Impact of photobiomodulation on external root resorption during orthodontic tooth movement in humans – A systematic review and meta-analysis

Abstract

BackgroundPhotobiomodulation has been gaining traction as a plausible therapy to control orthodontically induced root resorption. AimThe aim of the present review was to systematically appraise randomized controlled trials conducted to study the influence of photobiomodulation on external root resorption during orthodontic movement in humans. Methodology - A systematic search was carried out employing keywords in various electronic databases namely MEDLINE (Pubmed), Cochrane Library, Google Scholar, Semantic Scholar, ScienceDirect and Opengrey.eu for studies up to March 2020. Pre-defined inclusion and exclusion criteria were used to select the studies. Data extraction was carried out and the risk of bias was assessed using Cochrane Risk of Bias tool. Meta-analysis was conducted using random effects model for selected studies. Subgroup analysis was conducted for resorption on each axial surface of the tooth root viz. mesial, buccal, distal and palatal as well as for vertical thirds viz. cervical, middle and apical third. Summary of Findings was formulated according to GRADE Profile. ResultsThe search retrieved 1509 results out of which six studies were included for the systematic review. Two studies showed low overall risk of bias and the remaining four showed unclear risk of bias. The meta-analysis was conducted for three studies with an overall sample size of 120 teeth which showed a pooled mean difference of 0.08 (95% CI 0.15 – (−0.02) to 1.96, p=<0.0001) in favour of photobiomodulation group with respect to mean total resorption per tooth. I2 index revealed 88% heterogeneity. ConclusionIt is concluded that there is moderate grade of evidence to suggest beneficial effect of photobiomodulation on root resorption. Further high-quality randomized controlled trials with standardized intervention parameters are recommended. RegistrationPROSPERO registration number - CRD42020167291.