The effectiveness of low-level laser therapy and low-intensity pulsed ultrasound in reducing pain induced by orthodontic separation: a randomized controlled trial.

BACKGROUND: The low-level laser therapy (LLLT) and low-intensity pulsed ultrasound (LIPUS) have been recently applied to control pain during orthodontic treatment. OBJECTIVE: To evaluate and compare the effectiveness of LLLT and LIPUS in reducing pain induced by orthodontic separation. STUDY DESIGN: A single-blinded randomized controlled trial. METHODS: One hundred and fifty patients were randomly assigned into three groups; LLLT group, LIPUS group, and control group. After 5 min from the separators' placement, the first dose of the laser or the ultrasound was applied, the second dose was applied after 24 h, and the third dose was applied after 48 h on both maxillary and mandibular first molars. The exposure of laser was for 20 s at each point (maxillary and mandibular first molars), with an 810-nm aluminum-gallium-arsenide (AlGaAs) diode laser on continuous mode. The output power set at 150 mW, the energy density of 4 J/cm2, and a laser spot diameter of 7 mm were applied. Whereas the frequency of ultrasonic toothbrush was 1.6 MHz; and average output intensity was 0.2 W/cm2. The application was for 20 min (5 min on each first molar). The control group received the separators without another intervention. A Visual Analog Scale (VAS 100 mm) was used to assess pain intensity at several time intervals during the first four days after the separators' placement. RESULTS: A total of 145 patients were assessed. There was a significant difference in pain perception among the three groups after 5 min (P = .002). The maximum pain level was reached after 24 h. However, the laser group and the ultrasound group showed a statistically significant decrease in pain scores compared to the control group at all the assessment time points (P < .001). Whereas there was no difference between the laser group and the ultrasound group in reducing the pain scores (P > .05). CONCLUSIONS: The LLLT and the LIPUS effectively reduce the separation pain when applied in multiple doses without differences between them. TRIAL REGISTRATION: This trial was registered with the German Clinical Trials Register (DRKS). ( https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID= DRKS00029991). Date of registration: 26/08/2022.

A systematic review and meta-analysis of the role of nutrition and its impact on orthodontic treatment/management.

The nutritional needs already increased by adolescent growth, activity, and stress are further exacerbated by the physical, physiological, and psychological stress that orthodontic treatment causes. Hence, the main objective of this systematic review was to analyze the relationship between adequate nutrition and its impact on orthodontic treatment success rates. Using relevant keywords, reference searches, and citation searches, the databases such as PubMed-Medical Literature Analysis and Retrieval System Online, Web of Science, Cochrane, and Scopus were all searched. "Diet," "Minerals," "Nutrition," "Orthodontics," and "Vitamins" were the search terms used to scour the database. The 10 studies selected for the systematic review and subsequent meta-analysis could not conclusively establish the correlation between proper nutrition and its impact on orthodontic treatment of the patient. There was virtually little connection between patients' dietary intake and the effectiveness of their orthodontic treatment. Additionally, a direct causal link between the two could not be established legitimately because the majority of the studies reviewed only noted an impact during the early stages of the treatment. PROSPERO Registration Number: CRD42022380828.

Assessment of a single versus double application of low-level laser therapy in pain reduction following orthodontic elastomeric separation: A randomized controlled trial.

BACKGROUND: Periodontal ligament (PDL) pain, associated with the insertion of elastomeric separators, is one of the most annoying experiences at the beginning of orthodontic treatment. Low-level laser therapy (LLLT) has recently been suggested as a method of controlling this pain. OBJECTIVES: The aim of this study was to evaluate the effectiveness of LLLT on reducing the pain associated with elastomeric separation and to compare a single dose of LLLT (1 h before the insertion of elastomeric separators) vs 2 doses of LLLT (1 h before and immediately after the insertion). MATERIAL AND METHODS: This randomized controlled trial was conducted at the Department of Orthodontics, Faculty of Dentistry of University of Damascus and at the Department of Orthodontics of Adib-Allaham Center in Damascus, Syria. The sample population was comprised of 36 patients, aged between 12 and 25 years (mean age: 17 ±3.7 years), and the patients were randomly divided into 2 groups. A split-mouth design was employed. One group received 1 dose of laser therapy 1 h before the insertion of elastomeric separators, whereas the other one received 2 doses of laser therapy - 1 h before and immediately after the insertion of elastomeric separators. A GaAlAs laser with a wavelength of 830 nm and a power of 100 mW was used. The pain levels were recorded using the Visual Analog Scale (VAS) after 1, 6, 24, 48, and 96 h. Student's t-test and the repeated measures analysis of variance (ANOVA) were employed to detect significant differences. RESULTS: Low-level laser therapy significantly reduced post-separation pain when the experimental side was compared to the placebo side in the single-irradiation group (p < 0.05). Low-level laser therapy significantly reduced separation pain with no statistical difference between single and double irradiation protocols (p > 0.05). CONCLUSIONS: Low-level laser therapy had a positive effect on reducing the pain associated with elastomeric separation, whether it was applied as a single dose before elastomeric separation or as a double dose before and after this procedure.