The extended tentacles of laser - From diagnosis to treatment in orthodontics: An overview

Low-level laser therapy, piezocision, or their combination vs. conventional treatment for orthodontic tooth movement : A hierarchical 6-arm split-mouth randomized clinical trial

PURPOSE

The use non-invasive or minimally invasive methods to accelerate orthodontic tooth movements (OTM) is desirable. In this regard, low-level laser therapy (LLLT, photobiomodulation) and piezocision are suggested. However, because the efficacies of these methods remain controversial/inconclusive, we investigated and compared these two methods.

METHODS

Sixty-four quadrants in 32 patients were randomized into three parallel intervention groups of 22, 22, and 20 (6 parallel arms, n = 64 treatment/control sides). Bilateral first premolars were extracted and canine retraction commenced. In each group, one side of the mouth was randomly selected as control, while the other side underwent each of three interventions: LLLT (940 nm, 8 J, 0.5 W, 16 s, 12 sites), piezocision, and "LLLT + piezocision". At the 3rd, 6th, and 9th follow-up weeks, canine retraction and anchorage loss were measured. Data were analyzed statistically (α = 0.05).

RESULTS

After 9 weeks, LLLT, piezocision, and LLLT + piezocision improved canine retraction by 0.51, 1.14, and 1.93 mm, respectively. LLLT accelerated canine retraction (compared to control) by 1.6-, 1.4-, and 1.2-fold in the 3rd, 6th, and 9th week, respectively. These statistics were 2.1-, 1.7-, and 1.5-fold for piezocision and 2.7-, 2.1-, and 1.8-fold for LLLT + piezocision. Compared to controls, each intervention showed significant retraction acceleration (p < 0.05). The effect of LLLT + piezocision was greater than that of isolated piezocision (p < 0.05), which itself was greater than that for isolated LLLT (p < 0.05).

CONCLUSION

All three methods accelerated OTM, with the combination of LLLT + piezocision producing the strongest and LLLT producing the weakest acceleration.

Non-Ionizing Radiation in Swedish Health Care-Exposure and Safety Aspects

The main aim of the study was to identify and describe methods using non-ionizing radiation (NIR) such as electromagnetic fields (EMF) and optical radiation in Swedish health care. By examining anticipated exposure levels and by identifying possible health hazards we also aimed to recognize knowledge gaps in the field. NIR is mainly used in health care for diagnosis and therapy. Three applications were identified where acute effects cannot be ruled out: magnetic resonance imaging (MRI), transcranial magnetic stimulation (TMS) and electrosurgery. When using optical radiation, such as class 3 and 4 lasers for therapy or surgical procedures and ultra-violet light for therapy, acute effects such as unintentional burns, photo reactions, erythema and effects on the eyes need to be avoided. There is a need for more knowledge regarding long-term effects of MRI as well as on the combination of different NIR exposures. Based on literature and after consulting staff we conclude that the health care professionals' knowledge about the risks and safety measures should be improved and that there is a need for clear, evidence-based information from reliable sources, and it should be obvious to the user which source to address.