RESUMEN
Background Different techniques have been used to reduce functional treatment time including low-level laser therapy (LLLT), and the majority of studies have been conducted on animals. Therefore, the aim of the current study was to evaluate the effects of LLLT on improving orthodontic functional treatment using the Twin-Block (TB) appliance. Materials and methods This study was a three-arm, parallel-group randomized controlled trial. Patients were selected using the following inclusion criteria: skeletal Class II Division 1 malocclusion resulting from mandibular retrognathia (angle between the anterior cranial base and the NB plane (i.e., SNB angle): 73°-78°), the sagittal skeletal discrepancy angle (ANB angle) between 4° and 9°, and overjet between 5 and 9 mm. Forty-eight patients were randomly allocated into three equal groups. In the LLLT-TB group, the low-level laser device was used with a wavelength of 808 nm and power of 250 mW in addition to functional treatment with a Twin-Block appliance. The laser was applied on the skin at the bilateral temporomandibular joint (TMJ) regions, at five points, each point received 5 J of the laser for 20 seconds. The laser course was twice a week in the first month, every two weeks in the second month, and every three weeks up to the end of the treatment. The second group (the TB group) received functional treatment with a Twin-Block appliance, while patients in the third group (the untreated control group (UCG)) were observed for nine months without any intervention. Results There were statistically significant differences in treatment periods between the LLLT-TB group and the TB group (129 days and 235 days, respectively, P-value<0.001). The change in the effective mandibular length (Co-Gn) was the highest in the LLLT-TB group compared with the TB and the UCG groups (4.41 mm, 3.66 mm, and 1.07 mm, respectively; P-value<0.001). Conclusions The application of low-level laser therapy on the condylar regions accelerated the functional treatment in skeletal Class II malocclusion patients by approximately 45% and increased the bone growth and mandibular length. The improvement in the SNB angle was similar in both interventional groups. Irradiation of low-level laser stimulated bone growth at the condyles and did not cause anterior movement of the temporomandibular joint following functional orthopedic correction.
RESUMEN
BACKGROUND: Low-intensity pulsed ultrasound (LIPUS) is considered one of the techniques used to improve the mandibular growth. Many animal studies have reported that significant results can be obtained using LIPUS therapy with functional appliances. OBJECTIVES: This research aimed to evaluate the dentoskeletal changes produced by the combination of LIPUS therapy and functional treatment during the correction of skeletal class II malocclusion. MATERIAL AND METHODS: Forty-five patients aged 10.5-14 years with skeletal class II division 1 malocclusion were randomly divided into 3 equal groups: the LIPUS group, treated with a Twin-Block appliance in combination with LIPUS therapy; the TB group, treated with a Twin-Block appliance only; and the control group, which was observational and received no treatment. Cephalometric changes were compared between the 3 groups using the analysis of variance (ANOVA) and Tukey's post hoc tests at p < 0.05. RESULTS: A greater significant decrease in the ANB (A point, nasion, B point) angle was observed in the treated groups (-2.67° for the LIPUS group and -2.11° for the TB group) as compared to the control group (p < 0.001). A greater improvement in the mandibular length and position was observed in the LIPUS group than in the TB group (p < 0.001). The changes in the control group as a result of continuing growth were minimal and clinically non-significant. CONCLUSIONS: The application of LIPUS therapy in combination with functional treatment can have a great effect on growth stimulation during the correction of class II malocclusion. In addition, LIPUS was effective in reducing the duration of functional treatment.