Se han propuesto vibraciones de baja frecuencia como un medio para acelerar el movimiento del diente y reducir los tiempos de tratamiento de ortodoncia.

ANTECEDENTES

Determinar las diferencias en la precisión del movimiento dental en pacientes tratados con un protocolo de alineador y vibración de baja frecuencia, y reduciendo el intervalo de reemplazo del alineador con respecto a un protocolo convencional.

OBJETIVO

Este ensayo fue diseñado como un ensayo clínico controlado aleatorio de un solo centro.

DISEÑO

Participantes: pacientes (27,1 ± 9,0 años) que requirieron tratamiento de ortodoncia con alineadores. Aleatorización: los pacientes fueron asignados aleatoriamente a tres grupos según lo determinado por un esquema de aleatorización informático. Al grupo A se les asignó un protocolo convencional (los alineadores se reemplazan cada 14 días); el grupo B además usó un dispositivo de vibración de baja frecuencia durante 20 minutos al día; el grupo C siguió el mismo protocolo de vibración, pero reemplazó sus alineadores cada 7 días.
Se analizaron los modelos digitales antes y después del tratamiento utilizando el software VAM para identificar la precisión / imprecisión de los movimientos dentales. El análisis de varianza unidireccional (P <0.05) y la prueba post hoc de Bonferroni se usaron para identificar cualquier diferencia estadísticamente significativa entre los tres grupos en términos de precisión del movimiento del diente versus la prescripción

MÉTODOS

Números analizados: se analizaron un total de 45 pacientes (15 para cada grupo) (es decir, 2286 movimientos dentales). No surgieron diferencias estadísticamente significativas entre los grupos A y C en el arco superior, o entre los grupos A, B y C en el inferior. El grupo B mostró una precisión significativamente mayor con respecto al grupo A en la rotación del incisivo superior (P = 0.016), y al grupo C en la inclinación vestibulolingual (P = 0.007) y mesiodistal (P = 0.029) de los caninos superiores, y la inclinación vestibulolingual del molares superiores (P = 0.0001). Daños: No se registraron eventos adversos ni efectos secundarios.

RESULTADOS

Considerando todos los tipos de dientes y movimientos de los 45 participantes, la imprecisión total promedio fue de 2.1 ± 0.9 grados, con respecto a una prescripción promedio de 5.7 ± 2.2 grados. No hubo diferencia en la precisión entre el reemplazo de los alineadores acompañados de baja frecuencia vibración cada 7 días y su sustitución cada 14 días sin vibración. Además, la vibración de baja frecuencia parecía mejorar la precisión de un protocolo convencional en términos de rotación del incisivo superior.

CONCLUSIONES

el Registro Alemán de Ensayos Clínicos (DRK00015613).

REGISTRO DE PRUEBA

Low-frequency vibrations have been proposed as a means of accelerating tooth movement and reducing orthodontic treatment times.

BACKGROUND

To determine any differences in the accuracy of dental movement in patients treated with a low-frequency vibration aligner protocol and/or by reducing the aligner replacement interval with respect to a conventional protocol.

OBJECTIVE

This trial was designed as a single-centre, randomized controlled clinical trial.

Participants: Patients (aged 27.1 ± 9.0 years) who required orthodontic treatment with aligners. Randomization: Patients were randomly allocated to three arms as determined by a computer-randomization scheme. Group A were assigned a conventional protocol (aligners replaced every 14 days); group B also used a low-frequency vibration device for 20 minutes per day; group C followed the same vibration protocol but replaced their aligners every 7 days. Blinding:The operator who performed the set-up and the one who analysed the data were blinded to the group of the patients. Outcome: Pre- and post-treatment digital models were analysed using VAM software to identify the accuracy/imprecision of dental movements. One-way analysis of variance (P < 0.05) and the Bonferroni post hoc test were used to identify any statistically significant differences between the three arms in terms of the accuracy of tooth movement versus the prescription.

METHODS

Numbers analysed: A total of 45 patients (15 for group) were analysed (i.e. 2286 dental movements). Outcome: No statistically significant differences emerged between groups A and C in the upper arch, or among groups A, B, and C in the lower. Group B displayed significantly greater accuracy with respect to group A in upper incisor rotation (P = 0.016), and to group C in vestibulolingual (P = 0.007) and mesiodistal tipping (P = 0.029) of the upper canines, and vestibulolingual tipping of the upper molars (P = 0.0001). Harms: No adverse events or side-effects were registered.

RESULTS

Considering all tooth and movement types of the 45 participants, the mean total imprecision was 2.1 ± 0.9 degrees, with respect to a mean prescription of 5.7 ± 2.2 degrees.There was no difference in accuracy between replacing the aligners accompanied by low-frequency vibration every 7 days and replacing them every 14 days without vibration. Moreover, low-frequency vibration seemed to improve the accuracy of a conventional protocol in terms of upper incisor rotation.

CONCLUSIONS

The German Clinical Trials Register (DRK00015613).

TRIAL REGISTRATION

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--Artículo cedido por la Sociedad Italiana de Ortodoncia. 

Ortodoncia Española

La vibración de baja frecuencia ¿tiene un efecto en el tratamiento con alineadores? Un ensayo aleatorio controlado de centro único.

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