# Acceleration Techniques for Teeth Movements in Extractive Orthodontic Therapy
## 4 Discussion
### Low-Level Laser Therapy (LLLT)  
LLLT has emerged as one of the most promising new supportive treatment techniques in recent years since it is a non-intervention therapy that is easy to obtain and does not require expensive equipment [47]. LLLT has been demonstrated to increase angiogenesis by up-regulating chemical mediators such as the vascular endothelial growth factor, to facilitate osteoclast and osteoblast cell proliferation and differentiation, and to accelerate OTM [35]. Furthermore, low-level laser irradiation (LLLI) has been demonstrated to benefit analgesics in various clinical and therapeutic applications. LLLI reduces pain perception by preventing the release of arachidonic acid, which lowers prostaglandin E2 levels. It also causes the production of an endogenous opioid neuropeptide (beta-endorphin), which has powerful analgesic properties [52]. Several studies have been conducted to evaluate the impact of LLLT on improving OTM. [PERSON] et al. worked an RCCT with 60 patients divided into three groups: 20 treated with LLLT, 20 treated with LED biostimulation, and 20 in the CGr. The extraction site and buccal surface of the canine were exposed to light using an intraoral LED device called Biolight(r), which is comparable to Ortho-Pulse(r) and has a wavelength of 640 nm, an energy density of 10 j/cm\({}^{2}\), and a power density of 40 mW/cm\({}^{2}\)[35]. The patients were instructed to utilise the device for the maxillary dental arch for 5 min daily at the commencement of canine retraction. A GaAlAs diode laser with a wavelength of 810 nm and a power of 100 mW was used to treat the LLLT group. According to [PERSON] et al., LLLT looked to help accelerate OTM by 60%, while the LED could not significantly speed up the process. In addition, patient-centred outcomes showed that neither LLLT nor LED impacted how painful the procedure was felt by the patient [35]. On a sample of 22 patients, [PERSON] et al. examined the effect of LLLI delivered at 3-week intervals on OTM and pain related to OTM using self-ligating brackets [52]. According to [PERSON] et al., LLLT is a helpful technique that, if used at intervals of three weeks, can double the rate of OTM [52]. To assess the utilisation of non-invasive or minimally invasive techniques to expedite OTM, such as LLLT, [PERSON] et al. conducted a split-mouth RCT [50]. Three parallel intervention groups were randomly assigned to 64 quadrants in 32 patients: LLLT, LLLT with piezoelectrics, and CGr. A 940 nm laser with 8 J and 0.5 W of power was utilised for 16 s at six sites to accomplish LLLT. This was performed on the first day and then again after three and six weeks. This study demonstrated that although LLLT statistically and significantly sped up canine retraction and slowed anchoring loss, its effects were, at best, mild or moderate [50,78]. [PERSON] et al. evaluated the effectiveness of LLLT on 16 patients using a split-mouth RCT [47]. A GaAlAs diode laser with an output power of 100 mW and an 810 nm wavelength was used to treat the LLLT group for 10 s on both the buccal and lingual surfaces. LLLT in the conditions was used in our study. In orthodontic therapy, a GaAlAs diode laser with a twice-monthly radiation dose of 5.1 J/cm2 positively impacted OTM speed [47]. [PERSON] et al. assessed the effects of LLLT after extracting the first upper premolars for orthodontic purposes using a split-mouth RCT [42]. A diode laser operating in continuous wave mode at an 810 nm wavelength treated the test side at three places on the buccal and palatal sides at baseline, at 3, 7, and 14 days, and then every 15 days until the space closed. Only orthodontic traction was used on the C Side to treat the opposing chosen canine. This study shows that applying LLLT therapy successfully quickens OTM and lowers OTM-related discomfort levels [42]. In another split-mouth RCT, [PERSON] et al. evaluated the effects of LLLT [51]. After removing the first bicuspid on day 21, each canine was retracted using a 6 mm close coil NiTi spring stretched to 150 gm of force.