Influence of Low-level Laser Therapy Versus Low-intensity Pulsed Ultrasound on Different Orthodontic Tooth Movements

Study Overview
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Brief Summary
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The aim of this prospective clinical project will be to compare the effect of low-level laser therapy versus low intensity pulsed ultrasound on the rate of different orthodontic tooth movements

Detailed Description
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The aim of this prospective clinical project will be to compare the effect of low-level laser therapy versus low intensity pulsed ultrasound on the rate of different orthodontic tooth movements, specifically; canine retraction, incisors' leveling and alignment, maxillary molar distalization, and incisors' intrusion

Official Title
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Influence of Low-level Laser Therapy Versus Low-intensity Pulsed Ultrasound on Different Orthodontic Tooth Movements: A Comparative Clinical Investigation

Conditions
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Effect of Low Level Laser Versus Low Intensity Pulsed Ultra Sound on Rate of Different Orthodontic Tooth Movement by Millimeter

Intervention / Treatment
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* Device: low-level laser therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - A- leveling and alignment Eligibility criteria 1. Age ranges from 14 to 17 years. 2. Bilateral Class II molar relationship. 3. Skeletal Class I or mild Class II relationship. 4. Normal or decreased vertical height. 5. No posterior crowding or spaces. 6. Fully erupted maxillary first and second molars. 7. Congenitally missing or extracted third molars. 8. Good oral hygiene. 9. Absence of any periodontal disease and alveolar bone loss. 10. Absence of medications that may inhibit orthodontic movement Lower incisor leveling and alignment Inclusion criteria Complete permanent dentition (third molars not included); Moderate mandibular anterior crowding (with little's irregularity index score greater than 4 mm) who required non-extraction approach in the mandibular arch; No tooth size, shape or root abnormalities visible on the patient's radiographic records; No spaces in the mandibular arch; No blocked out tooth that did not allow for placement of the bracket at the initial bonding appointment; 6. No required management with interproximal stripping, inter-maxillary elastics, open NiTi springs, and removable or extra-oral devices. Canine retraction Eligibility criteria Age, 15 to 25 years; Class ii division 1 malocclusion with mild or no crowding; No previous orthodontic treatment; No systemic disease that might have affected bone formation or density, such as osteoporosis, hyperparathyroidism, or vitamin d deficiency; Adequate oral hygiene; Probing depth values not exceeding 3 mm across the Entire dentition; Adequate thickness of the attached gingiva (1-2 mm); No radiographic evidence of bone loss Exclusion Criteria: - Patients who required surgery to correct skeletal discrepancies. Patients with congenital dentoskeletal disorders. Missed or mutilated teeth in maxillary arch. Patients with poor oral hygiene and/or periodontally compromised patients Severe dental crowding that necessitates an extraction approach 2. Abnormal anteroposterior and vertical relationships; 3. Patients with cleft lip and palate, anomalies, and syndromes; 4. Previous orthodontic 5. Treatment; 6. Regular medications intake that could interfere with otm. -

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 22 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Lipus side: canine retraction<br>application of LIPUS with translation of maxillary canine that will be performed on intervention sides according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| No Intervention: LIPUS side control side<br>LIPUS side:canine retraction control side | |
| Experimental: LLLT side canine retraction<br>translation of maxillary canine that will be performed with LLLT application according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| No Intervention: LLLT side canine retraction control side<br>LLLT side canine retraction control side wihout intervention | |
| Experimental: LIPUS groupMolar distalization group inrervention side<br>distalization assisted with LIPUS according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| No Intervention: LIPUS groupMolar distalization group control side<br>distalization without LIPUS intervention | |
| Experimental: LLLT group: distalization intervntion side<br>distalization will be commenced with application of LLLT according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| No Intervention: LLLT group: distalization control side<br>distalization will be commenced without application of LLLT according to a standardized protocol | |
| Experimental: LIPUS group: leveling and alignment<br>leveling and alignment assisted with LIPUS according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| Experimental: LLLT group: leveling and alignment<br>leveling and alignment be commenced with application of LLLT according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| No Intervention: leveling and alignment without intervention<br>leveling and alignment without intervention | |
| Experimental: LIPUS group: Intrusion<br>intrusion assisted with LIPUS according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| Experimental: LLLT group: Intrusion<br>intrusion assisted with application of LLLT according to a standardized protocol | Device: low-level laser therapy<br>* LLLT and LIPUS has been found to speed up OTM by stimulating the RANK/RANKL/OPG system to initiate osteoclast formation.<br>* Other names: low intensity pulsed ultrasound;|
| No Intervention: intrusion control group<br>intrusion without intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Influence of low-level laser therapy versus low-intensity pulsed ultrasound on rate of different orthodontic tooth movements by millimeter | rate of orthodontic tooth movement by millimeter | post interventionalal at 6months |