Low-Intensity Laser Therapy

By Shadi Saba, DDS

Saba Orthodontics

. http://www.sabaortho.com/

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Low-Intensity Laser Therapy

The long duration of orthodontic treatment is a major concern for some patients. A noninvasive method of accelerating tooth movement in a physiologic manner has been proven to be quite effective. Infrared radiation from a semiconductor diode laser with a wavelength of 810 nm is used once every other week, during the crucial time when most orthodontic tooth movement is required. From the application of this low-intensity laser therapy, an average increase of 30% in the rate of tooth movement can be expected. Pain scores, when measured through a visual analog scale, are significantly lower compared with scores obtained from patients who do not receive the laser therapy.

Generally, the time required for fixed appliance treatment is 20 to 30 months. Reducing the treatment time requires increasing the rate of orthodontic tooth movement. Different methods can increase the rate of tooth movement, including local injections of prostaglandins around the gum tissue surrounding the tooth. These substances stimulate the rate of tooth movement, but have the undesirable side effects of local pain and discomfort during the injections. Another technique to very effectively increase the rate of tooth movement involves a surgical intervention, called AOO (Accelerated Osteogenic Orthodontics), also known as Wilckodontics. To learn more about this technique please visit our website (www.sabaortho.com), or refer to Dr. Saba's article on Wilckodontics in 2011.

Ablasive use of lasers has become common in dental practice. Low-intensity laser therapy has an energy output that is low enough so as not to cause the temperature of the treated tissue to rise above normal body temperature. Low-intensity laser therapy in its initial days was applied only in medical sciences such as orthopedics, surgery, and medicine. It is used to facilitate wound healing and to accelerate the callus formation at fracture sites.

The orthodontist uses a handpiece that emits the laser beam. For bio-stimulation, the output power is usually higher than for analgesic purposes. An exposure time of 30 seconds are used for pain reduction, versus an exposure time of 10 seconds to stimulate tooth movement.

Different researchers have found different results, but the increase in the amount of orthodontic tooth movement ranges between 1.3-fold to 2.08-fold. Some studies have shown that a pulsed mode, as opposed to a continuous mode of laser radiation can create more of a bio-stimulatory effect. The continuous mode also has peaks and valleys, because the laser unit cannot emit continuously in real time. To relieve orthodontic pain, several methods have been used. One method is non-steroidal anti-inflammatory drugs. Although they are effective in relieving pain, they might also reduce the rate of tooth movement. Studies have concluded that there is a significant pain reduction with the application of the low-intensity laser therapy immediately after placement of orthodontic braces until day 4.

Low-intensity laser therapy increases the rate of orthodontic tooth movement in a physiologic manner. It causes no side effect on the vitality of the teeth or the periodontium (the tissue surrounding a tooth). Low-intensity laser therapy also is an effective method of analgesia during orthodontic treatment.

The advantage of using this laser therapy for the orthodontist is that he/she can choose which teeth to apply the radiation to, where most of the movement is needed, without taxing the anchoring teeth.

Lastly, adults experience a much slower rate of tooth movement during orthodontics compared with children and adolescents due to decreased vascularity and cellularity of their bones. With increasing numbers of adults in orthodontic braces, application of laser therapy will specially be beneficial for this population to avoid long treatment times in braces.