Effect of Low Intensity Pulsed Ultrasound (LIPUS) on Tooth Movement and Root Resorption: A Prospective Multi-Center Randomized Controlled Trial

Tarek El-Bialy, Khaled Farouk, Terry D Carlyle, William Wiltshire, Robert Drummond, Tim Dumore, Kevin Knowlton, Bryan Tompson, Tarek El-Bialy, Khaled Farouk, Terry D Carlyle, William Wiltshire, Robert Drummond, Tim Dumore, Kevin Knowlton, Bryan Tompson

Abstract

The aim of this study was to evaluate the possible effect of low intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption in orthodontic patients. Twenty-one patients were included in a split-mouth study design (group 1). Ten additional patients were included with no LIPUS device being used and this group was used as the negative control group (group 2). Group 1 patients were given LIPUS devices that were randomly assigned to right or left side on upper or lower arches. LIPUS was applied to the assigned side that was obtained by randomization, using transducers that produce ultrasound with a pulse frequency of 1.5 MHz, a pulse repetition rate of 1 kHz, and average output intensity of 30 mW/cm2. Cone-beam computed tomography (CBCT) images were taken before and after treatment. The extraction space dimensions were measured every four weeks and root lengths of canines were measured before and after treatment. The data were analyzed using paired t-test. The study outcome showed that the mean rate of tooth movement in LIPUS side was 0.266 ± 0.092 mm/week and on the control side was 0.232 ± 0.085 mm/week and the difference was statistically significant. LIPUS increased the rate of tooth movement by an average of 29%. For orthodontic root resorption, the LIPUS side (0.0092 ± 0.022 mm/week) showed a statistically significant decrease as compared to control side (0.0223 ± 0.022 mm/week). The LIPUS application accelerated tooth movement and minimized orthodontically induced tooth root resorption at the same time.

Keywords: LIPUS; acceleration; clinical trial; low-intensity pulsed ultrasound; orthodontic tooth movement.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The CONSORT flow diagram.
Figure 2
Figure 2
Low-intensity pulsed ultrasound (LIPUS) device used in the clinical trial including A: handheld electronics; B: mouthpiece containing LIPUS transducers; and, C: oral ultrasound gel.
Figure 3
Figure 3
A case in the LIPUS group at the beginning (top left) and two months of the treatment (top right) the patient’s lower right side was treated by LIPUS and lower left side was control. CBCT scan showing root angulation after canine retraction (bottom left LIPUS treated side and right is control).
Figure 4
Figure 4
Comparison of the weekly rate of tooth movement in the active group.
Figure 5
Figure 5
Comparison of the weekly rate of root resorption in the active group.

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