The Protocol of Low-level Laser Therapy in Orthodontic Practice

Abstract

A BSTRACT Low-level laser therapy (LLLT) has been widely investigated as an adjunct technique for orthodontic treatment due to photobiomodulation effect. LLLT appears to be supportive for an orthodontic practice in terms of tooth movement acceleration, pain relief, and root resorption management. The decrease in these adverse effects will enhance the compliance in orthodontic patients, which could positively impact treatment outcomes. However, there seemed to be inconsistency in the impact of LLLT as well as its laser and treatment parameters. This scoping review aimed to evaluate the impact of different irradiation parameters on tooth movement acceleration, pain relief, and root resorption as well as to construct a protocol of LLLT in orthodontic practice. The search was conducted across PubMed, Scopus, Web of Science, Embase, Google Scholar, and the reference lists of identified articles. The last search was conducted on October 10, 2021 to identify experiments in humans regarding the application of LLLT as noninvasive treatment in orthodontic practice published between 2010 and 2021. However, they were excluded if they were not clinical research, if they did not report the source of laser, or if they were not relevant to tooth movement, pain perception, and root resorption, or if they were not available in English or in full-text. Following the systematic search and selection process, 60 articles were included in this review. A majority of included articles were published in the past few years. The findings of this review supported the application of LLLT in orthodontic practice with purposes of tooth movement acceleration and pain reduction. The positive impact of LLLT on root resorption had not been clearly evident yet. As this review demonstrated heterogeneity of both laser and treatment parameters, further research should be required to ensure the effectiveness of its specific parameters in orthodontic practice.

Light in Orthodontics: Applications of High-Intensity Lasers, Photobiomodulation, and Antimicrobial Photodymanic Therapies in Daily Practice

“…Extensive efforts have been dedicated to the development of therapies that can accelerate tooth movement, including techniques such as corticotomy and microosteoperforation. Studies conducted on animal and human models have already demonstrated that PBMT is a promising adjunctive tool for enhancing tooth movement (Figure 4), exhibiting proven efficacy and safety, and notably, no reported side effects [8,10,[37][38][39][40][41][42][43]. Orthodontic mechanics rely on the remodeling of periodontal tissue through the activation of various components, including periodontal fibroblasts, osteoblasts, osteocytes, osteoclasts, and the vascular system.…”

“…Evidence suggests that laser procedures promote accelerated health recovery, enabling the patient to proceed to the next stage. Throughout the treatment, photobiomodulation therapy (PBMT) can be used for analgesia after activations, repair of traumatic ulcers, and acceleration of tooth movement [8]. Meanwhile, antimicrobial photodynamic therapy (aPDT) proves to be an effective decontamination tool for numerous clinical infections caused by viruses, fungi, and bacteria.…”

Low-level laser therapy in dentistry

“…The diode laser wavelength of 658nm to 980nm were the most found ranges in the literature however the most common was 810nm and in clinical terms the follow-up application was at 3, 7 and 14 days for the first month and then every 15 days. The radiation points were variable from 2 to 10 points, where 10 points was the most common making an application on the buccal and lingual/palatine surface and the exposure time was variable from 10 to 300sec and the emitted energy of 25 J/cm2 [23] .…”

“…The application of LLLT to accelerate tooth movement was applied immediately after the application of force. The radiation points for each point were variable according to the literature from 2 to 16 where 6 and 10 points were the most common [23] . Application of low-level laser therapy to the condylar regions accelerated functional treatment in patients with skeletal class II malocclusion by approximately 45% and increased bone growth and mandibular length [24] .…”