Abstract
The objective of this review was to critically and systematically appraise the available evidence regarding the effectiveness of high-energy laser therapy (HELT) with flapless corticotomy in accelerating orthodontic tooth movement and the associated untoward effects.We searched eight databases electronically in August 2021: PubMed®, Medline®, Google Scholar, Cochrane Library, Scopus®, Web of Science™, Trip, and PQDT OPEN from ProQuest. Another search was done in the reference lists of the included studies. Randomized controlled trials (RCTs) were included in which patients had received fixed orthodontic treatment combined with HELT-assisted corticotomy in comparison with traditional orthodontic treatment. Cochrane’s risk of bias (RoB2) tool was used to assess the risk of bias.Five RCTs and one CCT were included in this review (155 patients). The HELT-based corticotomy around the upper canines led to a greater canine retraction at the first and second months (P < 0.001). In the third month, no statistically significant differences were noticed. In one RCT focusing on incisor intrusion, the irradiated upper incisors showed a greater intrusion speed than that of the control group (4.587 mm in 59 days vs. 3.78 mm in 95.8 days, respectively). No significant side effects associated with the application of HELT were reported. According to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach, the quality of evidence supporting these findings was low to moderate.Although the acceleration of tooth movement appeared to be significant at least in the first two months, there was low to moderate evidence concerning the efficacy of HELT-based flapless corticotomy in the acceleration of orthodontic tooth movement. There is a need for more well-conducted high-quality RCTs.
Highlights
BackgroundTraditional orthodontic treatment for moderate to severe malocclusions usually takes several years when fixed appliances are used [1], and this can reduce patient compliance and cause multiple side effects [2]
No systematic review was found in the literature evaluating the effectiveness of high-energy laser therapy with flapless corticotomy in accelerating orthodontic tooth movement
This study reported a significant difference in treatment time between the conventional and experimental groups (3.78 mm in 95.8 days vs. 4.587 mm in 59 days, respectively)
Summary
Traditional orthodontic treatment for moderate to severe malocclusions usually takes several years when fixed appliances are used [1], and this can reduce patient compliance and cause multiple side effects [2]. High-energy laser treatment (HELT) has a power output greater than 500 mW and can be used for cutting soft and hard tissues. High-energy laser therapy (HELT) is widely used in dentistry; it is used in caries removal, bacterial reduction during endodontic therapy, treatment of dentinal hypersensitivity, periodontal therapy, gingivectomy, and bone and soft tissue ablation [9]. HELT has been shown to be effective in preventing enamel demineralization [10], preparation of surfaces for bracket bonding [11], debonding of ceramic brackets [12], and accelerating tooth movements [13]
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