Effectiveness of Non-surgical Methods to Accelerate Orthodontic Movement: Systematic Review

Objectives: A long orthodontic treatment is associated with increased risk of bone necrosis, root resorption, caries and loss of patient motivation. Accelerating orthodontic tooth movement (OTM) is desirable for patients and dentists. Recent researches focused on accelerating OTM by physical, chemical or surgical techniques. Corticotomy, have shown that accelerates OTM. While, non-surgical methods showed variable rate of success. The purpose of this systematic review is to evaluate the available literature related to the effectiveness of non-surgical methods to accelerate OTM.
Methods: A literature search was performed on MEDLINE, EMBASE and CENTRAL databases up to October 2018. Inclusion criteria were: randomized clinical trials (RCT); fixed orthodontics; non-surgical methods used to accelerate OTM. Cochrane Collaboration’s tool was used for assessing the risk of bias of RCT. The primary outcomes evaluated was treatment duration and amount of tooth movement. Adverse effects were evaluated as secondary outcomes.
Results: Literature research identified 251 articles; after a screening of titles, abstracts and full-text studies; 14 fulfilled the inclusion criteria and were included. Ten studies investigated the effect of low-level laser therapy (LLLT), three of shock waves (SW) and one of vitamin D3 (VitD3). Seven studies resulted in high and seven with an unclear risk of bias. Out of ten studies investigating LLLT, seven reported a positive effect on OTM; two of the three studies of SW and the VitD3 study concluded that the therapies didn’t accelerate the OTM. None reported adverse effects related to the therapies.
Conclusions: 70% of the studies concluded that LLLT accelerates the OTM, but high heterogeneity in terms of study design and protocols avoid establishing conclusions about its efficacy and benefits. There is limited research-based evidence to conclude if SW and VitD3 could accelerate OTM. Universal clinical protocols and more high-quality clinical research are required to estimate the effectiveness of the techniques.