Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch—a randomized clinical controlled trial

Abstract

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm 2 , power density per second 1.59 W/cm 2 , dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Low-Level Laser Therapy with a 635 nm Diode Laser Affects Orthodontic Mini-Implants Stability: A Randomized Clinical Split-Mouth Trial

“…However, in the split-mouth clinical study presented by AlSayed et al, the authors obtained no difference in relieving elastomeric separators induced orthodontic pain after LLLT, applied at two different laser energy values (4 and 16 J). However, there is some bias in pain analysis in this study because the pain feeling by the patients could alsom be caused by the fixed orthodontic appliance [24]. There is no consistent thesis on pain during orthodontic treatment.…”

“…The PBM is a minimal-invasive treatment allowing to stimulate cellular processes such as ATP, DNA, and RNA synthesis [16,22]. Many authors demonstrated the positive effect of LLLT in bone healing [22], osteoblasts [22], fibroblasts [13] proliferation, nerve repair [19], increased peri-implant bone density [23], and reduced pain in orthodontics [24]. Our study aimed at testing the photomodulation effect of the LLLT on implant stability of orthodontic mini-implants placed in a maxilla and mini-implants failure rate and a pain level after the treatment.…”

“…That feature of the material is known as elastic straining and influences the properties of orthodontic wire. Discomfort and pain usually begin 2 to 4 h after the fixed orthodontic appliance placement (application of force) and progress for 24 h and progressively disappear in the next seven days [24,27].…”

The use of diode lasers in non-surgical therapy of periodontitis

“…Diode lasers in periodontology can also be used for gingivectomy/gingivoplasty of hypertrophic gingiva. A high relief of pain was also confirmed in orthodontic treatmen of patients after application of a diode laser with wavelength 635 nm [34]. Photobiomodulation (PBM) is especially indicated in the treatment of patients at risk of bacteremia or with immune deficiency [28].…”

Effect of Method of Ligation on the Pain Perception During Orthodontic Treatment- A Rct using Conventional Metal and Dual Activation Self-Ligating Brackets

“…18,21,22 . Other modalities including, photo biomodulation, low level laser therapy, vibration were noted to have a substantial level of pain reduction [23][24][25][26][27] . In the present study pain was tolerable for all the patients hence no other therapy was advised to reduce pain.…”