Clinical trial NCT05361616: Impact of Photobiomodulation on Pain During Orthodontic Treatment.
Official title: Impact of Photobiomodulation on Pain During Orthodontic Treatment
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Malocclusion
Orthodontic Treatment
Keywords: photobiomodulation
clear aligners
orthodontic pain
Lead sponsor: PBM Healing International Limited
Sponsor class: INDUSTRY
First posted: 2022-05-04
Enrollment: 32
Sex: ALL
Minimum age (years): 20
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The objective of this study is to determine to effect of PBM Ortho, a photobiomodulation device, in adult patients undergoing clear aligners orthodontic treatment. We hypothesize that PBM Ortho will reduced the orthodontic associated pain in the clear aligner patients. This effect will be evaluated by recording the pain on visual analog scale given to the patients before the placement of clear aligners and collecting saliva.

Detailed description: Pain associated with orthodontic treatment is one of the main causes of treatment discontinuation and patient non-cooperation. Several treatment modalities have been studied to alleviate orthodontic pain which includes pharmacological, mechanical, and behavioral approach. One potential treatment is the application of photobiomodulation (PBM) therapy which is a form of light therapy. The objective of this study is to determine to effect of PBM therapy in adult patients undergoing clear aligners orthodontic treatment. This effect will be evaluated by recording the pain on visual analog scale given to the patients before the placement of clear aligners and collecting saliva. The patients will be provided with active PBM Ortho device and sham PBM device (placebo, which will look similar to the active device) to use them at home for one 8 minutes application for 7 days (4 minutes per arch, upper or lower). The pain scale sheets will also be given to the patients to fill them every day for 7 days. The inflammatory protein associated with pain present in the saliva will be collected on Day 1 (24 hours after clear aligner treatment start), Day 4 (fourth day of treatment), and Day 7 (after 1 week from the treatment start). On the last visit, the device and pain scale sheets will be collected from the patients. If successful, this device therapy will reduce the orthodontic associated pain and improve patients' compliance and cooperation.

Eligibility criteria: Inclusion Criteria:

* Systemically healthy male and female patients (age 20 to 65), i.e., do not suffer from systemic illness nor require medication during the saliva collection period.
* Permanent dentition, with Little's Irregularity Index (LII) of 2 mm or greater for the upper and lower arch.
* Orthodontic treatment using clear aligners via non-extraction therapy.
* Patient is available for follow-up visits.
* Patient is able and willing to comply with the requirements of this trial protocol.
* Non-smoker with no use of chewing tobacco.
* Good oral hygiene.
* Caries free.
* No sign of periodontal disease.

Exclusion Criteria:

* Systemic diseases
* Medication use for the past 6 months; specially use of anti-inflammatory (e.g., NSAIDs), antiviral, antibiotics.
* Smoking.
* Active dental caries.
* Any periodontal problem including bleeding, tooth mobility, bone loss, attachment loss, deep pockets.
* Sleep apnea and other airway pathologies.

Primary outcomes:
measure: Visual analog scale
timeFrame: Day 0: prior to seating first clear aligner tray
measure: Visual analog scale
timeFrame: Day 1
measure: Visual analog scale
timeFrame: Day 2
measure: Visual analog scale
timeFrame: Day 3
measure: Visual analog scale
timeFrame: Day 4
measure: Visual analog scale
timeFrame: Day 5
measure: Visual analog scale
timeFrame: Day 6
measure: Visual analog scale
timeFrame: Day 7
Secondary outcomes:
measure: Saliva analysis
timeFrame: The saliva will be collected on Day 0
measure: Saliva analysis
timeFrame: The saliva will be collected on Day 1
measure: Saliva analysis
timeFrame: The saliva will be collected on Day 4
measure: Saliva analysis
timeFrame: The saliva will be collected on Day 7
Other outcomes:
Locations:
city: Edmonton
country: Canada
facility: Sphinx Orthodontic
state: Alberta
city: Edmonton
country: Canada
facility: Orthodontic Graduate Clinic, Kaye Clinic, University of Alberta
state: Alberta
Study officials:
References:
citation: White DW, Julien KC, Jacob H, Campbell PM, Buschang PH. Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial. Angle Orthod. 2017 Nov;87(6):801-808. doi: 10.2319/091416-687.1. Epub 2017 Jul 28.
citation: Wiedel AP, Bondemark L. A randomized controlled trial of self-perceived pain, discomfort, and impairment of jaw function in children undergoing orthodontic treatment with fixed or removable appliances. Angle Orthod. 2016 Mar;86(2):324-30. doi: 10.2319/040215-219.1. Epub 2015 Jul 17.
citation: Johal A, Fleming PS, Al Jawad FA. A prospective longitudinal controlled assessment of pain experience and oral health-related quality of life in adolescents undergoing fixed appliance treatment. Orthod Craniofac Res. 2014 Aug;17(3):178-86. doi: 10.1111/ocr.12044. Epub 2014 Apr 7.
citation: Polat O, Karaman AI. Pain control during fixed orthodontic appliance therapy. Angle Orthod. 2005 Mar;75(2):214-9. doi: 10.1043/0003-3219(2005)0752.0.CO;2.
citation: Long H, Wang Y, Jian F, Liao LN, Yang X, Lai WL. Current advances in orthodontic pain. Int J Oral Sci. 2016 Jun 30;8(2):67-75. doi: 10.1038/ijos.2016.24.
citation: Panda S, Verma V, Sachan A, Singh K. Perception of pain due to various orthodontic procedures. Quintessence Int. 2015 Jul-Aug;46(7):603-9. doi: 10.3290/j.qi.a33933.
citation: Baldini A, Nota A, Santariello C, Assi V, Ballanti F, Cozza P. Influence of activation protocol on perceived pain during rapid maxillary expansion. Angle Orthod. 2015 Nov;85(6):1015-20. doi: 10.2319/112114-833.1. Epub 2015 Mar 10.
citation: Mangnall LA, Dietrich T, Scholey JM. A randomized controlled trial to assess the pain associated with the debond of orthodontic fixed appliances. J Orthod. 2013 Sep;40(3):188-96. doi: 10.1179/1465313313Y.0000000045.
citation: Dray A. Inflammatory mediators of pain. Br J Anaesth. 1995 Aug;75(2):125-31. doi: 10.1093/bja/75.2.125.
citation: Ren Y, Vissink A. Cytokines in crevicular fluid and orthodontic tooth movement. Eur J Oral Sci. 2008 Apr;116(2):89-97. doi: 10.1111/j.1600-0722.2007.00511.x.
citation: Zeng M, Kou X, Yang R, Liu D, Wang X, Song Y, Zhang J, Yan Y, Liu F, He D, Gan Y, Zhou Y. Orthodontic Force Induces Systemic Inflammatory Monocyte Responses. J Dent Res. 2015 Sep;94(9):1295-302. doi: 10.1177/0022034515592868. Epub 2015 Jun 30.
citation: Scott DA, Krauss J. Neutrophils in periodontal inflammation. Front Oral Biol. 2012;15:56-83. doi: 10.1159/000329672. Epub 2011 Nov 11.
citation: Yan Y, Liu F, Kou X, Liu D, Yang R, Wang X, Song Y, He D, Gan Y, Zhou Y. T Cells Are Required for Orthodontic Tooth Movement. J Dent Res. 2015 Oct;94(10):1463-70. doi: 10.1177/0022034515595003. Epub 2015 Jul 17.
citation: Topolski F, Moro A, Correr GM, Schimim SC. Optimal management of orthodontic pain. J Pain Res. 2018 Mar 16;11:589-598. doi: 10.2147/JPR.S127945. eCollection 2018.
citation: Monk AB, Harrison JE, Worthington HV, Teague A. Pharmacological interventions for pain relief during orthodontic treatment. Cochrane Database Syst Rev. 2017 Nov 28;11(11):CD003976. doi: 10.1002/14651858.CD003976.pub2.
citation: Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1989 Jul;96(1):47-53. doi: 10.1016/0889-5406(89)90228-x.
citation: Fleming PS, Strydom H, Katsaros C, MacDonald L, Curatolo M, Fudalej P, Pandis N. Non-pharmacological interventions for alleviating pain during orthodontic treatment. Cochrane Database Syst Rev. 2016 Dec 23;12(12):CD010263. doi: 10.1002/14651858.CD010263.pub2.
citation: Wu S, Chen Y, Zhang J, Chen W, Shao S, Shen H, Zhu L, Ye P, Svensson P, Wang K. Effect of low-level laser therapy on tooth-related pain and somatosensory function evoked by orthodontic treatment. Int J Oral Sci. 2018 Jul 2;10(3):22. doi: 10.1038/s41368-018-0023-0.
citation: Al-Okla N, Bader D, Al-Mulla A, Ferguson D, Shaughnessy T. Effect of photobiomodulation on pain perception among orthodontic patients: a randomized clinical trial. J Clin Orthod. 2020 Feb;54(2):96-103. No abstract available.
citation: Farias RD, Closs LQ, Miguens SA Jr. Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: A randomized split-mouth clinical trial. Angle Orthod. 2016 Mar;86(2):193-8. doi: 10.2319/122214-933.1. Epub 2015 Jul 1.
citation: Sfondrini MF, Vitale M, Pinheiro ALB, Gandini P, Sorrentino L, Iarussi UM, Scribante A. Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application: Randomized Clinical Trial. Biomed Res Int. 2020 May 25;2020:7460938. doi: 10.1155/2020/7460938. eCollection 2020.