Diode Laser Versus LED for Maxillary Canine Retraction in Orthodontic Patients

Can Tho University of Medicine and Pharmacy34 enrolled

Overview

This study aims to compare the effects of diode laser and light-emitting diode (LED) photobiomodulation on maxillary canine retraction during fixed orthodontic treatment. Participants requiring bilateral maxillary first premolar extraction will receive both interventions using a split-mouth design. One maxillary canine will receive diode laser photobiomodulation, while the contralateral maxillary canine will receive LED photobiomodulation. Maxillary canine movement will be evaluated at 4, 8, 12, and 16 weeks during retraction to compare the amount and rate of tooth movement between the two interventions. Pain associated with orthodontic tooth movement will also be assessed. Pulp oxygen saturation (SpO₂) of the maxillary canines will be measured to evaluate changes in pulpal oxygenation during orthodontic canine retraction. SpO₂ will be assessed at baseline and at predefined follow-up time points, including 20 minutes, 24 hours, 7 days, and 4 weeks. Changes in SpO₂ will be compared between the diode laser and LED sides. Cone-beam computed tomography (CBCT) will be used to evaluate changes in maxillary canine root length and alveolar bone dimensions before and after canine retraction. The study is expected to determine whether diode laser and LED photobiomodulation differ in their effects on orthodontic canine retraction, pulpal oxygenation, pain, and associated dental and alveolar bone changes.

This is an interventional split-mouth clinical study comparing diode laser and light-emitting diode (LED) photobiomodulation during maxillary canine retraction in patients undergoing fixed orthodontic treatment. After alignment and leveling, maxillary canine retraction will be performed using standardized orthodontic mechanics. Each participant will receive both photobiomodulation interventions. One maxillary canine will receive diode laser photobiomodulation, while the contralateral maxillary canine will receive LED photobiomodulation according to the predefined side-allocation procedure. The interventions will be repeated at 4-week intervals during the 16-week observation period. Digital intraoral scans will be obtained to quantify maxillary canine movement. Cumulative canine retraction will be assessed at 4, 8, 12, and 16 weeks. The amount and rate of canine retraction will be compared between the diode laser and LED sides within the same participant. Pulp oxygen saturation (SpO₂) of the maxillary canines will be assessed to evaluate pulpal oxygenation during orthodontic tooth movement. SpO₂ measurements will be obtained separately from the canine receiving diode laser photobiomodulation and the contralateral canine receiving LED photobiomodulation at baseline, 20 minutes, 24 hours, 7 days, and 4 weeks after initiation of canine retraction. Changes from baseline and differences in SpO₂ between the two intervention sides will be evaluated. Pain associated with orthodontic tooth movement will be assessed using a visual analog scale (VAS) after photobiomodulation. Cone-beam computed tomography (CBCT) examinations obtained before and after the canine retraction period will be used to evaluate changes in maxillary canine root length and alveolar bone dimensions. Because both interventions are administered within the same participant, the split-mouth design allows direct within-participant comparison of diode laser and LED photobiomodulation while reducing the influence of interindividual biological variability.

Interventions

Diode Laser PhotobiomodulationDEVICE

Diode laser photobiomodulation at a wavelength of 810 nm will be applied to the maxillary canine during orthodontic retraction. Irradiation will be delivered at 12 points around the canine root, including six points on the buccal side and six points on the palatal side. The root area will be divided into cervical, middle, and apical regions. The laser will be applied for 10 seconds per region, delivering 1 J per region and a total energy of 6 J per tooth. The energy density will be 5.1 J/cm². The intervention will be repeated at 4-week intervals during the 16-week canine retraction period.

LED PhotobiomodulationDEVICE

The contralateral maxillary canine will receive light-emitting diode (LED) photobiomodulation during orthodontic canine retraction. LED irradiation will be applied at 12 points around the canine root, including six points on the buccal side and six points on the palatal side. The LED will be applied for 5 seconds at each point, with an energy density of 6 J/cm² and a wavelength range of 430-480 nm. The intervention will be repeated at 4-week intervals during the 16-week canine retraction period.

Eligibility

Sex: ALLMin age: 15 YearsMax age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with complete permanent dentition and cervical vertebral maturation at CS5 or CS6 according to the Baccetti classification. * Angle Class I malocclusion. * Indication for fixed orthodontic treatment requiring bilateral extraction of the maxillary first premolars. * Similar position, morphology, and dimensions of the maxillary canines on both sides. * No previous orthodontic treatment. * Willingness to participate in the study and provision of informed consent. Exclusion Criteria: * Patients with bleeding or coagulation disorders, diabetes mellitus, bone diseases, or periodontal diseases. * Use of medications that may affect orthodontic tooth movement or coagulation, including aspirin, heparin, warfarin, nonsteroidal anti-inflammatory drugs, or glucocorticoids. * History of maxillofacial trauma or craniofacial anomalies. * Smoking. * Pregnancy. * Requirement for extraction of teeth other than the first premolars.

Outcomes

Primary Outcomes

Amount of Maxillary Canine Retraction

The amount of maxillary canine retraction will be measured in millimeters using digital intraoral scans. Canine movement will be assessed by comparing the position of the maxillary canine at baseline and at each follow-up time point. The amount of retraction on the diode laser side will be compared with that on the contralateral LED side within the same participant.

Time frame: Baseline, 4 weeks, 8 weeks, 12 weeks, and 16 weeks

Secondary Outcomes

Pain Intensity Following Orthodontic Canine Retraction

Pain intensity will be assessed using a Visual Analog Scale (VAS) following photobiomodulation during orthodontic canine retraction. Participants will record pain separately for the diode laser and LED sides. VAS scores will be compared between the two intervention sides.

Time frame: 1 day, 3 days, and 7 days after photobiomodulation

Change in Maxillary Canine Root Length

Maxillary canine root length will be measured using cone-beam computed tomography (CBCT) to assess changes in root length associated with orthodontic canine retraction. Changes from baseline will be compared between the diode laser and LED sides.

Time frame: Baseline and 16 weeks

Change in Alveolar Bone Dimensions Around the Maxillary Canine

Alveolar bone dimensions around the maxillary canine will be evaluated using cone-beam computed tomography (CBCT). Changes from baseline will be compared between the diode laser and LED sides.

Time frame: Baseline and 16 weeks

Change in Pulp Oxygen Saturation of the Maxillary Canine

Pulp oxygen saturation (SpO₂) of the maxillary canines will be measured to evaluate changes in pulpal oxygenation during orthodontic canine retraction. SpO₂ values will be recorded separately for the maxillary canine receiving diode laser photobiomodulation and the contralateral maxillary canine receiving LED photobiomodulation. Changes from baseline and differences between the two intervention sides will be assessed.

Time frame: Baseline, 20 minutes, 24 hours, 7 days, and 4 weeks after initiation of canine retraction.