Photobiomodulation on Molar Verticalization With Mini-implant
Condition: Orthodontic Appliances; Low-Level Light Therapy
Study type: Interventional

Summary: 
      The objective of this study will be to evaluate the effect of photobiomodulation on the
      acceleration of the orthodontic movement of molar verticalization and its effect on pain and
      inflammation of the periodontal tissues.

      Thirty-four healthy patients aged 30-60 years, who need to recover the prosthetic space for
      oral rehabilitation after loss of the posterior inferior dental elements and inclination of
      the adjacent element, will be randomly divided into 2 groups: G1 (control group) -
      verticalization by mini-implant + PBM (photobiomodulation) simulation (placebo); G2
      (experimental group) - verticalization by mini-implant + PBM. The movements will occur with
      the aid of mini-implants and elastomeric chains ligatures. The PBM will occur with diode
      laser application, 660 nm (nanometers), 100mW (milliwatts), receiving 1J(joule) per point,
      10s (seconds), 10 points (5 per buccal and 5 per lingual) and radiant exposure of 25 J / cm².
      The crevicular gingival fluid (FGC) will be collected to analyzed Interleukins IL1β, IL-6,
      IL-8, IL-10(Interleukins) and TNF-α (tumor necrosis factor) by ELISA (enzyme-linked
      immunosorbent assay). Radiographic shots will be taken each month to ascertain the amount (in
      degrees) of verticalization. To evaluate the pain, the Visual Analogue Scale will be used in
      all the consultations, and to evaluate the quality of life, the OHIP-14 (oral health impact
      profile) questionnaire will be applied. Analgesics will be given and the number of drugs will
      be counted. If the data are normal, they will be submitted to the Student's t-test. The data
      will be presented as means ± SD(standard deviation) and the value of p will be defined as
      <0.05.
    

Detailed description: 
      Loss of a dental element can generate several repercussions in the stomatognathic system.
      According to the latest survey by the Ministry of Health, in 2010, Brazilian adults had, on
      average, 7 missing teeth. This loss may lead to movement of the adjacent teeth and the
      antagonist, which would make prosthetic rehabilitation harder to do. Anchoring systems, such
      as mini-implants, have been increasingly used as a treatment option because they act with
      heavy but controlled forces and without side effects. Recent studies have shown that
      photobiomodulation (PBM) can accelerate orthodontic movement in the molar intrusion. The
      objective of this study will be to evaluate the effect of photobiomodulation on the
      acceleration of the orthodontic movement of molar verticalization and its effect on pain and
      inflammation of the periodontal tissues.

      Thirty-four healthy patients aged 30-60 years, who need to recover the prosthetic space for
      oral rehabilitation after loss of the posterior inferior dental elements and inclination of
      the adjacent element, will be randomly divided into 2 groups: G1 (control group) -
      verticalization by mini-implant + PBM simulation (placebo); G2 (experimental group) -
      verticalization by mini-implant + PBM. The movements will occur with the aid of mini-implants
      and elastomeric chains ligatures. The PBM will occur with diode laser application, 660 nm,
      100mW, receiving 1J per point, 10s, 10 points (5 per buccal and 5 per lingual) and radiant
      exposure of 25 J / cm². The orthodontic forces of verticalization (corresponding to any
      exchange of elastomeric ligation) will be applied every 30 days and the PBM will be applied
      immediately, 3 and 7 days of each month, for a period of 3 months. The crevicular gingival
      fluid (FGC) will be collected on the 1st, 3rd and 7th days after the first activation, and
      then on the 3rd day of the following two months. Interleukins IL1β, IL-6, IL-8, IL-10 and
      TNF-α will be analyzed by ELISA. Radiographic shots will be taken each month to ascertain the
      amount (in degrees) of verticalization. To evaluate the pain, the Visual Analogue Scale will
      be used in all the consultations, and to evaluate the quality of life, the OHIP-14
      questionnaire will be applied. Analgesics will be given and the number of drugs will be
      counted. If the data are normal, they will be submitted to the Student's t-test. The data
      will be presented as means ± SD and the value of p will be defined as <0.05.
    

Intervention name(s): Placement of the mini-implant and verticalization
Intervention type(s): Procedure
Intervention description(s): an orthodontic mini-implant will be installed in the retromandibular region. The site will be anesthetized. The region will be pre-drilled by about 5mm with a spear drill attached to an implant motor. Once the mini-implant has been selected, it will be locked into position using a kit-specific digital key. Being threaded clockwise until the intramucosal mini-implant is at the gingival level. After installation, a metallic orthodontic lingual will be glued to the molar mesial to be verticalized. The lingual button will be glued to the inclined molar mesial with orthodontic adhesive. A gray chain elastomeric ligature will attach the head of the mini-implant to the lingual button glued to the molar mesial. A light force of 150gr will be imposed (measured with a tensiometer) in all cases, regardless of tooth position. This chain elastic will be changed every 30 days for a period of 3 months. After 90 days of the experiment time, the mini-implants will be removed.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 34 individuals will be randomly divided into 2 groups: G1 (control group) - verticalization by mini-implant + PBM simulation (placebo); G2 (experimental group) - verticalization by mini-implant + PBM.
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: orthodontic treatment,; photobiomodulation,; mini-implant,; verticalization of molars