT:The aim of this study was to assess whether the application of low-level laser therapy (LLLT) during the first stage of orthodontic treatment has an effect on local bone resorption and is detectable at the systemic level by measuring deoxypyridinoline levels (Pyrilinks) in urine. This was a randomized (1:1), double-blind, active-controlled, parallel-group trial. 28 adult patients who were going to start orthodontic treatment were randomly divided into the control group (n: 13) and the experimental group (n: 15), the latter of which received LLLT. All of the subjects underwent testing of urine samples: the first one on the day before the beginning of orthodontic treatment (T0), and the second one 5 days after bracket placement to measure Pyrilinks values (Dpd/Cr) in urine. Group differences were evaluated with Student's paired t-test. At the beginning of the study, the Pyrilinks were in the normal range for 53.57 % of the patients, and 46.43 % had elevated values according to the normal ranges. Only taking into account the normal values at (T0), the average Pyrilinks for control group (T0) were 5.75± 1.20 nM/mM, (T1): 6.02±3.00 nM/mM. For experimental group, (T0) was 5.71± 0.72, and it was 6.63± 0.73 in (T1).There were no significant differences in the Pyrilinks changes. (p= 0.75). In the experimental group levels raised statistically significant (p = 0.009). LLLT on patients starting orthodontic treatment with normal Pyrilinks levels have a statistically significant increment on their levels 5 days post irradiation.

Low-level laser therapy (LLLT) improves alveolar bone healing in rats

“…These confirms the acceleration in the repair process determined by its action on cell proliferation, also demonstrating that the results of using the laser were less effective in the late times, since, in the final post-operative period (10 days), there was no difference in the repaired bone between the irradiated group and the control. Thus, the role of the laser in the proliferation of osteoblasts, fibroblasts, macrophages, and lymphocytes, further assisting in the differentiation and activation of osteoclasts and pre-osteoblasts observed in this study, justifies an accelerated response in bone repair in the irradiated groups compared to control, corroborating the reports of other researchers [51][52][53].…”

Is it possible to anchor a tooth with photobiomodulation?

“…The protocol for preparing a tooth and improving periapical bone density before orthodontic treatment is the same as that used to accelerate tooth movement. The difference between the two scenarios is the stimulus provided by the application of force, which recruits pre-osteoclasts and leads to an increase in osteoclastogenesis[ 13 ]. When applied prior to movement (without force), osteoblast proliferation increases, improving the bone density of the anchoring unit.…”

“…Considering all the above principles, it can be concluded that PBM cannot be used to achieve absolute anchorage of a tooth[ 1 ]; bone remodeling is a dynamic process involving both apposition and resorption. When a laser is applied, it increases osteoblast proliferation without being cytotoxic to preosteoclasts[ 13 ]. During orthodontic treatment, we can achieve differential movements by using PBM as an adjuvant before applying force.…”