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Photobiomodulation therapy assisted orthodontic tooth movement: potential implications, challenges, and new perspectives

激光光子生物调节疗法辅助正畸牙齿移动:潜在的作用、挑战与新观点

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Abstract

Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster. Additionally, photobiomodulation therapy (PBMT), a non-invasive treatment, when applied in orthodontics, contributes to alleviating pain and reducing inflammation induced by orthodontic forces, along with improving tissue healing processes. Moreover, PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption (OIIRR) during orthodontic treatment (OT) due to its capacity to modulate inflammatory, apoptotic, and anti-antioxidant responses. However, a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement (OTM) in relation to OIIRR, casting doubt on its beneficial effects. In PBMT-assisted orthodontics, delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues. The penetration of light to the root surface is another crucial unknown factor. Both the penetration depth and distribution of light in periodontal tissues are unknown. Thus, advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations. This review explores possibilities for improving the application and effectiveness of PBMT during OTM. The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells, with a special focus on immunomodulatory effects during OTM.

摘要

口腔科激光治疗的研究在过去的十年里取得了巨大的进展。激光引发的光子生物调节效应能够调控牙周组织的生物学特性,促进损伤牙周组织更快愈合。光子生物调节疗法(PBMT)作为一种非侵入性治疗方式,有助于减轻正畸治疗引起的疼痛和牙周组织炎症,同时促进牙周组织愈合。此外,PBMT作为一种可通过改善炎症、调节细胞凋亡和抗氧化反应等生物学作用预防正畸导致的炎性牙根吸收(OIIRR)的新方法,受到越来越多研究者的关注。但也有研究表明,PBMT在正畸牙齿移动(OTM)过程中与OIIRR相关性的循证有效性仅为中等等级,这是由于光子在牙周组织中的穿透呈现指数衰减,难以向牙根表面提供足够的、适量的能量以达到最佳效果;另一方面,光是否能穿透牙周组织到达牙根表面也是影响激光在OIIRR治疗中的另外一个关键未知因素,光子在牙周组织中的穿透深度和能量分布强度尚不可知。因此,研究者需要克服以上局限性,以开发PBMT在正畸中的应用方法。本综述旨在阐述PBMT在OTM和预防OIIRR中的潜在作用及其相关机制,尤其是在OTM期间的免疫调节作用。

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (Nos. 81991500 and 81991502).

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Writing – original draft: Jiawen YONG and Sabine GRÖGR. Writing – review & editing: Julia VON BREMEN, Márcia MARTINS MARQUES, Andreas BRAUN, and Sabine RUF. Project administration and supervision: Xiaoyan CHEN, Sabine RUF, and Qianming CHEN. Conceptualization, data curation, and figures and tables processing: Jiawen YONG, Sabine GRÖGR, and Xiaoyan CHEN. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.

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Correspondence to Qianming Chen  (陈谦明).

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Jiawen YONG, Sabine GRÖGER, Julia VON BREMEN, Márcia MARTINS MARQUES, Andreas BRAUN, Xiaoyan CHEN, Sabine RUF, and Qianming CHEN declare that they have no conflict of interest.

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Yong, J., Gröger, S., Von Bremen, J. et al. Photobiomodulation therapy assisted orthodontic tooth movement: potential implications, challenges, and new perspectives. J. Zhejiang Univ. Sci. B 24, 957–973 (2023). https://doi.org/10.1631/jzus.B2200706

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  • DOI: https://doi.org/10.1631/jzus.B2200706

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