Effectiveness of Low-Level Laser Therapy in Reducing Orthodontic Pain: A Systematic Review and Meta-Analysis.

Naira Figueiredo Deana,Carlos Zaror,Nilton Alves,Paulo Sandoval

doi:10.1155/2017/8560652

Naira Figueiredo Deana, Carlos Zaror + Show 2 more

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https://doi.org/10.1155/2017/8560652

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Abstract

Objectives To assess the effectiveness of low-level laser therapy (LLLT) in reducing orthodontic pain after the application of orthodontic force (OF). Methods A systematic search was conducted in the MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science, and EBSCOhost databases. The study included randomized clinical trials (RCT) which analysed the effectiveness of LLLT in reducing orthodontic pain assessed at 24 and 72 hrs after the application of OF. The risk of bias of the eligible trials was assessed using the Cochrane Collaboration's risk of bias tool. Standard mean difference was calculated and pooled by meta-analysis using random effect models. ResultsOf 467 identified articles, 20 RCT were finally included. In the risk of bias assessments, 13 studies presented a high risk, 5 an unclear risk, and 2 a low risk. The meta-analysis showed that in patients treated with laser versus placebo there was a difference in favour of LLLT in spontaneous pain 24 and 72 hrs after the installation of light archwires and spontaneous pain and chewing pain 24 and 72 hrs after the installation of elastomeric separators. ConclusionsLLLT proved to be effective in promoting a reduction in spontaneous and chewing pain after the application of OF; however, the poor quality of the evidence requires these results to be treated with caution.

Highlights

Orthodontic treatment (OT) is essential for functional and aesthetic rehabilitation of the chewing apparatus [1]
Various methods have been proposed for reducing the discomfort caused by pain during tooth movement, such as the use of anti-inflammatory medication [14], acupuncture [15], and low-level laser therapy (LLLT) [16]; the secondary effects of the administration of nonsteroidal antiinflammatory drugs (NSAID) may affect the rate of movement [14, 17]
The research question for this work was as follows: Are the intensity and duration of the pain produced by the application of orthodontic force lower in patients who have received near infrared low-level laser therapy than in patients who received a placebo or no therapy of any kind? The aim of this study was to assess the effectiveness of near infrared low-level laser therapy in reducing orthodontic pain after the application of orthodontic force

Summary

Introduction

Orthodontic treatment (OT) is essential for functional and aesthetic rehabilitation of the chewing apparatus [1]. The application of orthodontic force and consequent tooth movement promote remodelling of the alveolar bone around the tooth root [2,3,4]. The application of force to a tooth triggers a temporary inflammatory process mediated by a variety of inflammatory cytokines, with no pathological condition [5]. When a mechanical force is applied to the teeth, an inflammatory reaction is triggered in the periodontal tissue [11] resulting in the release of inflammatory mediators such as prostaglandins, T substance, histamine, and serotonin [12]. Previous studies have indicated that an increase in prostaglandin-E2 (PGE2) levels is related to the initial intensity of the pain, while an increase in interleukin-1 is related to pain occurring 24 hours after the application of orthodontic force [13]

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