Orthodontic treatment is a common and effective approach to correcting dental malocclusions and improving oral function and aesthetics. The process involves applying mechanical forces to move teeth into their desired positions, which can lead to discomfort and pain for patients, especially during the initial stages of treatment. While the ultimate goal of orthodontic therapy is to achieve proper alignment, the associated pain and the time required to complete the treatment often become significant concerns for patients. (Jheon et al., 2017). The duration of treatment, which typically spans several months or even years, is influenced by various factors including the type of malocclusion, the force applied, and the biological response of the periodontal tissues to the applied forces. (Sangle et al., 2023). Recent advancements in orthodontic care have focused on finding ways to accelerate tooth movement while minimizing the discomfort experienced by patients. Low-level laser therapy (LLLT), also known as photobiomodulation (PBM), has garnered significant attention as a non-invasive method to enhance biological healing processes. LLLT has been shown to stimulate cellular activity, increase collagen production, and improve blood circulation, potentially influencing the rate of tooth movement (Fini et al., 2020). Several studies suggest that LLLT may enhance the osteoclast and osteoblast activity in the periodontal tissues, leading to more rapid bone resorption and apposition, which could expedite the tooth movement process (Suzuki et al., 2016). Additionally, LLLT has been shown to reduce pain perception, possibly by modulating nerve activity and inflammation (Guo et al., 2021).
Patients aged 15-30 years requiring fixed orthodontic treatment.
Extraction treatment plan with bilateral canine retraction.
Good oral hygiene and periodontal health.
No systemic diseases or medications affecting bone metabolism.
Previous orthodontic treatment.
Smoking or alcohol consumption.
Pregnancy or lactation.
Use of analgesics or anti-inflammatory drugs during the study period.
Parallel
Low level laser therapy
Procedure/SurgeryAll participants will receive standard orthodontic treatment using appliances. The type of tooth movement studied will include, (e.g., canine retraction, molar distalization). Orthodontic adjustments will be performed at intervals (e.g., every 4 weeks) by a single calibrated orthodontist to ensure consistency of force application. Force magnitude will be monitored using (e.g., strain gauges, force measuring devices) at each adjustment The LLLT group will receive laser treatment using a Ga-As-Al diode laser operating at a wavelength of 810 nm. The laser parameters will be as follows: Participants receive low-level laser therapy in addition to standard orthodontic treatment. • The laser device used is a Ga-As-Al diode laser with a wavelength of 810 nm, power output of 100 mW, and energy density of 5 J/cm² (Sousa et al., 2011). • Laser application is performed at specific time points: immediately after bracket placement, on days 3, 7, and 14, and then monthly until the end of the study.
tooth movement measurement
Tooth Movement Measurement • Method: Cephalometric radiographs will be taken at baseline, 4 weeks, and 8 weeks to assess tooth movement. Linear measurements will be made between specific cephalometric landmarks by a calibrated and blinded examiner using digital imaging software. • Parameters: The distance between the canine and second premolar is measured at baseline and at monthly intervals until the end of the study. • Tool: Digital calipers and specialized software (e.g., OrthoAnalyzer) are used for precise measurements (Ren et al., 2003).
pain assessment
Pain Assessment • Tool: Visual Analog Scale (VAS) is used to measure pain levels. • Timing: Pain is assessed at baseline (before treatment) and at 6 hours, 24 hours, 3 days, 7 days, and 14 days after the application of orthodontic force and LLLT/sham irradiation. • Procedure: Participants mark their pain level on a 10 cm line, where 0 indicates no pain and 10 indicates the worst pain imaginable
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