Abstract
This review aimed to identify the efficacy of low-level laser therapy (LLLT) in the management of orthodontic pain. This systematic review and meta-analysis was carried out in accordance with Cochrane Handbook and the PRISMA statement. An extensive literature search for RCTs, quasi-RCTs, and CCTs was performed through CENTRAL, PubMed, Embase, Medline, CNKI, and CBM up to October 2011. Risk of bias assessment was performed via referring to the Cochrane tool for risk of bias assessment. Meta-analysis was implemented using Review Manager 5.1. As a result, four RCTs, two quasi-RCTs, and two CCTs were selected from 152 relevant studies, including 641 patients from six countries. The meta-analysis demonstrated that 24 % risk of incidence of pain was reduced by LLLT (RR = 0.76, 95 % CI range 0.63–0.92, P = 0.006). In addition, compared to the control group, LLLT brought forward “the most painful day” (MD = −0.42, 95 % CI range −0.74– − 0.10, P = 0.009). Furthermore, the LLLT group also implied a trend of earlier end of pain compared with the control group (MD = −1.37, 95 % CI range −3.37–0.64, P = 0.18) and the pseudo-laser group (MD = −1.04, 95 % CI range −4.22–2.15, P = 0.52). However, because of the methodological shortcomings and risk of bias of included trials, LLLT was proved with limited evidence in delaying pain onset and reducing pain intensity. In the future, larger and better-designed RCTs will be required to provide clearer recommendations.
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References
Erdinç AM, Dinçer B (2004) Perception of pain during orthodontic treatment with fixed appliances. Eur J Orthod 26(1):79–85
Ngan P, Bradford K, Wilson S (1989) Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop 96:47–53
Xiaoting L, Yin T, Yangxi C (2010) Interventions for pain during fixed orthodontic appliance therapy. A systematic review. Angle Orthod 80(5):925–932
Krishnan V (2007) Orthodontic pain: from causes to management—a review. Eur J Orthod 29(2):170–179
Polat O, Karaman AI (2005) Pain control during fixed orthodontic appliance therapy. Angle Orthod 75:214–219
Lim HM, Lew KK, Tay DK (1995) A clinical investigation of the efficacy laser therapy in reducing orthodontic postadjustment pain of low level. Am J Orthod Dentofacial Orthop 108:614–622
Turhani D, Scheriau M, Kapral D, Benesch T, Jonke E, Bantleon HP (2006) Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofacial Orthop 130(3):371–377
Tortamano A, Lenzi DC, Haddad AC, Bottino MC, Dominguez GC, Vigorito JW (2009) Low-level laser therapy for pain caused by placement of the first orthodontic archwire: a randomized clinical trial. Am J Orthod Dentofacial Orthop 136(5):662–667
Harazaki M, Isshiki Y (1997) Soft laser irradiation effects on pain reduction in orthodontic treatment. Bull Tokyo Dent Coll 38(4):291–295
Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM (2009) Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 374(9705):1897–1908
Youssef M, Ashkar S, Hamade E, Gutknecht N, Lampert F, Mir M (2008) The effect of low-level laser therapy during orthodontic movement: a preliminary study. Lasers Med Sci 23(1):27–33
Cruz DR, Kohara EK, Ribeiro MS, Wetter NU (2004) Effects of low-intensity laser therapy on the orthodontic movement velocity of human teeth: a preliminary study. Lasers Surg Med 35(2):117–120
Higgins JPT, Green S (2009) Cochrane handbook for systematic reviews of interventions. Wiley, Chichester
Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097
Juping S, Xueqin B, Hongbin L (2003) The clinical observation on the semiconductor laser irradiation in reducing pain accompanying with orthodontic treatment [Article in Chinese]. J Dent Prev Treat 11(4):249–250
Xinhua S, Baijuan G (2001) The clinical study on the low reaction level laser irradiation in reducing pain accompanying orthodontics treatment [Article in Chinese]. Chin J Orthod 8(4):175–177
Fujiyama K, Deguchi T, Murakami T, Fujii A, Kushima K, Takano-Yamamoto T (2008) Clinical effect of CO2 laser in reducing pain in orthodontics. Angle Orthod 78(2):299–303
Vandeska-Radunovic V, Kristiansen AB, Heyeraas KJ (1994) Changes in blood circulation in teeth supporting tissues incident to experimental tooth movement. Eur J Orthod 16:361–369
Vandevska-Radunovic V (1999) Neural modulation of inflammatory reactions in dental tissues incident to orthodontic tooth movement—a review of the literature. Eur J Orthod 21:231–247
Nicolay OF, Davidovitch Z, Shanfeld JL, Alley K (1990) Substance P immune reactivity in periodontal tissues during orthodontic tooth movement. Bone Miner 11:19–29
Bernhardt MK, Southard KA, Batterson KD, Logan HL, Baker KA, Jakobsen JR (2001) The effect of preemptive and/or postoperative ibuprofen therapy for orthodontic pain. Am J Orthod Dentofacial Orthop 120(1):20–27
Walker JB Jr, Buring SM (2001) NSAIDs impairment of orthodontic tooth movement. Ann Pharmacother 35:113–115
Kehoe MJ, Cohen SM, Zarrinnia K, Cowan A (1996) The effect of acetaminophen, ibuprofen, and misoprostol on prostaglandin E2 synthesis and the degree and rate of orthodontic tooth movement. Angle Orthod 66:339–350
Pesevska S, Nakova M, Ivanovski K, Angelov N, Kesic L, Obradovic R, Mindova S, Nares S (2010) Dentinal hypersensitivity following scaling and root planning: comparison of low-level laser and topical fluoride treatment. Lasers Med Sci 25(5):647–650
Silveira PC, Silva LA, Freitas TP, Latini A, Pinho RA (2010) Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing. Lasers Med Sci 26(1):125–131
Alghamdi KM, Kumar A, Moussa NA (2011) Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 27(1):237–249
Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S et al (2011) Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci 27(1):71–78
Sakurai Y, Yamaguchi M, Abiko Y (2000) Inhibitory effect of low-level laser irradiation on LPS-stimulated prostaglandin E2 production and cyclooxygenase-2 in human gingival fibroblasts. Eur J Oral Sci 108:29–34
Pires D, Xavier M, Araújo T, Silva JA Jr, Aimbire F, Albertini R (2010) Low-level laser therapy (LLLT; 780 nm) acts differently on mRNA expression of anti- and pro-inflammatory mediators in an experimental model of collagenase-induced tendinitis in rat. Lasers Med Sci 26(1):85–94
Lucas C, Stanborough RW, Freeman CL (2000) Efficacy of low-level laser therapy on wound healing in human subjects: a systematic review. Lasers Med Sci 15:84–93
Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56
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He, W.L., Li, C.J., Liu, Z.P. et al. Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis. Lasers Med Sci 28, 1581–1589 (2013). https://doi.org/10.1007/s10103-012-1196-y
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DOI: https://doi.org/10.1007/s10103-012-1196-y