Low-level laser therapy increases interleukin-1β in gingival crevicular fluid and enhances the rate of orthodontic tooth movement.

Abstract

We read with great interest the well performed study in the October issue, “Low-level laser therapy increases interleukin-1β in gingival crevicular fluid and enhances the rate of orthodontic tooth movement” (Varella AM, Revankar AV, Patil AK. Am J Orthod Dentofacial Orthop 2018;154:535-44.e5), on the effects of low-level laser therapy on interleukin (IL) 1β levels in gingival crevicular fluid and its correlation with orthodontic tooth movement. As stated in the article,1Varella A.M. Revankar A.V. Patil A.K. Low-level laser therapy increases interleukin-1β in gingival crevicular fluid and enhances the rate of orthodontic tooth movement.Am J Orthod Dentofacial Orthop. 2018; 154: 535-544Abstract Full Text Full Text PDF Scopus (29) Google Scholar orthodontic tooth movement is a highly complex process defined as an adaptive biologic response to interference in the physiologic equilibrium of the dentofacial structures by an externally applied force,2Isola G. Matarese G. Cordasco G. Perillo L. Ramaglia L. Mechanobiology of the tooth movement during the orthodontic treatment: a literature review.Minerva Stomatol. 2016; 65: 299-327PubMed Google Scholar from both biomechanical and biologic points of view. This stress, which accumulates over time in the periodontal apparatus, can result in a significant reduction in the speed of the tooth movement and in the relative orthodontic treatment length, a condition that sometimes determines the success of the treatment. Among the possible agents for dental movement, low-level laser therapy (LLLT) has been shown to be a valid method that sustains tooth movement by means of the photobiostimulation effect which would allow a greater speed of orthodontic movement.3Matarese G. Ramaglia L. Cicciù M. Cordasco G. Isola G. The effects of diode laser therapy as an adjunct to scaling and root planing in the treatment of aggressive periodontitis: a 1-year randomized controlled clinical trial.Photomed Laser Surg. 2017; 35: 702-709Google Scholar The tissue-stimulating effect induced by LLLT is also due to the biologic growth and metabolic changes of soft and hard oral tissues, which stimulates, in the long term, a better bone and tissue neoformation process, which also facilitates a greater shift in the shortest time.4Qamruddin I. Alam M.K. Mahroof V. Fida M. Khamis M.F. Husein A. Effects of low-level laser irradiation on the rate of orthodontic tooth movement and associated pain with self-ligating brackets.Am J Orthod Dentofacial Orthop. 2017; 152: 622-630Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar Moreover, the use of LLLT in the orthodontic field has been shown to be effective in tissue biostimulation, with stimulating effects in tissue repair and dental displacement, as well as inhibiting the release of pain mediators related to analgesia.5Deana N.F. Zaror C. Sandoval P. Alves N. Effectiveness of low-level laser therapy in reducing orthodontic pain: a systematic review and meta-analysis.Pain Res Manag. 2017; 2017: 8560652Google Scholar Therefore, due to the importance of the topic analyzed in the study, we have some comments about some missing points of their detailed and well performed analysis. As reported by Varella et al,1Varella A.M. Revankar A.V. Patil A.K. Low-level laser therapy increases interleukin-1β in gingival crevicular fluid and enhances the rate of orthodontic tooth movement.Am J Orthod Dentofacial Orthop. 2018; 154: 535-544Abstract Full Text Full Text PDF Scopus (29) Google Scholar their treated patient presented increased levels of IL-1β in the experimental teeth treated with LLLT compared with the control canines, with a positive correlation between the IL-1β levels and the amounts of tooth movement across all time intervals. In this regard, did the authors also analyze the IL-10 levels and the IL-1β/IL-10 ratio? Previous investigators have suggested that a higher IL-1β/IL-10 ratio may be correlated with a good status of periodontal health as indicated by a lower proportion of periodontal pathogens of the orange and red complex.6Goutoudi P. Diza E. Arvanitidou M. Effect of periodontal therapy on crevicular fluid interleukin-1β and interleukin-10 levels in chronic periodontitis.J Dent. 2004; 32: 511-520Crossref PubMed Scopus (103) Google Scholar Furthermore, did the authors evaluate (maybe unpublished data) the effectiveness of LLLT in reducing orthodontic pain? Previous studies have indicated that an increase in prostaglandin-E2 (PGE2) levels is related to the initial intensity of the pain, and that an increase in IL-1 is related to pain occurring 24 hours after the application of orthodontic force.7Youssef M. Ashkar S. Hamade E. Gutknecht N. Lampert F. Mir M. The effect of low-level laser therapy during orthodontic movement: a preliminary study.Lasers Med Sci. 2008; 23: 27-33Crossref PubMed Scopus (179) Google Scholar Moreover, LLLT has been shown to be effective for treating orthodontic pain because it is easy to apply and a noninvasive tool in orthodontic patients.5Deana N.F. Zaror C. Sandoval P. Alves N. Effectiveness of low-level laser therapy in reducing orthodontic pain: a systematic review and meta-analysis.Pain Res Manag. 2017; 2017: 8560652Google Scholar We compliment the authors for conducting this important study that raises interesting questions to discuss and suggests these different and alternative orthodontic treatment methods. It is our opinion that more studies aimed at describing the different adjunct in the orthodontic procedures should be performed in the orthodontic field. A more comprehensive detailed approach could also stimulate further clinicians and researcher to provide further methods, maybe with a multidisciplinary approach, aimed at opening up future directions for the LLLT during orthodontic treatment. Authors' responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 155Issue 4PreviewWe appreciate the interest from the readers of AJO-DO in our article (Varella A, Revankar AV, Patil AK. Low-level laser therapy increases interleukin 1β in gingival crevicular fluid and enhances the rate of tooth movement in humans. Am J Orthod Dentofacial Orthop 2018;154:535-44). We would like to clarify some misunderstandings related to the article. Full-Text PDF