Systematic Review: Is High-Energy Laser Therapy (HELT) With Flapless Corticotomy Effective in Accelerating Orthodontic Tooth Movement?

The objective of this review was to critically and systematically appraise the available evidence regarding the effectiveness of high-energy laser therapy (HELT) with flapless corticotomy in accelerating orthodontic tooth movement and the associated untoward effects. We searched eight databases electronically in August 2021: PubMed®, Medline®, Google Scholar, Cochrane Library, Scopus®, Web of Science™, Trip, and PQDT OPEN from ProQuest. Another search was done in the reference lists of the included studies. Randomized controlled trials (RCTs) were included in which patients had received fixed orthodontic treatment combined with HELT-assisted corticotomy in comparison with traditional orthodontic treatment. Cochrane's risk of bias (RoB2) tool was used to assess the risk of bias. Five RCTs and one CCT were included in this review (155 patients). The HELT-based corticotomy around the upper canines led to a greater canine retraction at the first and second months (P < 0.001). In the third month, no statistically significant differences were noticed. In one RCT focusing on incisor intrusion, the irradiated upper incisors showed a greater intrusion speed than that of the control group (4.587 mm in 59 days vs. 3.78 mm in 95.8 days, respectively). No significant side effects associated with the application of HELT were reported. According to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach, the quality of evidence supporting these findings was low to moderate. Although the acceleration of tooth movement appeared to be significant at least in the first two months, there was low to moderate evidence concerning the efficacy of HELT-based flapless corticotomy in the acceleration of orthodontic tooth movement. There is a need for more well-conducted high-quality RCTs.