Abstract
The aim of this retrospective clinical study was to determine if there is a reduction in the overall treatment duration in orthodontic patients using low-intensity pulsed ultrasound (LIPUS) and Invisalign SmartTrack® clear aligners. Data were collected from the first thirty-four patients (9 males, 25 females; average age 41.37 ± 15.02) who finished their orthodontic treatment using an intraoral LIPUS device and Invisalign clear aligners in a private clinic. The LIPUS parameters used by patients at home for 20 min/day were: ultrasonic frequency 1.5 MHz, pulse duration 200µs, pulse repetition rate 1 kHz, and spatial average-temporal average intensity 30mW/cm2. A control group (11 males, 23 females; average age 31.36 ± 14.41) matching for the same malocclusions was randomly selected from finished treatment cases of the same clinician. The date of first Invisalign attachment placement and first use of LIPUS application was recorded as T0, and the date of retainer delivery was recorded as T1. The treatment duration (T1–T0) and treatment reduction percentage with LIPUS device were collected and analyzed using two-sample t-test in Microsoft Excel. Treatment duration was significantly reduced in the LIPUS group (541.44 ± 192.23 days) compared to control group (1061.05 ± 455.64 days) (p < 0.05). The LIPUS group showed on average 49% reduction in the overall treatment time as compared to the control group. The average compliance of the patients using LIPUS was 66.02%. Patients who used LIPUS showed a clinically significant reduction in the overall orthodontic treatment duration compared to the control group who used Invisalign clear aligners only.
Highlights
Malocclusion is defined as misalignment of teeth and/or jaws in any or all the three dimensions of space
Tooth roots are covered by special mineralized tissue cementum that is connected to the alveolar bone through the surrounding highly vascularized soft connective tissue, the periodontal ligament (PDL) [2]
The current retrospective clinical study analyzed the effect of low-intensity pulsed ultrasound (LIPUS) on the orthodontic treatment time reduction using Invisalign clear aligners
Summary
Malocclusion is defined as misalignment of teeth and/or jaws in any or all the three dimensions of space. Tooth roots are covered by special mineralized tissue cementum that is connected to the alveolar bone through the surrounding highly vascularized soft connective tissue, the periodontal ligament (PDL) [2]. The compression of blood vessels in PDL on the pressure side leads to decreased nutrient flow, stenosis, and formation of necrotic tissue [7,8]. This inflammatory process causes migration of phagocytic cells, like macrophages, giant cells, and osteoclasts, which further leads to bone resorption on the pressure side of PDL. Change in orthodontic biomechanics by using low friction/frictionless orthodontic techniques, and development of various techniques to accelerate OTM, including pharmacological agents (e.g., parathyroid hormone, Vitamin D3, Prostaglandins) [10], magnetic fields [11], corticotomy [12], distraction osteogenesis [13], low-level laser [14], and mechanical vibration [15]
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