Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.00320
Revista de Odontologia da UNESP
Original Article

Influence of photobiomodulation on pain perception during initial orthodontic tooth movement

Influência do fotobiomodulação na percepção da dor durante o movimento ortodôntico inicial

Welinton Lemos RUMÃO; Heloísa Cristina VALDRIGHI; Vivian Fernandes FURLETTI; Giovana Renata GOUVÊA; Milton SANTAMARIA-JR

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Abstract

Abstract: Introduction: Laser in low intensity (LLI) has been used to reduce the discomfort and pain that is triggered by the forces applied during orthodontic treatment.

Objective: To evaluate the effect of LLI application in the pain perception of periodontal ligament initial compression, during orthodontic tooth movement; and to compare the effect of this therapy between men and women.

Material and method: The sample consisted of 30 volunteers, who needed orthodontic band placement on mandibular first molars. After insertion of the elastic separators, LLI was applied to the mesial and distal apical region (wavelength 808nm, energy 2J, time 20s and fluency of 8.32J/cm2) and at three points on the root region (wavelength 808nm, energy 1J, time 10s and fluency of 4.16J/cm2) of the first molar (irradiated side) and compared to the contralateral first molar (non-irradiated side), in three time intervals: 0hs, 24hs and 48hs. Pain perception was evaluated by the Visual Analog Scale (VAS), at 0hs, 24hs and 48hs after insertion, with significance of 5%.

Result: The pain level was observed to be significantly lower (p<0.05) on the irradiated side, irrespective of gender and time. Women presented a significantly higher pain level (p<0.05) than men, irrespective of time and side. There were no significant differences between the time intervals (p>0.05).

Conclusion: It was concluded that LLI reduced the perception of initial pain in patients in whom compression of the periodontal ligament was promoted by elastic separation, and that women had a greater perception of pain sensitivity in the time intervals studied.

Keywords

Pain, tooth movement, photobiomodulation, laser in low intensity

Resumo

Resumo: Introdução: O tratamento com Laser em Baixa Intensidade (LBI) tem sido utilizado para reduzir o desconforto e a dor desencadeados pelas forças aplicadas durante o tratamento ortodôntico.

Objetivo: Avaliar o feito da aplicação de LBI na percepção da dor na compressão inicial do ligamento periodontal durante o movimento dentário ortodôntico; e comparar o efeito desta terapia entre os sexos.

Material e método: A amostra foi composta por 30 voluntários, que necessitavam de bandagem dos primeiros molares inferiores. Após a instalação dos elásticos separadores, aplicou-se o LBI infravermelho na região apical mesial e distal (comprimento de onda 808nm, energia 2J, tempo 20s e fluência de 8,32J/cm2) e em três ponto na região radicular (comprimento de onda 808nm, energia 1J, tempo 10s e fluência de 4,16J/cm2) no lado irradiado e comparou-se com o primeiro molar contralateral não irradiado (lado controle), em três tempos: 0hs, 24hs e 48hs. A percepção de dor foi avaliada pela interpretação da Escala Visual Analógica (EVA) em 0hs, 24hs e 48hs após a instalação, com nílvel de significância de 5%.

Resultado: Observou-se que o nível de dor foi significativamente menor (p<0,05) no lado irradiado, independentemente do sexo e do tempo. O sexo feminino apresentou nível de dor significativamente maior (p<0,05) que o sexo masculino, independentemente do tempo e do lado. Não houve diferença significativa entre os tempos (p>0,05).

Conclusão: Concluiu-se que o LBI diminui a percepção de dor inicial em pacientes onde se promoveu a compressão do ligamento periodontal por meio de separação elástica, e que o sexo feminino apresentou maior percepção da sensibilidade dolorosa nos tempos observados.
 

Palavras-chave

Dor, movimento dentário, fotobiomodulação, Laser em Baixa Intensidade

References

1 Spadari GS, Zaniboni E, Vedovello SAS, Santamaria MP, Amaral MEC, Santos GMT, et al. Electrical stimulation enhances tissue reorganization during orthodontic tooth movement in rats. Clin Oral Investig. 2017 Jan;21(1):111-20. http://dx.doi.org/10.1007/s00784-016-1759-6. PMid:26917494.

2 Krishnan V. Orthodontic pain: from causes to management: a review. Eur J Orthod. 2007 Apr;29(2):170-9. http://dx.doi.org/10.1093/ejo/cjl081. PMid:17488999.

3 Farias RD, Closs LQ, Miguens SAQ Jr. Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: a randomized split-mouth clinical trial. Angle Orthod. 2016 Mar;86(2):193-8. http://dx.doi.org/10.2319/122214-933.1. PMid:26132512.

4 Xiaoting L, Yin T, Yangxi C. Interventions for pain during fixed orthodontic appliance therapy: a systematic review. Angle Orthod. 2010 Sep;80(5):925-32. http://dx.doi.org/10.2319/010410-10.1. PMid:20578865.

5 Al-Balbeesi HO, Bin Huraib SM, AlNahas NW, AlKawari HM, Abu-Amara AB, Vellappally S, et al. Pain and distress induced by eslastomeric and spring separators in patients undergoing orthodontic treatment. J Int Soc Prev Community Dent. 2016 Nov-Dec;6(6):549-53. http://dx.doi.org/10.4103/2231-0762.195519. PMid:28032047.

6 Azodo CC, Umoh AO. Analgesics prescription in Nigerian dental healthcare services. Niger J Basic Clin Sci. 2013;10(2):86-90. http://dx.doi.org/10.4103/0331-8540.122768.

7 Fujiyama K, Deguchi T, Murakami T, Fujii A, Kushima K, Takano-Yamamoto T. Clinical effect of CO(2) Laser in reducing pain in orthodontics. Angle Orthod. 2008 Mar;78(2):299-303. http://dx.doi.org/10.2319/033007-153.1. PMid:18251609.

8 Lobre WD, Callegari BJ, Gardner G, Marsh CM, Bush AC, Dunn WJ. Pain control in orthodontics using a micropulse vibration device: a randomized clinical trial. Angle Orthod. 2016 Jul;86(4):625-30. http://dx.doi.org/10.2319/072115-492.1. PMid:26496680.

9 Fernandes-Dias SB, Marco AC, Santamaria M Jr, Kerbauy WD, Jardini MAN, Santamaria MP. Connective tissue graft associated or not with low laser therapy to treat gingival recession. Randomized clinical trial. J Clin Periodontol. 2015 Jan;42(1):54-61. http://dx.doi.org/10.1111/jcpe.12328. PMid:25363203.

10 Neves LMG, Matheus RL, Santos G, Esquisatto M, Amaral MEC, Mendonça F. Effects of microcurrent application and 670 nm InGaP low-level laser irradiation on experimental wound healing in healthy and diabetic Wistar rats. Laser Phys. 2013 Feb;23(3):035604. http://dx.doi.org/10.1088/1054-660X/23/3/035604.

11 Sun G, Tunér J. Low-level laser therapy in dentistry. Dent Clin North Am. 2004 Oct;48(4):1061-76. http://dx.doi.org/10.1016/j.cden.2004.05.004. PMid:15464564.

12 Silva Neves FL, Silveira CA, Fernandes-Dias SB, Santamaria M Jr, Marco AC, Kerbauy WD, et al. Comparison of two power densities on the healing of palatal wounds after connective tissue graft removal: randomized clinical trial. Lasers Med Sci. 2016 Sep;31(7):1371-8. http://dx.doi.org/10.1007/s10103-016-1988-6. PMid:27344670.

13 Nimeri G, Kau CH, Abou-Kheir NS, Corona R. Acceleration of tooth movement during orthodontic treatment-a frontier in Orthodontics. Prog Orthod. 2013 Oct;14(1):42. http://dx.doi.org/10.1186/2196-1042-14-42. PMid:24326040.

14 El-Bialy T, Farouk K, Carlyle TD, Wiltshire W, Drummond R, Dumore T, et al. Effect of low intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption: a prospective multi-center randomized controlled trial. J Clin Med. 2020 Mar;9(3):804. http://dx.doi.org/10.3390/jcm9030804. PMid:32188053.

15 Kawasaki K, Shimizu N. Effects of low-energy laser irradiation on bone remodeling during experimental tooth movement in rats. Lasers Surg Med. 2000;26(3):282-91. http://dx.doi.org/10.1002/(SICI)1096-9101(2000)26:3<282::AID-LSM6>3.0.CO;2-X. PMid:10738291.

16 Nalcaci R, Cokakoglu S. Lasers in orthodontics. Eur J Dent. 2013 Sep;7(S 01 Suppl 1):S119-25. http://dx.doi.org/10.4103/1305-7456.119089. PMid:24966719.

17 Yassaei S, Fekrazad R, Shahraki N. Effect of low level laser therapy on orthodontic tooth movement: a review article. J Dent. 2013 May;10(3):264-72. PMid:25512754.

18 Medrado ARAP, Pugliese LS, Reis SRA, Andrade ZA. Influence of lowlevel laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med. 2003;32(3):239-44. http://dx.doi.org/10.1002/lsm.10126. PMid:12605432.

19 Kipshidze N, Nikolaychik V, Keelan MH, Shankar LR, Khanna A, Kornowski R, et al. Low-power helium: neon laser irradiation enhances production of vascular endothelial growth factor and promotes growth of endothelial cells in vitro. Lasers Surg Med. 2001;28(4):355-64. http://dx.doi.org/10.1002/lsm.1062. PMid:11344517.

20 Medrado AP, Soares AP, Santos ET, Reis SR, Andrade ZA. Influence of laser photobiomodulation upon connective tissue remodeling during wound healing. J Photochem Photobiol B. 2008 Sep;92(3):144-52. http://dx.doi.org/10.1016/j.jphotobiol.2008.05.008. PMid:18602833.

21 Alazzawi MMJ, Husein A, Alam MK, Hassan R, Shaari R, Azlina A, et al. Effect of low level laser and low intensity pulsed ultrasound therapy on bone remodeling during orthodontic tooth movement in rats. Prog Orthod. 2018 Apr;19(1):10. http://dx.doi.org/10.1186/s40510-018-0208-2. PMid:29658096.

22 Gama SKC, Habib FAL, Monteiro JSC, Paraguassú GM, Araújo TM, Cangussú MCT, et al. Tooth movement after infrared laser phototherapy: clinical study in rodents. Photomed Laser Surg. 2010 Oct;28(Suppl 2):S79-83. http://dx.doi.org/10.1089/pho.2009.2618. PMid:20932152.

23 Doshi-Mehta G, Bhad-Patil WA. Efficacy of low-intensity laser therapy in reducing treatment time and orthodontic pain: a clinical investigation. Am J Orthod Dentofacial Orthop. 2012 Mar;141(3):289-97. http://dx.doi.org/10.1016/j.ajodo.2011.09.009. PMid:22381489.

24 Oliver RG, Knapman YM. Attitudes to orthodontic treatment. Br J Orthod. 1985;12(4):179-88. http://dx.doi.org/10.1179/bjo.12.4.179. PMid:3863673.

25 Patel S, McGorray SP, Yezierski R, Fillingim R, Logan H, Wheeler TT. Effects of analgesics on orthodontic pain. Am J Orthod Dentofacial Orthop. 2011 Jan;139(1):e53-8. http://dx.doi.org/10.1016/j.ajodo.2010.07.017. PMid:21195257.

26 Karu TI. A suitable model for wound healing: how many times are we to stumble over the same block? Lasers Surg Med. 1999;25(4):283-4. http://dx.doi.org/10.1002/(SICI)1096-9101(1999)25:4<283::AID-LSM1>3.0.CO;2-3. PMid:10534743.

27 Krishnan V, Davidovitch Z. Cellular, molecular, and tissue-level reactions to orthodontic force. Am J Orthod Dentofacial Orthop. 2006 Apr;129(4):469.e1-32. http://dx.doi.org/10.1016/j.ajodo.2005.10.007. PMid:16627171.

28 Kyrkanides S, O’Banion MK, Subtelny JD. Nonsteroidal anti-inflammatory drugs in orthodontic tooth movement: metalloproteinase activity and collagen synthesis by endothelial cells. Am J Orthod Dentofacial Orthop. 2000 Aug;118(2):203-9. http://dx.doi.org/10.1067/mod.2000.105872. PMid:10935962.

29 Stolik S, Delgado JA, Anasagasti L, Pérez AM. Effective thermal penetration depth in photo-irradiated Ex vivo human tissues. Photomed Laser Surg. 2011 Oct;29(10):669-75. http://dx.doi.org/10.1089/pho.2010.2948. PMid:21612514.

30 Kassák P, Sikurová L, Kvasnicka P, Bryszewska M. The response of Na+/K+-ATPase of human erythrocytes to green laser light treatment. Physiol Res. 2006;55(2):189-94. PMid:15910177.

31 Kasai S, Kono T, Yamamoto Y, Kotani H, Sakamoto T, Mito M. Effect of low-power Laser irradiation on impulse conduction in anesthetized rabbits. J Clin Laser Med Surg. 1996 Jun;14(3):107-9. http://dx.doi.org/10.1089/clm.1996.14.107. PMid:9484084.

32 McCarthy MM, Arnold AP. Reframing sexual differentiation of the brain. Nat Neurosci. 2011 Jun;14(6):677-83. http://dx.doi.org/10.1038/nn.2834. PMid:21613996.

33 Fillingim RB, Gear RW. Sex differences in opioid analgesia: clinical and experimental findings. Eur J Pain. 2004 Oct;8(5):413-25. http://dx.doi.org/10.1016/j.ejpain.2004.01.007. PMid:15324773.
 


Submitted date:
01/20/2020

Accepted date:
06/08/2020

5f16e73f0e8825a46b9517e4 rou Articles
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