Abstract
Objective Low-intensity pulsed ultrasound (LIPUS) is a noninvasive modality to stimulate bone remodeling (BR) and the healing of hard and soft tissues. This research evaluates the biostimulatory effect of LIPUS on the rate of orthodontic tooth movement (OTM) and associated pain, when applied at 3-week intervals. Methods Twenty-two patients (11 males and 11 females; mean age 19.18 ± 2.00 years) having Angle's Class II division 1 malocclusion needing bilateral extractions of maxillary first bicuspids were recruited for this split-mouth randomized clinical trial. After the initial stage of alignment and leveling with contemporary edgewise MBT (McLaughlin–Bennett–Trevisi) prescription brackets (Ortho Organizers, Carlsbad, Calif) of 22 mil, followed by extractions of premolars bilaterally, 6 mm nickel-titanium spring was used to retract the canines separately by applying 150 g force on 0.019 × 0.025-in stainless steel working archwires. LIPUS (1.1 MHz frequency and 30 mW/cm2 intensity output) was applied for 20 minutes extraorally and reapplied after 3 weeks for 2 more successive visits over the root of maxillary canine on the experimental side whereas the other side was placebo. A numerical rating scale- (NRS-) based questionnaire was given to the patients on each visit to record their weekly pain experience. Impressions were also made at each visit before the application of LIPUS (T1, T2, and T3). Models were scanned with a CAD/CAM scanner (Planmeca, Helsinki, Finland). Mann–Whitney U test was applied for comparison of canine movement and pain intensity between both the groups. Results No significant difference in the rate of canine movement was found among the experimental (0.90 mm ± 0.33 mm) and placebo groups (0.81 mm ± 0.32 mm). There was no difference in pain reduction between experimental and placebo groups (p > 0.05). Conclusion Single-dose application of LIPUS at 3-week intervals is ineffective in stimulating the OTM and reducing associated treatment pain.
Highlights
As face and smile is the core of communication, people from different walks of life have become more aware of their dentofacial proportions and facial esthetics
Orthodontic tooth movement is a complex process of bone resorption and deposition in response to mechanical force [2], which involves sequential mechanical cyclical stretches of periodontal ligaments, fluid shear stress and compression, Pain Research and Management inflammatory cytokine production, and cellular differentiation and multiplication, followed by remodeling of the surrounding [3, 4]
Among the least invasive procedures, low-level laser therapy and mechanical vibration have recently gained some popularity in expediting the orthodontic tooth movement and minimizing the associated pain; the results are not predictable [8,9,10,11]
Summary
As face and smile is the core of communication, people from different walks of life have become more aware of their dentofacial proportions and facial esthetics. More and more people are seeking fixed orthodontic treatment, but their prime concern is the lengthy course of treatment and discomfort associated with tooth movement [1]. Orthodontic tooth movement is a complex process of bone resorption and deposition in response to mechanical force [2], which involves sequential mechanical cyclical stretches of periodontal ligaments, fluid shear stress and compression, Pain Research and Management inflammatory cytokine production, and cellular differentiation and multiplication, followed by remodeling of the surrounding [3, 4]. Among the least invasive procedures, low-level laser therapy and mechanical vibration have recently gained some popularity in expediting the orthodontic tooth movement and minimizing the associated pain; the results are not predictable [8,9,10,11]
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