Evaluation of photobiomodulation therapy to accelerate bone formation in the mid palatal suture after rapid palatal expansion: a randomized clinical trial

Abstract

To evaluate the efficiency of photobiomodulation therapy (PBMT) in the midpalatal suture (MPS) and pain sensation in patients undergoing rapid palatal expansion (RPE). Thirty-four individuals with the diagnosis of skeletal maxillary hypoplasia were divided in two groups: laser (n = 18) and control (n = 16). Treatment plan consisted of the use of the Hyrax expander in all patients. Subjects in the laser group were irradiated with diode laser (980 nm, 0.3 W) in six spots bilaterally distributed along the MPS for 10 s during the active phase of treatment and after overcorrection (passive phase of RPE). Control group received sham irradiations with the laser in standby mode to characterize the placebo effect. Digital occlusal radiographs were performed at different time-points for bone formation evaluation in both groups. The effects of laser irradiation on pain were assessed by the visual analog scale (Wong-Baker Faces Pain Scale). Bone formation between groups was not significantly different (p = 0.2273). At 3 months, bone formation was not yet complete in both groups. Pain sensation was similar between groups (p = 0.3940). However, pain was significantly higher for the first 7 days of treatment compared with the 14th day. PBMT did not accelerate bone regeneration in the MPS and pain sensation was similar.

Effect of Low-Level Laser Therapy on Bone Formation in Rapid Palatal Expansion: A Systematic Review

“…In Matos and colleagues' study, 13 unlike the other three, the mean age of the control group (8.2 years) was significantly lower than the laser group (9.2) (P = 0.0308), but sex was kept similar between the two groups. This article showed no significant difference in bone formation and pain sensation in the case of laser irradiation.…”

“…A third author evaluated any disagreements to reach a solution. Finally, 4 articles 12,13,25,26 met the inclusion criteria. The PRISMA diagram of the included studies is shown in Figure 1.…”

“…Cepera et al 26 Garcia, V. J. et al (12) (2015) Ferreira, F. N. et al (25) (2015) Matos, D. S. et al (13) Incisal papilla, at the regions right and left to the palatal raphe, and most posterior region along the midpalatal suture 6 spots distributed bilaterally, parallel and at a 0.5 cm distance from the suture…”

“…11 Low-level laser therapy (LLLT) uses low and non-thermal energy to accelerate tissue repair procedures and metabolic bone activities. 15 Many studies on animals 16,17 and humans 13 have confirmed the advantages of LLLT during new bone formation. Thus, using LLLT has been recommended to improve the retention of RME.…”

“…11 Different methods have been tested to increase the speed of bone remodeling, like the case of drug injections, the application of ultrasound, an orthodontic treatment combined with periodontal surgery with a bone graft, and the application of low-intensity lasers. 12 Low-intensity lasers are accepted in orthodontic treatments due to their biostimulating effects on pain reduction, 13 acceleration in tooth movement, 14 and alveolar remodeling. 11 Low-level laser therapy (LLLT) uses low and non-thermal energy to accelerate tissue repair procedures and metabolic bone activities.…”