Effect Of Low Level Laser Therapy on the Rate of En- Masse Retraction: RCT

Not Applicable

Completed

Interventions: Procedure: En- masse retraction and LLLT
Procedure: En- masse retraction without LLLT

Brief Summary: There is scarcity in the literature regrading the effect of Low Level Laser Therapy (LLLT) on the rate of en-masse retraction. This study aims to investigate whether LLLT would affect the rate of en-masse retraction in females having bimaxillary dento-alveolar protrusion.

Detailed Description: Individuals having bimaxillary dentoalveolar protrusion are characterized by proclined upper and lower incisors and increased procumbency of the lips thus suffering from poor facial esthetics. The conventional management of these patients is the extraction of the first premolars and retraction of the anterior teeth.

One of the treatment techniques is in the form of canine retraction followed by four incisors retraction. This conventional method takes tedious work and tremendous time, thus affecting the patients' satisfaction adversely. The other technique is retraction of the whole set of anterior teeth as one unit (Canine and incisors), which is referred to as "En-Masse retraction".

Enhancing the rate of orthodontic tooth movement has always been a supreme goal of orthodontic research hoping to raise the level of care delivered to patients, hence, increase patients' satisfaction.

One of the proposed modalities of increasing the rate of tooth movement is Low Level Laser Therapy (LLLT). Thus, the aim of the current consideration was to evaluate the impact of LLLT on the rate of en-masse retraction in adult females having bimaxillary dentoalveolar protrusion.

Recruitment & Eligibility

Inclusion Criteria

Adult females
Patients having bimaxillary dento- alveolar protrusion and Class I Molar relation
Cases requiring maximum anchorage during retraction.
Good general and oral health

Exclusion Criteria

Patients suffering from any systemic diseases interfering with tooth movement.
Patients with extracted or missing permanent teeth. (except for third molars).
Patients with badly decayed teeth (Other than 1st premolars).
Patients with any parafunctional habits (i.e. Bruxism, tongue thrusting, mouth breathing, etc...).
Patients with previous orthodontic treatment
Pregnant females

Arm && Interventions

Group	Intervention	Description
LG (Group A)	En- masse retraction and LLLT	En- masse retraction using NiTi closed coil springs rendering 200 g/side were employed following first premolars extraction and insertion of buccal TADs to provide maximum anchorage. Retraction was done along with the application of LLLT till the end of retraction.
NLG (Group B)	En- masse retraction without LLLT	En- masse retraction using NiTi closed coil springs rendering 200 g/side were employed following first premolars extraction and insertion of buccal TADs to provide maximum anchorage. No LLLT was applied to this group

Primary Outcome Measures

Name	Time	Method
Rate of en-masse retraction	From date of first premolars' extraction until the date of anterior teeth retraction, assessed up to an average of 1 year	The antero-posterior movement of anterior teeth will be assessed by measuring the digitilized study models taken of the patients monthly (measured in mm)

Secondary Outcome Measures

Name	Time	Method
Anterior teeth Tip and Torque	From date of first premolars' extraction until the date of anterior teeth retraction, assessed up to an average of 1 year	By comparing angular changes in the teeth's tip and torque in relation to reference planes
Anchorage (Loss/ Gain)	From date of first premolars' extraction until the date of anterior teeth retraction, assessed up to an average of 1 year	By comparing linear and angular changes in the first molars in relation to reference planes
First molars' rotation	From date of first premolars' extraction until the date of anterior teeth retraction, assessed up to an average of 1 year	Study models that are taken pre and post retraction (then digitilized) will be used to assess the rotation of the maxillary first molars in relation to a reference line
Anterior teeth's root resorption	From date of first premolars' extraction until the date of anterior teeth retraction, assessed up to an average of 1 year	Assessed via comparing the pre \& post- retraction CBCTs using Lavender \& Malmgren Grading system
Pain Associated	From date of first premolars' extraction until the date of anterior teeth retraction, assessed up to an average of 1 year	Each patient will fill a questionnaire regarding his treatment experience in a VAS scoring from 0-10