ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title There is Conflicting Evidence Regarding the Use of Low-Level Laser Therapy of Alveolar Bone to Accelerate Orthodontic Tooth Movements
Clinical Question For patients receiving orthodontic treatment, could low-level laser therapy accelerate tooth movements and shorten the overall treatment period?
Clinical Bottom Line Low-level laser therapy is a non-invasive procedure that may be used for accelerating orthodontic tooth movements. However, more research is needed to determine the efficacy and the applicability of this procedure. The research is conflicting.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24554452Ge/20146 RCTs and 3 quasi-RCTs involving 211 patients from six countries.Meta-Analysis
Key resultsThe meta-analysis results of 9 relevant studies showed that with low-level laser therapy there is a possibility of accelerating orthodontic tooth movements in 7 days ("mean difference 0.19, 95 % CI [0.02, 0.37], p = 0.03") and 2 months ("mean difference 1.08, 95 % CI [0.16, 2.01], p = 0.02"), especially using lower energy density (5 and 8 J/cm2) when compared to a higher energy density (20 and 25 J/cm2).
#2) 22720793 Long/20133 RCTs and 1 quasi-RCT, involving 53 patients.Meta-Analysis
Key resultsThe meta analysis results of this study found that "low-level laser therapy was unable to accelerate orthodontic tooth movement." This conclusion was based on the pooled mean differences between the controlled group and the low-level laser therapy group regarding accumulative moved distance, which were "0.32 (95% CI: −0.04, 0.68), 0.76 (95% CI: −0.14, 1.65), and 0.73 (95% CI: −0.68, 2.14) for 1 month, 2 months, and 3 months, respectively."
Evidence Search ("laser therapy, low-level"[MeSH Terms] OR ("laser"[All Fields] AND "therapy"[All Fields] AND "low-level"[All Fields]) OR "low-level laser therapy"[All Fields] OR ("low"[All Fields] AND "level"[All Fields] AND "laser"[All Fields] AND "therapy"[All Fields]) OR "low level laser therapy"[All Fields]) AND accelerating[All Fields] AND ("tooth movement"[MeSH Terms] OR ("tooth"[All Fields] AND "movement"[All Fields]) OR "tooth movement"[All Fields])
Comments on
The Evidence
Validity: In the first meta-analysis (Ge/2014) only 6 RCTs and 3 quasi-RCTs out of 173 relevant studies were feasible for meta-analysis. Five out of these 9 selected articles were assessed to have a moderate risk of bias and the rest were assessed as high risk of bias, whereas in the second meta-analysis (Long/2013) there was no publication bias according to Begg's and Egger's tests. Three of the included studies in Ge/2014 and one included study in Long/2013 were quasi-RCTs in which the treatment was assigned based on a nonrandom method. Perspective: Based on these meta analyses, low-level laser therapy could be a promising option for decreasing the overall orthodontic treatment period. However, more extensive research is needed to truly determine the efficacy of this treatment option.
Applicability There is a high demand among patients for faster orthodontic therapy. Decreasing the overall treatment period can increase the patient compliance and allow the practitioner to treat more patients. However, the current evidence in regard to low-level laser therapy is conflicting and not sufficient to use this treatment method routinely in dental practice.
Specialty/Discipline (General Dentistry) (Orthodontics) (Pediatric Dentistry)
Keywords Orthodontics, laser therapy, tooth movement
ID# 2745
Date of submission: 06/25/2014spacer
E-mail abood6000@gmail.com
Author Abdulmohsen Alqasir
Co-author(s) Saad Almujel, Nguyen Teresa
Co-author(s) e-mail saadalmojel@yahoo.com, NguyenT16@livemail.uthscsa.edu
Faculty mentor/Co-author Clarence C. Bryk, DDS, MS
Faculty mentor/Co-author e-mail brykc@uthscsa.edu
Basic Science Rationale
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