The effects of a clinically feasible application of low-level laser therapy on the rate of orthodontic tooth movement: A triple-blinded randomized controlled clinical trial.

Maxillary first premolars were extracted. Patients were then bonded with self-ligating orthodontic SPEED brackets. A standardised wire sequence of 0.014-inch or 0.016-inch nickel titanium (NiTi) for 8 weeks, 0.018 x 0.018-inch 3t Tri-Tanium Memory wire for 8 weeks and 0.019 x 0.025-inch beta-titanium molybdenum for 8 weeks was used to achieve levelling and alignment. Anchorage was established using a transpalatal arch from the second molars and reinforced with consolidation of the second premolars, first and second molars using a 0.010-inch stainless steel ligature tie on either side. Canine retraction commenced on an 0.020-inch stainless steel wire using medium super-elastic NiTi closed coil springs attached to 5mm powerarms from the canine to the first molar. The NiTi coils were set to deliver 150g force, determined using a calibrated spring gauge and verified at each appointment. Occlusal stops were placed on the first molars to prevent any occlusal interference during retraction. The primary investigator (DM) carried out the intervention. This investigator is a dentist and attended a training course to safely use the laser therapy unit. An aluminium gallium arsenide laser 808±5nm nm diode, power: 0.20 W, irradiance: 1.97W/cm2 in continuous wave mode was used. LLLT was delivered by applying the laser probe over 8 points per canine tooth (4 buccal, 4 palatal). The laser output was set at 10 seconds per point, continuous mode. This gave 1.72 Joules (J) of energy per point, a total of 13.87J per visit. Low level laser therapy was applied at commencement of canine retraction, day 0 (T0), day 28 (T1), and day 56 (T2) immediately after spring activation. Protective goggles were worn, and patients were irradiated individually in an enclosed room as per laser specifications. This occured at an Urband Dental Hospital, Orthodontics Department in an enclosed treatment room. The sham laser function did not deliver any energy output however would perform identically to the test laser function, therefore, and as the wavelength used was not in the visible spectrum, the operator and patient were blinded. Any breakages were rectified within 24 hours else the patient was excluded from the study. Materials: SPEED brackets (Hanson prescription, Strite Industries, Cambridge, Ontario, Canada) Nickel titanium (NiTi) (3M Unitek, Monrovia, California, USA) 3t Tri-Tanium Memory wire (American Orthodontics, Sheboygan, WI) medium super-elastic NiTi closed coil springs (Orthomax, TOMY International Inc., Australia) Powerarms (0.016 x 0.016-inch SS – Dentarum, Ispringen, Germany) beta-titanium molybdenum (TMA, 3M Unitek) Calibrated spring gauge (Dentarum) Occlusal stops (Transbond Plus Light Cure Band Adhesive; 3M Unitek) An aluminium gallium arsenide laser (Thor Photomedicine Ltd, Buckinghamshire, UK).