Synergistic Effects of Photobiomodulation and Surgical Corticotomy on Accelerated Orthodontic Tooth Movement: A Prospective Clinical Study on Canine Retraction

Abstract

Introduction: Prolonged orthodontic treatment often leads to patient discomfort and reduced compliance, necessitating faster approaches. Corticotomy surgery promotes quicker tooth movement by stimulating localised bone remodeling. Photobiomodulation (PBM), a non-invasive light therapy, enhances cellular function and healing. Their combined application may offer a synergistic effect in accelerating canine retraction during orthodontic therapy. The present study was conducted based on the rationale that combining PBM with corticotomy may produce a synergistic effect, further accelerating tooth movement and potentially reducing overall treatment duration. Aim: To investigate the combined effects of PBM therapy and surgical corticotomy on accelerating orthodontic tooth movement, focusing on the extent and rate of canine retraction. Materials and Methods: The present prospective split-mouth clinical study was conducted between January and September 2024 at Saveetha Dental College, Chennai, Tamil Nadu, India, with 15 patients aged 18-35 years. Fifteen patients indicated for bilateral first premolar extractions in both arches to manage crowding, with intact canines, second premolars, and first molars, good periodontal health, and plaque and gingival index scores of 0.1-0.9 and 0.1-1.0 respectively, were included. Each of the 15 patients had one side (test side) treated with PBM and surgical corticotomy, while the other side (control side) received only surgical corticotomy. Canine retraction was measured at 4, 8, and 12 weeks using intraoral scans, and the extent and rate of movement were statistically analysed using independent t-tests, and one-way repeated measures Analysis of Variance (ANOVA). A p-value below 0.05 was deemed statistically significant. Results: The test group showed significantly greater canine retraction at 4 weeks (2.5±0.3 mm vs. 1.5±0.2 mm, p=0.005), 8 weeks (4.8±0.4 mm vs. 3.0±0.3 mm, p=0.003), and 12 weeks (6.3±0.5 mm vs. 4.0±0.4 mm, p=0.008) compared to the control group. The retraction rate was significantly higher in the test group across all monthly intervals (p<0.05). Conclusion: PBM therapy in conjunction with surgical corticotomy significantly accelerates the extent and rate of canine retraction, suggesting its potential as an effective adjunct in orthodontic treatment.