TO OBSERVE THE EFFECT OF LOW LEVEL LASER THERAPY ON APICAL ROOT RESORPTION OCCURING DURING ORTHODONTIC TREATMENT AT THE STAGE OF MAXILLARY CANINE RETRACTION USING THE ARCH WIRES NANO COATED WITH PARYLENE.RANDOMIZED CONTROLLED TRIAL AND CBCT STUDY.

Phase 4

Not yet recruiting

Conditions: Pathological resorption of teeth,

Registration Number: CTRI/2023/10/058291

Lead Sponsor: Dr.Prajakta Joshi

Brief Summary: Orthodontic treatment aims in establishing, aesthetic, stable and functional occlusion. Duration of the Orthodontic corrections ranges between 12-30 months according to severity of malocclusion, compliance of the patient and other factors.1 Due to longer duration for Orthodontic corrections, patient is apprehensive about Orthodontic treatment and tends to avoid treatment. Review of literature shows that, the root resorption is related to time and force employed during orthodontic treatment. Longer the treatment time, greater is the chance for root resorption, caries, and decreased patient compliance.2 Reducing the treatment duration of Orthodontic corrections is the greatest challenge faced by every Orthodontist. Various treatment modalities suggested for accelerating tooth movement are injections of prostaglandin, 1,25(OH)2D3 (active form of vitamin D3); Parathyroid hormone, Osteocalcin and Relaxin. Electric stimulation; surgical methods (corticotomy, piezo-surgery) mechanical / physical methods (vibrations, lasers/Photo-biomodulation) and use of magnets are also reported for accelerating tooth movements.3,4 Out of various techniques suggested for accelerating tooth movement, application of low-level laser therapy (LLLT) is one of the convenient and non-invasive technique. In addition to reducing the treatment duration, it also reduces the intensity of pain associated with Orthodontic corrections and has healing effects on periodontium.5 Orthodontic forces lead to cellular response in periodontal ligament in the form of bone resorption on pressure side and bone deposition on tension side.This happens via RANK-RANKL-OPG pathway and inflammatory mediators like IL-1, IL-8, TNF-Î±.3 Low intensity lasers stimulate the dentoalveolar complex; induce wound healing by fibroblast and chondral proliferation; collagen synthesis, and nerve regeneration.6 It impacts on ATP production by mitochondria. Light accelerated orthodontics (LAO) increases ATP production at localized site which stimulates osteoblastic cellular proliferation and differentiation leading to increase in bone re-modelling procedure and thus accelerate the tooth movement. 1 Low intensity lasers induce osteoclastogenesis by inducing RANK/RANKL pathway which induces signaling molecules such as MAPK (Mitogen activated protein kinase), c-fos and nitric oxide. This helps in reduction of relapse, pain and root resorption due to orthodontic forces.3,4 Orthodontic appliances are exposed to saliva flow, food, temperature, and appliance force in oral cavity which leads to bio-corrosion, changes in microstructure, surface topography, mechanical properties and leaching of ions. Overcoming frictional resistance between the bracket and wires and then bringing tooth movement requires higher force values. Study of literature shows that nanocoating of wires with different nanoparticles reduces the frictional resistance thereby reducing the orthodontic force needed for tooth movement.7 Coating techniques and modifications of arch wire composition can control leaching of ions, eliminate friction and bacterial adhesion and thus accelerate orthodontic tooth movement.8 The anchorage loss also can be controlled by frictionless mechanism. Root resorption in Orthodontics is an undesired feature during Orthodontic corrections and is directly related to amount of force applied for Orthodontic corrections. Invention in field of nano-coatings have offered the field of Orthodontics its greatest advantage in reducing the friction. One of the nanoparticles, Parylene coatings have advantages like: It is highly resistant to corrosive conditions of body fluids, it is bio- compatible, has dry film lubricity, ability to form a thin continuous pinhole free inert film, low density, high dielectric barrier, and has proper thermal and UV stability.Judicious application of incorporating the advantages of gaining accelerated tooth movement with better comfort to the patient, without root resorption would be a dream come true in Orthodontic practice. Review of literature does not report about any studies showing effect of Parylene coating and use of LLLT in accelerating Orthodontics treatment. The present study aims at evaluating the effect of application of low-level laser therapy (LLLT) on apical root resorption during maxillary canine retraction by sliding mechanics employing arch wires nano coated with parylene to obtain accelerated tooth movement with more comfort to patient and with minimal root resorption.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 15

Inclusion Criteria

1. Permanent dentition including right and left second molars in both the arches.
1. The patient with completed levelling and alignment, requiring Orthodontic treatment with first premolar extraction and ready to retract maxillary canines.
1. Good oral hygiene.

Exclusion Criteria

1. Any medical or dental condition that, in the opinion of the investigator, could negatively affect study results during the expected length of the study.
1. Currently using any investigational drug or any other investigational device.
1. Planning to relocate or move during the treatment period.
1. Allergic to acetaminophen (use of aspirin or nonsteroidal anti-inflammatory drugs is excluded for patients while on the study).
1. Use of bisphosphonates (osteoporosis drugs) during the study.
1. Pregnancy.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Application of low-level laser therapy (LLLT) may reduce the apical root resorption during maxillary canine retraction by sliding mechanics employing arch wires nano coated with Parylene.	6 months

Secondary Outcome Measures

Name	Time	Method
Parylene nano coated arch wires with & without application of low-level laser therapy may speed up the Orthodontic treatment.	6 months

Trial Locations

Locations (1): Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital , Hingna, Nagpur, Maharashtra.
🇮🇳
Nagpur, MAHARASHTRA, India
Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital , Hingna, Nagpur, Maharashtra.
🇮🇳Nagpur, MAHARASHTRA, India
Dr Prajakta Joshi
Principal investigator
8208602611
prajaktajoshi0825@gmail.com