Laser Corticotomy Research Articles

Effect of laser corticotomy on canine retraction rate: a split-mouth randomized clinical trial

BackgroundThis study assessed the effect of corticotomy with Er: YAG (erbium-doped yttrium aluminium garnet) laser on the rate of canine retraction.MethodsThis randomized split-mouth controlled clinical trial was conducted on 12 patients undergoing orthodontic treatment with extraction of maxillary first premolars. Following initial leveling and alignment, an alginate impression was made from the maxillary arch, and Er: YAG laser corticotomy was performed in one of the maxillary quadrants of each patient. Canine retraction was started immediately after corticotomy by placement of nickel-titanium (NiTi) closed coil springs at both sides. At the end of each month, alginate records were repeated for 4 months. Study models were scanned, and the anteroposterior movement of canine was quantified bilaterally. Pain was also measured by a visual analog scale (VAS). Probing depth (PPD) of canines and two adjacent teeth was also evaluated and pulp vitality was assessed by performing the cold test. Data were analyzed by paired and independent t-test and one-way ANOVA (alpha = 0.05).ResultsThe rate of canine retraction was significantly greater in the laser-assisted corticotomy quadrant than the control (P < 0.05). No significant difference existed in posterior anchorage loss, canine rotation angle, PPD, pulp vitality, or pain score between two groups (P > 0.05).ConclusionsFlapless Er: YAG laser corticotomy significantly enhanced canine retraction rate with no adverse effect on other parameters.

Comparison of Upper and Lower Canine Retraction Rates Assisted by Flapless Laser Corticotomy.

Comparison of Upper and Lower Canine Retraction Rates Assisted by Flapless Laser Corticotomy.

Effects of Flapless Laser Corticotomy in Upper and Lower Canine Retraction: A Split-mouth, Randomized Controlled Trial.

Aim One of the major difficulties in orthodontic treatment is the lengthy course of therapy, particularly in situations involving extractions. Hence, various methods for accelerating tooth movement rate had been devised. Flapless corticotomy is one of those methods. This study aimed to evaluate the effects of flapless laser corticotomy (FLC) compared to the conventional retraction (CR) method on the rate of canine retraction. Methods A split-mouth, randomized controlled trial included 56 canines from 14 patients (12 females and two males) with a mean age of 20.4 ± 2.5 years, who were complaining of bimaxillary protrusion requiring extraction of four premolars. All canines were randomly assigned to four groups (maxillary FLC, maxillary control CR, mandibular FLC, and mandibular control CR). Randomization was performed by creating two equal, random computer-generated lists with a 1:1 allocation ratio-one list for the right side and one for the left. The allocation concealment was achieved using opaque sealed envelopes until the time of intervention. FLC was applied on the experimental sides before canine retraction by drilling six holes penetrating 3 mm into the bone on the mesial and distal sides of the canines. Subsequently, all canines were retracted employing closed coil springs to deliver a force of 150 g using indirect anchorage from temporary anchorage devices (TADs).All canines were assessed at T0 (before retraction), T1 (one month after retraction), T2 (two months), and T3 (three months) using three-dimensional (3D) digital models. Additionally, canine rotation, molar anchorage loss assessed using 3D digital models, root resorption assessed using cone beam computed tomography (CBCT), probing depth, plaque, gingival indices, and pulp vitality were all evaluated as secondary outcomes. It was possible to blind only the outcome analysis expert (single-blinded). Results The measurementsof canine retraction during the follow-up period from T0 to T3 were 2.46 ± 0.80 mm and 2.55 ± 0.79 mm in maxillary FLC and control groups, respectively, and 2.44 ± 0.96 mm and 2.31 ± 0.95 mm in mandibular FLC and control groups, respectively. The results demonstrated a statistically non-significant difference in the distance of canine retraction between the FLC and control groups at all time points. Moreover, no differences were observed between groups in canine rotation, molar anchorage loss, root resorption, probing depth, plaque, gingival indices, and pulp vitality (p > 0.05). Conclusion In the FLC procedure performed in this study, the rate of upper and lower canine retraction could not be accelerated and no significant differences were observed between FLC and control groups in canine rotation, molar anchorage loss, root resorption, periodontal condition, and pulp vitality.

Assessment of Accelerating Orthodontic Tooth Movement by Hard Laser Corticotomy

Assessment of Accelerating Orthodontic Tooth Movement by Hard Laser Corticotomy

Algorithms for orthodontic treatment of patients with maxillary constriction based on the stages of formation of the palatal suture

Improving the effectiveness of complex orthodontic treatment of patients with constriction and deformation of the upper jaw during the period of replacement and permanent bite based on the analysis of cone-beam computed tomography (CBCT) data. The results of complex treatment of 70 patients with constriction and deformation of the upper jaw during the period of temporary and permanent bite are presented. The patients were divided into groups according to the stage of formation of the midpalatal suture: 1st group - 40 patients with stage «A» and «B» (average age 11.5 years); 2nd group - 15 patients with stage «C» (average age 20.5 years); 3rd group - 15 patients with stage «D» and «E» (average age 24.5 years). Orthodontic treatment was carried out using palatine expanders with a dental and intraosseous type of fixation. The complex treatment consisted of: orthodontic treatment using a bracket system, transgingival laser corticotomy, piezocorticotomy, surgically assisted rapid palatal expansion, orthodontic appliances for the expansion of the upper jaw. After conducting a clinical X-ray examination of all patients and analyzing the data obtained, we developed algorithms for therapeutic measures. As a result of the diagnosis and treatment planning, the expansion of the upper jaw was achieved both at the dental alveolar and skeletal levels. Detailed algorithms of complex treatment were developed based on the analysis of CBCT data, the stage of formation of the midpalatal suture individually for each patient. It was found that the analysis of CBCT data makes it possible to choose the optimal treatment method for patients with skeletal deformities of the dentition complex, thereby increasing the effectiveness of orthodontic treatment.

Improving the effectiveness of treatment of the adult patients with dentoalveolar anomalies and deformities using Er,Cr:YSGG laser: a clinical study

Of the work is to develop and substantiate the method of minimally invasive complex orthodontic treatment of patients with constriction and deformation of the upper jaw in the period of permanent bite with the combined use of a bracket system, orthodontic devices for the expansion of the upper jaw and fractional photothermolysis to improve the effectiveness of complex treatment. The results of complex treatment of patients with the deficiency of the upper jaw in the period of permanent bite are presented. Complex treatment consisted of orthodontic treatment using a bracket system, laser corticotomy, orthodontic devices for the expansion of the upper jaw. Ultrasound examination before and after the procedure was performed to obtain reliable results of laser impact on bone tissue. After conducting a clinical and radiological examination (using cone-beam computed tomography) of all patients and analyzing the data obtained, we have developed algorithms for therapeutic measures. As a result of orthodontic treatment aimed at the expansion of the upper jaw patients who underwent fractional photothermolysis procedure achieved the expansion of the upper jaw at both the dentoalveolar and skeletal levels. It was found that a comprehensive approach with minimally invasive effects can improve the effectiveness of treatment of patients with constriction and deformation of the upper jaw during the period of permanent bite and achieve stable treatment results.

Efficacy of Er,Cr Laser incision Corticotomy in Rapid Maxillary Canine Retraction: A Split-Mouth Randomized Clinical Trial.

Introduction: This study sought to evaluate the efficacy of lasercision corticotomy for the acceleration of canine movement. Our secondary objectives were assessing the canine rotation, the rate of anchorage control, the level of pain, and the gingival index (GI). Methods: Twelve orthodontic patients (9 females and 3 males) referring to the School of Dentistry and one dental clinic from May 2019 to September 2019 participated in this split-mouth randomized clinical trial. The allocation of the test and control sides was performed by flipping a coin. The mean age of patients was 18.91±3.87 years (range 15-30 years). The treatment plan included maxillary first premolar extraction. Following the initial leveling and alignment phase, an initial impression was made. Corticotomy was carried out with the erbium, chromium-doped yttrium scandium gallium garnet (Er, Cr: YSGG) laser (3.5 W, 30 Hz, 40% air, 80% water) in one maxillary quadrant (the laser side). Canine retraction was immediately initiated following surgery using nickel-titanium closed-coil springs with 150 g force. The impression was repeated 1 month after the onset of retraction. The casts were scanned, and the distance between the canine cusp tip and the rugae line was measured to quantify the amount of anteroposterior canine movement. The molar anchorage control was also evaluated by measuring the distance between the mesial contact of the permanent first molar and the rugae line. Gingival health was evaluated using the GI. The modified McGill pain questionnaire was used to assess the level of patients' pain. Results: Lasercision corticotomy accelerated canine retraction with no adverse effect on gingival health. Anchorage loss in the posterior teeth and pain scores were not significantly different between the control and laser sides. Conclusion: Laser corticotomy can effectively accelerate canine retraction with no complications or discomfort for the patients.

Complex orthodontic-surgical rehabilitation of adults with malocclusions and deformations in dentition

The aim of the study was the development and substantiation of the method of orthodontic treatment of patients with malocclusions and deformities of dentoalveolar arches with the combined use of braces, orthodontic miniscrew, piezo-surgical corticotomy or laser corticotomy to improve the efficiency and reduce the time of complex treatment. The results of complex rehabilitation of 80 adult patients with dentoalveolar anomalies and deformities of dentition are presented. As a result of the orthodontic treatment of patients who underwent piezo-surgical corticotomy the bodily movement of the posterior teeth in the area of the previously removed tooth was achieved. After piezo-surgical or laser corticotomy the rate of tooth protraction remained elevated for 3 to 5 months (on average 0.3±0.5 mm/month), then gradually decreased. Piezo-surgical corticotomy led to a decrease in bone density, which was measured on the Hounsfield scale. As a result of orthodontic treatment in patients who underwent laser corticotomy an expansion of the upper jaw and normalization of occlusion in the transversal and sagittal directions was achieved: in the region of the hard palate by 7.1±0.4 mm; in the region of the alveolar bone by 6.5±0.5 mm; in the region of the roots of molars by 6.4±0.9 mm; in the area of crowns of molars by 8.3±0.7 mm. It was found that the combined use of piezo-surgical corticotomy and orthodontic miniscrews improve the efficiency and reduce the duration of orthodontic treatment by 3 to 6 months.

Acceleration of Canine Movement by Laser Assisted Flapless Corticotomy : An Innovative Approach in Clinical Orthodontics

Background: Corticotomy-assisted orthodontic treatment is done to induce a state of increased tissue turnover and transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. It considered as an adjunct treatment option for orthodontic treatment of adults. The aim of this Study was to elucidate the effectiveness of a new surgical approach for acceleration of maxillary canine retraction in human with laser assisted flapless corticotomy and evaluate its effect on vitality of pulp and gingival sulcus depth. Materials and methods: the sample comprised of 15 Iraqi patients (9 females and 6 males; mean age 21.7), who were required extraction for their maxillary first premolars followed by retraction of the canines as part of their orthodontic treatment plan. The study was designed as a split-mouth study. Decortications were done in the second stage of orthodontic treatment using Er:YAG laser to perform series of holes mesially and distally to the canine at the side with more space between the canine and second premolar without reflecting a surgical flap. The net canine movements and molar anchorage loss were calculated after six weeks. Vitality test, radiographical assessment and gingival sulcus depth were investigated. Results and Conclusions: The canines on the laser corticotomy side showed statisticaly higher mean value of retraction than their controls during six weeks period. Pulp vitality response and post surgery gingival sulcus depth showed no significant difference between the pre-laser and post-laser surgery. Based on the result of our study, flapless laser assisted corticotomy can be considered for acceleration of orthodontic tooth movement in humans.

THE INNOVATED LASER ASSISTED FLAPLESS CORTICOTOMY TO ENHANCE ORTHODONTIC TOOTH MOVEMENT

Introduction: Corticotomy-facilitated orthodontics provides a means for rapidly moving teeth purportedly with little damaging effects to the periodontium and with greatly reduced treatment time. The aim of this study was to enhance the orthodontic tooth movement by reducing the cortical bone layer (resistant to bone re-sorption relative to spongious bone) following Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er-Cr: YSGG)laser irradiation, without reflection of surgical soft tissue flap. Methods: In the present experimental study, 8 New Zealand Male rabbits were the samples for the research. The right first premolar of each rabbit (experiment group) underwent treatment for mesial movement with 75 gram of orthodontic force by using closed Ni-Ti coil spring (Dentaurum®). Coil spring was fixed in the cervical region of first premolars by means of ligature wire and No-Mix composite (Dentaurum®) and also activated to the cervical site of incisors. The left first premolars of the subjects were considered as the control group. Laser corticotomy was performed in anesthetized rabbits. Samples were sacrificed for determination of tooth movement after initiating premolar protraction on the 21 th day. The amount of orthodontic tooth movement was assessed by using a metal feeler gauge with the precision of 0.01 mm, between mesial surface of the second premolars and distal surfaces of the first premolars. The statistical package of SPSS (Kolmogorov - Smirnov and ANOVA test) was used for analytical evaluation of the measurements. Results: The amount of orthodontic tooth movement in the experimental group (mean=1.653±0.34 mm) was significantly (p<0.001) greater than that of the control group (mean=0.936 ±0.28 mm). The innovated laser assisted corticotomies enhanced the rate of orthodontic tooth movement on the intervention side, significantly (p<0.001). Conclusion: The innovated method of laser assisted flapless corticotomy is a useful procedure for reducing treatment time and damage to periodontium. It also eliminates the necessity of more invasive intervention of flap surgery.

Neurophysiological monitoring of alveolar nerve function during sensor-controlled Er:YAG laser corticotomy in rabbits

The sensor-controlled Er:YAG laser system may be a potent tool for tissue specific cutting in surgery. In order to investigate the impact of the laser on neural tissues, inferior alveolar nerve (IAN) function was monitored by the jaw-opening reflex (JOR) during specific corticotomy in rabbits. Laser jaw corticotomy was performed in 13 anesthetized rabbits. During and after specific corticotomy the JOR was evoked by electric intraoral stimulation to monitor effects on IAN function. The JOR permanently abolished in one case and transiently failed immediately after surgery but largely recovered within days in another rabbit. In one experiment JOR threshold increased 7 days after corticotomy. Histology did not prove any objective nerve pathology. Monitoring IAN function by the JOR demonstrated the relatively low risk of nerve damaging during sensor-controlled laser corticotomy.

Comparison of the Effect of the Carbon Dioxide Laser and the Bipolar Coagulator on the Cat Brain

The carbon dioxide laser has recently received clinical acceptance in neurosurgical practice. There are, however, few studies reported in the neurosurgical literature, either clinical or experimental, concerning its safety or efficacy on a physiological level by comparison to a more conventional tool. This study is not a description of a surgical technique, but is rather a basic physiological comparison of two surgical instruments. In this study, 11 cats were pretreated with the protein-bound dye, Evans blue. A corticotomy was performed in one hemisphere with the carbon dioxide laser and in the other with a microbipolar coagulator and a sharp blade. The subsequent extravasation of dye was presumed to be proportional to the amount of blood-brain barrier disruption associated with each lesion. When effective power settings for the two devices were compared, the laser lesions had significantly less extravasation of blue dye. This indicated that there was less damage to the blood-brain barrier surrounding laser corticotomy than surrounding conventional bipolar coagulation and sharp dissection at comparable power settings for each modality.

Comparison of the Effect of the Carbon Dioxide Laser and the Bipolar Coagulator on the Cat Brain

Abstract The carbon dioxide laser has recently received clinical acceptance in neurosurgical practice. There are, however, few studies reported in the neurosurgical literature, either clinical or experimental, concerning its safety or efficacy on a physiological level by comparison to a more conventional tool. This study is not a description of a surgical technique, but is rather a basic physiological comparison of two surgical instruments. In this study, 11 cats were pretreated with the protein-bound dye, Evans blue. A corticotomy was performed in one hemisphere with the carbon dioxide laser and in the other with a microbipolar coagulator and a sharp blade. The subsequent extravasation of dye was presumed to be proportional to the amount of blood-brain barrier disruption associated with each lesion. When effective power settings for the two devices were compared, the laser lesions had significantly less extravasation of blue dye. This indicated that there was less damage to the blood-brain barrier surrounding laser corticotomy than surrounding conventional bipolar coagulation and sharp dissection at comparable power settings for each modality.