Effects of Vibrational Appliances on Orthodontic Tooth Movement and Patient Discomfort
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Background: Shortening orthodontic treatment duration while maintaining quality results is a sought-after goal in orthodontics. Different techniques involving mechanical vibrations, low dose light treatments, and biological mediators have been used to accelerate orthodontic tooth movement and achieve the final desirable clinical outcomes over shorter treatment periods. However, most of these techniques remain controversial in terms of their effectiveness. Purpose: To determine the effects of the supplementary use of low level vibratory stimulation on canine retraction and pain perception in adolescents undergoing full-fixed orthodontic treatment with extraction. Material and Methods: This randomized controlled clinical trial included 21 healthy adolescent subjects aged between 12 to 17 years, who were undergoing full-fixed Edgewise orthodontic treatment with maxillary first premolar extraction.Subjects were randomly assigned to two different groups using GraphPad Software: 1) Experimental group used a supplementary vibratory device (AcceleDent Aure, OrthoAccel Technologies, Inc.) for 20 minutes every night at 7 pm; and 2) Control group only underwent full-fixed orthodontic treatment without supplementary devices. Three-dimensional palatal landmark superimpositions were conducted using serial maxillary digital models. The monthly rate of tooth movement (mm), the total amount of tooth movement (mm) at 3 months, and the perceived pain level (using Visual Analogue Scale) after each activation were recorded. Results: The total amount of tooth movement was 1.12 mm (SD 0.22) versus 1.39 (SD 0.36) mm at 4 weeks (p=0.05), 2.59 mm (SD 0.37) versus 2.49 (SD 0.76) mm at 8 weeks (p=0.702) and 3.54 mm (SD 0.23) versus 3.37 mm (SD 1.37) at 12 weeks (p=0.716) in control versus experimental groups respectively. The rate of tooth movement was 1.21 mm/month (SD 0.32) in the control and 1.12 mm/month (SD 0.20) in the experimental, the differences in means between experimental and control groups were not statistically significant (p 0.05) at any of the three time points. Finally, there were statistically significant changes in the level of pain over the 7 days period following each device adjustment wasn’t statistically significant between the two treatment groups. Conclusion: This study found no statistical and clinical significant differences in terms of canine retraction and pain perception between the experimental and control groups. The supplementary use of AcceleDent to accelerate tooth movement is not supported in this study. Future studies with larger samples are warranted.