Comparison of Rate of Tooth Movement, Root Resorption and Pulp Vitality during En masse Anterior Retraction with Micro-osteoperforation and Low Level Laser Therapy: A Randomised Clinical Trial

Abstract

Introduction: Micro-osteoperforation (MOP) and Low Level Laser Therapy (LLLT) are rapidly gaining popularity in clinical practice due their proven success in accelerating tooth movement and acceptable patient compliance. However, literature shows an inconsistent and variable evidence of their iatrogenic effects on the root and pulp due to biological variations of the samples chosen by the previously studies. Aim: To evaluate and compare the rate of tooth movement, changes in amount of external root resorption and pulp vitality in teeth during en masse anterior retraction associated with MOP and LLLT using split mouth technique. Materials and Methods: This was a double blinded, single center split mouth randomised clinical trial conducted at Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, Bangalore, Karnataka, India from March 2019 to October 2019. Total of 11 patients with bimaxillary dentoalveolar protrusion which required all four first premolar extractions were included in the study. Nickel Titanium (NiTi) closed coil springs were used for en masse retraction in upper and lower arches with force of 150g per side. Root resorption of all anterior teeth was evaluated using Cone Beam Computed Tomography systems (CBCT) and pulp vitality was checked using cold test after 4 months. The data was entered in Microsoft excel and the Statistical Package for Social Sciences software (SPSS) version 18.5 (SPSS Inc, Chicago) software was used for data entry and statistical analysis. A p-value of less than 0.05 was considered as statistically significant. Results: Total of 11 patients in which 9 were females and 2 males aged between 18-30 years with mean age 19±4.21 year, participated in this trial. LLLT (4 mm) and MOP (4.05 mm) showed similar performance in acceleration of tooth compared to each other. The overall root resorption was more in the experimental groups (LLLT- 2.60 mm, MOP- 2.84 mm) compared to the allotted controls. However, the canine showed less root resorption in both the experimental groups compared to the control. The overall root resorption was similar in both the experimental groups. The canine in LLLT group (0.30 mm) showed less root resorption compared to canine in MOP group (0.59 mm). There was no change in the pulp vitality status in both the experimental groups and the control groups. Conclusion: The overall root resorption in a given quadrant increases with increased rate of tooth movement. The tooth which was subjected to acceleratory orthodontic technique showed less root resorption compared to control. The tooth subjected to LLLT showed less root resorption as compared to the tooth subjected to MOP.