An evaluation of root resorption associated with the use of photobiomodulation during orthodontic treatment with clear aligners: a retrospective cohort pilot study

Abstract

Objectives To evaluate the change in tooth root volume using cone-beam computed tomography (CBCT) in a group of patients treated concurrently with clear aligners and an adjunctive photobiomodulation (PBM) device. Materials and Methods This retrospective cohort pilot study included the records of 32 consecutively treated clear aligner patients (23 female, 9 male) from the private practice of one orthodontist. The PBM group (n = 16) used the device once per day for 5 minutes per arch and was compared with a matched control group (n = 16). A semiautomated segmentation technique was used to obtain tooth volume of anterior teeth from CBCT imaging prior to (T0) and during or immediately following (T1) orthodontic treatment with clear aligners. The change in root volume between time points was assessed. Results There was no statistically significant difference between the pre- and posttreatment root volumes of maxillary and mandibular anterior teeth, regardless of which intervention group the patient belonged to (P > .05). There was also no difference in the mean percentage change in root volume between clear aligner patients in this study who were treated with the PBM device compared with a matched control group (P > .05). Conclusions Clear aligner patients in this study who changed their aligners every 3 to 5 days and used adjunctive photobiomodulation therapy did not experience clinically relevant orthodontically induced external root resorption. Due to the small sample size and measurement error in the root segmentation process, the results should be interpreted with caution.

Photobiomodulation in Orthodontics: Mechanisms and Clinical Efficacy for Faster Tooth Movement

“…In related research, Rossi et al [40] explored the impact of PBM on root resorption in orthodontic patients using clear aligners, with no notable difference in root resorption observed between the group using PBM and the control group. This outcome suggests that PBM's adjunctive application in orthodontic treatments using clear aligners does not escalate the risk of orthodontically induced external root resorption; however, caution is advised when interpreting these results due to the limited sample size and possible measurement inaccuracies [40]. Olek et al [41] also reported that photodynamic therapy could decrease microbial levels in patients with fixed orthodontic appliances, presenting a viable alternative to traditional periodontal maintenance practices [41].…”

“…The non-invasive nature of PBM is one of its most notable advantages, eliminating the need for surgical interventions, thereby reducing the risk of complications [39]. This aspect alone makes PBM a safer choice, especially when compared to methods that involve electrical stimulation in moist environments [38][39][40][41]. Additionally, PBM's precision in action and control, facilitated by the use of specific wavelengths tailored to individual treatment plans, enhances its safety profile and effectiveness [38][39][40][41].…”

“…This aspect alone makes PBM a safer choice, especially when compared to methods that involve electrical stimulation in moist environments [38][39][40][41]. Additionally, PBM's precision in action and control, facilitated by the use of specific wavelengths tailored to individual treatment plans, enhances its safety profile and effectiveness [38][39][40][41]. Unlike traditional orthodontic methods, PBM does not result in tissue damage, infection, blood loss, or discomfort, providing relief from these conditions instead [38][39][40][41].…”

“…Additionally, PBM's precision in action and control, facilitated by the use of specific wavelengths tailored to individual treatment plans, enhances its safety profile and effectiveness [38][39][40][41]. Unlike traditional orthodontic methods, PBM does not result in tissue damage, infection, blood loss, or discomfort, providing relief from these conditions instead [38][39][40][41]. Furthermore, its capacity to promote tissue healing, angiogenesis, bone remodeling, and accelerated tooth movement underscores its value as an adjunctive therapy in orthodontics [24,25].…”

“…Moreover, the effective utilization of PBM devices requires specific clinician training to prevent potential misuse or excessive use, which could lead to tissue damage. Another significant barrier to the widespread adoption of PBM is the cost of laser equipment, which, along with the need for intensive safety training, may limit accessibility for some practices and patients [24,25,[38][39][40][41][42][43][44][45][46].…”