低水平激光的光生物调节作用对加速正畸牙齿移动的效果:一项分口随机临床试验的系统评价和荟萃分析。

Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials.

机构信息

Laser Dentistry Master Program, European Program EMDOLA, University of Barcelona, Barcelona, Spain.

Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Km 20, Autonorte I-55, Chía, 250008, Bogotá, Cundinamarca, Colombia.

出版信息

Lasers Med Sci. 2023 Sep 4;38(1):200. doi: 10.1007/s10103-023-03870-7.

Abstract

Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm were associated with faster orthodontic tooth movement.

摘要

尽管有几项研究评估了低水平激光疗法 (LLLT) 对正畸加速移动的影响,但结果仍不一致。这种不一致可能归因于 LLLT 应用方案的差异,尤其是在波长范围方面。目的:(i) 评估 LLLT 对正畸加速移动的临床效果,(ii) 确定最有效的 LLLT 波长,以加速正畸治疗中的牙齿移动。从创建到 2022 年 10 月,在 MEDLINE(PubMed)、Scopus、ScienceDirect 和 LILACS 上进行了搜索。纳入标准:对系统健康的患者进行的关于 LLLT 加速正畸运动(特别是尖牙内收)效果的分口随机临床试验 (RCT)。使用 RoB-2 评估偏倚风险。应用随机效应模型。有 19 项 RCT 符合定性综合的纳入标准,有 18 项 RCT 纳入定量综合。17 项研究被评为存在一定偏倚风险,2 项研究被归类为低偏倚风险。总的来说,本系统评价和荟萃分析存在中度偏倚风险。本系统评价和荟萃分析的结果表明,接受 LLLT 治疗的组在第一个(OR 为 0.28,95%CI(0.07 至 0.48))、第二个(OR 为 0.52,95%CI(0.31 至 0.73))和第三个(OR 为 0.41,95%CI(0.03 至 0.79))月随访中,正畸牙移动速度更快。波长≤810nm 和能量密度值≤5.3J/cm 与更快的正畸牙齿移动相关。

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