Laser-Assisted Orthodontic Tooth Movement in Saudi Population: A Prospective Clinical Intervention of Low-Level Laser Therapy in the 1st Week of Pain Perception in Four Treatment Modalities
Table 1
Subjects and methodology in detail.
Selection guideline
Inclusive
Exclusive
Angle class I or II or III malocclusion with ectopic maxillary canine requiring space creation or extraction of first premolar.
Patient on long-term medication, craniofacial anomalies/malformation, with parafunctional habits, temporomandibular joint dysfunction, multiple missing teeth, and periodontally compromised
Population
Patients in orthodontic treatment
Intervention
Laser-assisted orthodontic tooth movement
Comparison
Nonlaser-assisted orthodontic tooth movement
Outcome
Laser-assisted orthodontic tooth movement
Study design
Prospective clinical intervention
Sample size calculation
GPower software version 3.0.10 with power 80%, α 0.05, and effect size (d) 0.22 was used. Hence, the total sample size intended for this research was 32, each group required minimum of 8 subjects.
Study groups
Laser
Nonlaser
Treatment modalities
Self-ligating
Conventional
Self-ligating
Conventional
Number of subjects
8
8
8
8
Age of subjects
Between 14 and 25.
Armamentarium
The laser unit was a 940 nm aluminum-gallium-arsenide (Al-Ga-As) diode laser (iLase; Biolase, Irvine, CA, USA) set on continuous mode with power at 100 mW. The diameter of the optical fiber tip was 0.04 cm2, the energy density was calculated to be 7.5 J/cm2 for each point, and total energy density was 75 J per tooth.
Orthodontic treatment
For all patients, treatment has been commenced by bonding the upper arch with preadjusted edgewise 0.022 inch slot MBT prescription brackets, Agility® self-ligating bracket system (Franklin, USA), and ortho organizers conventional type bracket system (Carlsbad, CA, USA). Alignment and leveling started using 0.012 inch superelastic nickel-titanium (NiTi) wire followed by 0.014, 0.016, and 0.018 in NiTi wires, changed at 4-week interval between each wire.
Laser application
Laser applied on gingival mucosa for 3 seconds each on 5 points labially/buccally and palatally per tooth, starting from central incisor to the first molar. These points were mesial and distal over the cervical-third of the root and the middle of the root and also mesial and distal over the apical-third of the root. The fiber tip of the laser was in close but light contact with the surface of the gingival tissues and held perpendicular to the mucosa overlying the roots of teeth.
Pain perception
Numerical rating scale (NRS) questionnaire was used to measure pain intensity. After orthodontic bracket bonding and/or application of laser, these questionnaires were given to the participants to be completed at home and returned at the following appointment. The participants were asked to record pain after 4 hours, 24 hours, 3 days, and 7 days. In addition, telephone calls/messages were made at day-3 and day-7 to ensure accurate collection of data.
Statistical analysis
IBM SPSS Statistics version 22.0 (IBM Co., Armonk, NY, USA) was used to analyze the data. Descriptive analysis was performed to obtain the mean values of pain in among 4 groups. Since the distribution of data was not normal, series of Mann–Whitney U test was used to compare the level of pain between 2 groups. A scatterplot matrix with all scatterplots is presented. Kruskal–Wallis H test was performed to see the differences among 4 groups.
