The Effectiveness of Photobiomodulation Therapy

on Accelerating Orthodontic Tooth Movement: A

Randomized Controlled Trial
 Our team

Dr.Siriporn Silapascran ทพ.ปรัชญ์ หัสดาลอย ทพญ.ฤทธิพร อังสนันท์

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 Introduction
Orthodontic treatment can be a lengthy process, often
lasting up to several years.

Orthodontic treatment requires an average of 18 to 24

months of therapy.

Dental
pain
Increase the risk of gingivitis, caries, and external root
resorption
Introduction
Reduces the duration of orthodontic
treatment time.

Not Simple to Free of side

invasive. use. effects.

Can become part of the orthodontist’s therapeutic

tools.
Introduction
Low-level laser therapy
(LLLT)

Photobiomodulation therapy (PBMT) + Orthodontic

treatment
Accelerating Orthodontic Tooth
Movement
However, the effectiveness of PBM therapy on
accelerating orthodontic movement remains unclear.
 Objective
The objective of this study is to evaluate the effectiveness of PBM therapy on accelerating
orthodontic tooth movement in patients undergoing fixed orthodontic treatment.
Review Literature
Review Literature
The reduction of treatment time in orthodontics
requires
An acceleration of the dental movements.
Can be achieved through
methods

1. Speed up the biological 2. Improving the mechanics and

phenomena behind movements the orthodontic techniques.

surgical, pharmacological, Self-ligating or “low-friction”

Etc. equipment
shown positive results, some
disadvantages prevent them from
being applied in routine clinical
practice.
Am. J. Orthod. Dentofac. Orthop. 1992, 102, 45–
Review Literature

Pharmacological therapy with cytokine, Parathormone PTH,

vitamin D, and RANKL/RANK/OPG show promising results while
on the other hand, relaxin reveals disadvantages, not by accelerating
dental movement, but by increasing tooth mobility.
Ann. N. Y. Acad. Sci. 2005, 1041, 388–
394.
Surgical approaches have the most predictable outcomes but with
limited application due to their aggressiveness.
Am. J. Orthod. Dentofac. Orthop. 2007, 131, 160.e1–
160.e10.
Piezocision technique is considered one of the best surgical
approaches because it produces a good periodontal tissue response
and an excellent aesthetic outcome.
Am. J. Orthod. Dentofac. Orthop. 1998, 114, 372–382.

https://www.youtube.com/watch?v=tohvl04IB8c
 The disadvantage of these surgical techniques, in addition to the
invasiveness, is that the acceleration only occurs in the first 3 to 4 months
and it declines with time to the same level as the controls.
Am. J. Orthod. Dentofac. Orthop. 2011, 139 (Suppl. 4), S83–
S101.

PBMT has shown positive outcomes, but further investigations should be done to
find the best energy and duration to achieve the highest success rate.
Prog. Orthod.
2013.

PBMT
device
Orthodontic tooth movement occurs in the presence of mechanical
stimuli involving remodeling of the alveolar bone and periodontal
ligament (PDL). Bone remodeling is a process that involves both bone
resorption on the pressure site and bone formation on the tension site.
Orthodontic tooth movement can be controlled via the size of the applied
force and the biological responses from the PDL .
Crit. Rev. Oral Biol. Med. 1991, 2, 411–
450.
 หลักการทำงาน
คร่าวๆ

Photobiomodulation therapy
(PBMT)
(low-intensity laser )

photon energy reaches the cell nucleus and increases the synthesis
of
DNA, RNA, protein synthesis.

increases the cellular mitotic

activity.

stimulates the proliferation of osteoclasts, osteoblasts, and fibroblasts, and thereby

affects bone remodeling and accelerates tooth movement.

photo-biostimulating action on cellular metabolic processes, increasing the activity of target cells and the result of the
interaction between cellular chromophores and laser radiation determines the cellular and tissue responses that translates, from
a therapeutic point of view, not only into biostimulation but also into analgesic and anti-inflammatory abilities
. J. Photochem. Photobiol. B Boil. 2016, 154, 8–15.
Methodology
Hypothesis

Hypothesis: Photobiomodulation therapy will accelerate orthodontic tooth movement

compared to a orthodontic treatment with fixed appliances only, as indicated by a significant
difference in the rate of tooth movement between the two groups.
Research design
Randomized controlled trial (RCT) with a single-blind “split-mouth”
design.
The inclusion criteria used for patient selection were the
following:
1.Participants will be recruited from the orthodontic clinic at a Bangkokthonburi
university hospital.
2. The need to extract the first upper and/or lower premolars to obtain the space
necessary for the correct alignment of the arches or the distalization of the frontal sectors
to restore correct antero-posterior occlusal positions (compensate for a class II or solve a
bi-protrusion)

3. Presence of canines, second premolars, and first permanent molars in

the arch
4. good periodontal health
conditions
5. Absence of systemic diseases or pharmacological treatments that could interfere
with the orthodontic movement, such as the intake of analgesic or anti-inflammatory drugs.

The sample size will be determined using power analysis, with a two-tailed alpha
level of 0.05 and power of 0.80
 Randomized controlled trial (RCT) with a single-
blind.
“split-mouth” design
In each patient, the arch(es) subjected to extractions was divided into two sides or
groups

Randomizatio
the experimental or laser group n the placebo group/control group
received irradiation at the level of the canines did not receive irradiation.
canines

The subjects involved were not aware of the quadrant of the arch that would receive the laser treatment (single-blind
RCT)

Two weeks after the extractions, the canines were distalized simultaneously and symmetrically on the experimental and
placebo sides of the arch
 The first activations were performed on the first day of the experimental protocol (day 0) to
trigger orthodontic movement.

The laser application began on the same day as the first activations for canine
retraction

irradiated with an aluminum gallium arsenide (GaAlAs) double-diode laser (LUMIX 2, Fisioline, Verduno, Italy) wavelengths
at 650 nm

PBMT protocol performed on the vestibular and palatal sides of the canine’s root for a total of six points for the laser
application.

The same protocol was repeated on days 3, 7, and 14. PBMT PROTOCOL.

Step 1: Laser Application on Vestibular Side

Apical third (10 s) Medium third (10 s) Cervical third (10 s)

Step 2: Laser Application on Palatal Side

Apical third (10 s) Medium third (10 s) Cervical third (10 s)

 The outcome measure will be the rate of orthodontic tooth movement in 1 month,
measured using digital models. (intra-oral scanner model)

Cusp tip of canine(g,h)- MBcusp of first

Average Distal Displacement Entity of Canines (mm) after 1 Month of Follow-
molar Up (Difference T0 − T2).

Data
Analysis:
Statistical analysis will be performed using SPSS
software
The rate of orthodontic tooth movement will be compared between the experimental and control groups using t-tests
This study will be conducted in
accordance with the ethical principles
outlined in the Declaration of Helsinki.

Participants will provide written informed

consent prior to enrollment in the study.
 Conclus
ion
This study will provide valuable
information on the effectiveness
of PBM therapy in accelerating
orthodontic tooth movement. If
successful, PBM therapy could
potentially be used as a clinical
tool to reduce treatment time and
improve patient satisfaction in
orthodontic treatment.
 Thank you
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