This study aims to compare the effects of diode laser and light-emitting diode (LED) photobiomodulation on maxillary canine retraction during fixed orthodontic treatment. Participants requiring bilateral maxillary first premolar extraction will receive both interventions using a split-mouth design. One maxillary canine will receive diode laser photobiomodulation, while the contralateral maxillary canine will receive LED photobiomodulation.
Maxillary canine movement will be evaluated at 4, 8, 12, and 16 weeks during retraction to compare the amount and rate of tooth movement between the two interventions. Pain associated with orthodontic tooth movement will also be assessed.
Pulp oxygen saturation (SpO₂) of the maxillary canines will be measured to evaluate changes in pulpal oxygenation during orthodontic canine retraction. SpO₂ will be assessed at baseline and at predefined follow-up time points, including 20 minutes, 24 hours, 7 days, and 4 weeks. Changes in SpO₂ will be compared between the diode laser and LED sides.
Cone-beam computed tomography (CBCT) will be used to evaluate changes in maxillary canine root length and alveolar bone dimensions before and after canine retraction.
The study is expected to determine whether diode laser and LED photobiomodulation differ in their effects on orthodontic canine retraction, pulpal oxygenation, pain, and associated dental and alveolar bone changes.
Patients with complete permanent dentition and cervical vertebral maturation at CS5 or CS6 according to the Baccetti classification.
Angle Class I malocclusion.
Indication for fixed orthodontic treatment requiring bilateral extraction of the maxillary first premolars.
Similar position, morphology, and dimensions of the maxillary canines on both sides.
Patients with bleeding or coagulation disorders, diabetes mellitus, bone diseases, or periodontal diseases.
Use of medications that may affect orthodontic tooth movement or coagulation, including aspirin, heparin, warfarin, nonsteroidal anti-inflammatory drugs, or glucocorticoids.
History of maxillofacial trauma or craniofacial anomalies.
Smoking.
Parallel
Diode Laser Photobiomodulation
DeviceDiode laser photobiomodulation at a wavelength of 810 nm will be applied to the maxillary canine during orthodontic retraction. Irradiation will be delivered at 12 points around the canine root, including six points on the buccal side and six points on the palatal side. The root area will be divided into cervical, middle, and apical regions. The laser will be applied for 10 seconds per region, delivering 1 J per region and a total energy of 6 J per tooth. The energy density will be 5.1 J/cm². The intervention will be repeated at 4-week intervals during the 16-week canine retraction period.
LED Photobiomodulation
DeviceThe contralateral maxillary canine will receive light-emitting diode (LED) photobiomodulation during orthodontic canine retraction. LED irradiation will be applied at 12 points around the canine root, including six points on the buccal side and six points on the palatal side. The LED will be applied for 5 seconds at each point, with an energy density of 6 J/cm² and a wavelength range of 430-480 nm. The intervention will be repeated at 4-week intervals during the 16-week canine retraction period.
Amount of Maxillary Canine Retraction
The amount of maxillary canine retraction will be measured in millimeters using digital intraoral scans. Canine movement will be assessed by comparing the position of the maxillary canine at baseline and at each follow-up time point. The amount of retraction on the diode laser side will be compared with that on the contralateral LED side within the same participant.
Pain Intensity Following Orthodontic Canine Retraction
Pain intensity will be assessed using a Visual Analog Scale (VAS) following photobiomodulation during orthodontic canine retraction. Participants will record pain separately for the diode laser and LED sides. VAS scores will be compared between the two intervention sides.
Change in Maxillary Canine Root Length
Maxillary canine root length will be measured using cone-beam computed tomography (CBCT) to assess changes in root length associated with orthodontic canine retraction. Changes from baseline will be compared between the diode laser and LED sides.
Change in Alveolar Bone Dimensions Around the Maxillary Canine
Alveolar bone dimensions around the maxillary canine will be evaluated using cone-beam computed tomography (CBCT). Changes from baseline will be compared between the diode laser and LED sides.
Change in Pulp Oxygen Saturation of the Maxillary Canine
Pulp oxygen saturation (SpO₂) of the maxillary canines will be measured to evaluate changes in pulpal oxygenation during orthodontic canine retraction. SpO₂ values will be recorded separately for the maxillary canine receiving diode laser photobiomodulation and the contralateral maxillary canine receiving LED photobiomodulation. Changes from baseline and differences between the two intervention sides will be assessed.
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