Mechanical methods can accelerate orthodontic tooth movement by stimulating alveolar bone remodeling. Non-invasive approaches include low-level lasers, electric currents, vibration, and pulsed ultrasound. Low-level lasers increase the proliferation of osteoblasts, osteoclasts, and fibroblasts, accelerating bone remodeling and tooth movement. Vibration and pulsed ultrasound decrease friction and induce bone remodeling through changes in bone metabolism and cellular differentiation. These mechanical methods provide alternatives to accelerate orthodontic treatment while avoiding risks of surgical methods.

1. MECHANICAL METHODS IN
ACCELARATING ORTHODONTICS
Dr. Genoey George

2. INTRODUCTION
• Orthodontic treatment is a dental procedure which generally requires several
months to years.
• Unfortunately, long orthodontic treatment time poses several disadvantages like
higher predisposition to caries, gingival recession, and root resorption
• Several approaches have been advocated to accelerate orthodontic tooth
movement. They can be broadly classified into surgical and non-surgical.

3. PHYSICAL / MECHANICAL METHODS
All surgical methods are invasive in one way or the other and so have their related
complications and side effects. Therefor device assisted approach, which is far less invasive
has come into use to accelerate orthodontic tooth movement.
• Direct electric currents
• Pulsed electromagnetic field
• Static magnetic field
• Resonance vibration
• Low level laser

4. BONE BENDING THEORY FARRAR(1888)
Zengo AN, Bassett CAL, Pawluk RJ, Prountzos G. In vivo bioelectric potentials in the dentoalveolar
complex. Am J Orthod. 1974;66(2):130–9.

5. BONE BENDING THEORY FARRAR(1888)
Zengo AN, Bassett CAL, Pawluk RJ, Prountzos G. In vivo bioelectric potentials in the dentoalveolar
complex. Am J Orthod. 1974;66(2):130–9.
“Application of discontinuous forces cause the bioelectrical potential to be created
and so the idea of using cyclic forces and vibrations were considered”

6. ELECTRIC CURRENT & ELECTRO MAGNETIC FIELD (1980)
Zeev Davidovitch, D.M.D., Mathew D. Finkelson, B.S., Shulamit Steigman, D.M.D., Joseph L. Shanfeld, Ph.D., Paul C. Montgomery, Ph.D.,
and Edward Korostoff PD. Electric currents, bone remodeling, and orthodontic tooth movement. II. Increase in rate of tooth movement
and periodontal cyclic nucleotide levels by combined force and electric current. Am J Orthod. 1980

7. ELECTRIC CURRENT & ELECTRO MAGNETIC FIELD
Zeev Davidovitch, D.M.D., Mathew D. Finkelson, B.S., Shulamit Steigman, D.M.D., Joseph L. Shanfeld, Ph.D.,
Paul C. Montgomery, Ph.D., and Edward Korostoff PD. Electric currents, bone remodeling, and orthodontic
tooth movement. II. Increase in rate of tooth movement and periodontal cyclic nucleotide levels by combined
force and electric current. Am J Orthod. 1980
• Effect of D.C Current Into Periodontal Tissues
• Direct effect of rate of tooth movement by application of electric current in
alveolar bone.
• It can accelerate orthodontic tooth movement by 2.42mm/month. In case of
canines, the current should be applied 5 hours a day

8. PHOTO-STIMULATION: LED AND LOW LEVEL LASER
• Wound healing,
• Control inflammation
• Reduce pain
• Improve blood circulation
Photo-bio-stimulation may be used therapeutically through lasers and light emitting diodes. Both
uses near infrared wavelength of around 600 to 1000 nm. The ideal and recommended range is
730 to 850 nm which being relatively narrow allows more response from the tissue.
Yoshida T, Yamaguchi M, Utsunomiya T, Kato M, Arai Y, Kaneda T, et al. Low-energy laser irradiation accelerates
the velocity of tooth movement via stimulation of the alveolar bone remodeling. Orthod Craniofacial Res.
2009;12(4):289–98.

9. PHOTOBIOSTIMULATION : cellular and molecular level
• Single Oxygen Hypothesis – Porphyrins and flavoproteins
• Redox properties alteration Hypothesis –
• Effect On RNA & DNA
Chung S, Milligan M, Gong SG. Photobiostimulation as a modality to accelerate orthodontic tooth movement.
Semin Orthod [Internet]. 2015;21(3):195–202.
REDOX POTENTIAL ALTERED FOR OXIDATION
INCREASE IN CELLULAR METABOLISM
INCREASE Na+/K+ PUMP ACTIVITY AND INTRACELLULAR Ca2+

10. LOW LEVEL LASER THERAPY
• THE BIOSTIMULATORY EFFECT OF LASER - ACCELERATING TOOTH MOVEMENT.
Yuhan DM, Shetty S, Nambiar S, Philip N, Ashith MV. Accelerated orthodontics-surgical, mechanical and pharmacological
methods. Eur J Mol Clin Med. 2020;7(10):1293-306.
APPLICATION OF LASER
PROLIFERATION OF OSTEOBLAST, OSTEOCLAST & FIBROBLAST
INCREASE IN BONE REMODELLING
ACCELARATES TOOTH MOVEMENT

11. LOW LEVEL LASER THERAPY
• Tooth movement is accelerated by the production of ATP and activation of cytochrome-C.
• In 2004, Cruz et al was the first to carry out a human study on the effect of low-intensity laser
therapy on orthodontic tooth movement. They showed that :
“irradiated canines were retracted at a rate 34% greater than the control canines over 60 days.”
Cruz DR, Kohara EK, Ribeiro MS, Wetter NU. Effects of low-intensity laser therapy on
the orthodontic movement velocity of human teeth: A preliminary study. Lasers Surg Med. 2004;35(2):117–20

12. LOW LEVEL LASER THERAPY
Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on orthodontic tooth
movement. J Indian Orthod Soc 2017;51:81-6.

13. LOW LEVEL LASER THERAPY
Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on orthodontic tooth
movement. J Indian Orthod Soc 2017;51:81-6.
Infrared spectrum (810 nm wavelength)
Aluminum Gallium Arsenide
Power of 100 mW, dose of 5.0 J/cm2

14. LOW LEVEL LASER THERAPY
Total time required for canine retraction -
67% lesser than the time required on control site.
There was about 1.7 folds increase in retraction rate.
Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on orthodontic tooth
movement. J Indian Orthod Soc 2017;51:81-6.

15. LOW LEVEL LASER THERAPY
• Sousa et al. - 5.0 J/cm² and found 2 folds increase
• Youssef et al. - 8.0 J/cm² and found 2 folds increase
• Al Sayed Hasan et al. - Increase in OTM by applying 2.25 J/cm².
• Dalaie et al. in their study found no significant difference in OTM between controlled and
lased side.
AlSayed Hasan MM, Sultan K, Hamadah O. Low-level laser therapy effectiveness in accelerating orthodontic tooth
movement: A randomized controlled clinical trial. Angle Orthod 2016.

16. VIBRATION AIDED ORTHODONTIC TOOTH MOVEMENT
ALVEOLAR BONE BENDS
DEFORMATION OF CRYSTALLINE STRUCTURES
CHANGE IN BONE METABOLISM
CELLULAR DIFFERENTIATION
TOOTH MOVEMENT
Asiry MA. Biological aspects of orthodontic tooth movement: A review of literature. Saudi journal of
biological sciences. 2018 Sep 1;25(6):1027-32.

17. VIBRATION AIDED ORTHODONTIC TOOTH MOVEMENT
Shapiro et al - orthodontic force aid in tooth movement should not be continuous.
intermittent force applied by the vibrational force help tooth movement in two ways.
Shapiro E, Roeber FW, Klempner LS. Orthodontic movement using pulsating force-induced piezoelectricity.
Am J Orthod. 1979;76(1):59–66.
DECREASE FRICTIONAL RESISTANCE
INDUCE BONE REMODELLING

18. VIBRATION AIDED ORTHODONTIC TOOTH MOVEMENT
0.2N at 30 Hz
0.06N at 111 Hz

19. VIBRATION AIDED ORTHODONTIC TOOTH MOVEMENT
Aljabaa A, Almoammar K, Aldrees A, Huang G. Effects of vibrational devices on orthodontic tooth movement:
A systematic review. American Journal of Orthodontics and Dentofacial Orthopedics. 2018

20. VIBRATION AIDED ORTHODONTIC TOOTH MOVEMENT
Aljabaa A, Almoammar K, Aldrees A, Huang G. Effects of vibrational devices on orthodontic tooth movement:
A systematic review. American Journal of Orthodontics and Dentofacial Orthopedics. 2018
The best evidence on vibration and orthodontic therapy consists of the 5 RCTs identified in
this systematic review. One RCT reported increased tooth movement, but 5 reports from 4
RCTs reported no difference.

21. VIBRATION AIDED ORTHODONTIC TOOTH MOVEMENT
Pavlin D, Anthony R, Raj V, Gakunga PT. Cyclic loading (vibration) accelerates tooth movement in orthodontic
patients: a doubleblind, randomized controlled trial. Semin Orthod 2015;21:187-94.
The application of cyclic loading (vibration) of 0.25 N (25 g) at the frequency of 30
Hz, significantly increases the rate of orthodontic tooth movement.

22. LOW INTENSITY PULSED ULTRASOUND – (LIPU)
• Mechanical energy passed through the living tissue creating biochemical changes
at the cellular and molecular level.
• Acoustic Wave therapy
• Bio stimulatory Effect
Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on orthodontic tooth
movement. J Indian Orthod Soc 2017;51:81-6.

23. LOW INTENSITY PULSED ULTRASOUND – (LIPU)
El-Bialy T, Lam B, Aldaghreer S, Sloan AJ. The effect of low intensity pulsed ultrasound in a 3D ex vivo orthodontic
model. J Dent
FASTER TOOTH MOVEMENT PREVENTS RESORPTION OF ROOT
INDUCE PERIODONTAL
REGENERATION
El-Bialy et al anti-root resorptive action of LIPUS is due to the induced deposition of
cementum and dentin which acts as a preventive layer against root resorption

24. LOW INTENSITY PULSED ULTRASOUND – (LIPUS)
El-Bialy T, Farouk K, Carlyle TD, Wiltshire W, Drummond R, Dumore T, Knowlton K, Tompson B. Effect of low
intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption: a prospective multi-center randomized
controlled trial. Journal of Clinical Medicine. 2020 Mar 16;9(3):804.

25. LOW INTENSITY PULSED ULTRASOUND – (LIPUS)
El-Bialy T, Farouk K, Carlyle TD, Wiltshire W, Drummond R, Dumore T, Knowlton K, Tompson B. Effect of low
intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption: a prospective multi-center randomized
controlled trial. Journal of Clinical Medicine. 2020 Mar 16;9(3):804.
LIPUS output:
Frequency - 1.5 MHz,
Output intensity - 30 mW/cm²

26. LOW INTENSITY PULSED ULTRASOUND – (LIPUS)
El-Bialy T, Farouk K, Carlyle TD, Wiltshire W, Drummond R, Dumore T, Knowlton K, Tompson B. Effect of low
intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption: a prospective multi-center randomized
controlled trial. Journal of Clinical Medicine. 2020 Mar 16;9(3):804.

27. LOW INTENSITY PULSED ULTRASOUND – (LIPUS)
Akagi, H.; Nakanishi, Y.; Nakanishi, K.; Matsubara, H.; Hirose, Y.; Wang, P.L.; Ochi, M. Influence of
low-intensity pulsed ultrasound stimulation on expression of bone-related genes in rat bone marrow cells.
J. Hard Tissue Biol. 2016, 25, 1–5.
LIPUS increases RANK-L protein expression in the osteoclasts to accelerate bone
Resorption,while in osteoblasts LIPUS increases bone-forming proteins RUNX2 ,OPG and ALP
Akagi, H.et al (2016)
LIPUS increased the rate of tooth movement and decreased orthodontically induce
root resorption when applied for 20 min per day for up to six months.

28. CONCLUSSION
• All these developments provide us with a wide array of techniques that are being
put forward by treatment needs of patients.
• Further possibilities are still being explored by various peoples from within and
outside the orthodontic fraternity. These efforts will help us get better and faster
results expanding the reach and possibilities of orthodontic treatment.

29. REFERENCES
• Zengo AN, Bassett CAL, Pawluk RJ, Prountzos G. In vivo bioelectric potentials in the dentoalveolar complex. Am J
Orthod. 1974;66(2):130–9.
• Zeev Davidovitch, D.M.D., Mathew D. Finkelson, B.S., Shulamit Steigman, D.M.D., Joseph L. Shanfeld, Ph.D., Paul
C. Montgomery, Ph.D., and Edward Korostoff PD. Electric currents, bone remodeling, and orthodontic tooth
movement. II. Increase in rate of tooth movement and periodontal cyclic nucleotide levels by combined force
and electric current. Am J Orthod. 1980
• Yoshida T, Yamaguchi M, Utsunomiya T, Kato M, Arai Y, Kaneda T, et al. Low-energy laser irradiation accelerates
the velocity of tooth movement via stimulation of the alveolar bone remodeling. Orthod Craniofacial Res.
2009;12(4):289–98.
• Hamblin MR, Demidova TN. Mechanisms of low level light therapy. Mech Low-Light Ther. 2006;6140:614001.
• Chung S, Milligan M, Gong SG. Photobiostimulation as a modality to accelerate orthodontic tooth movement.
Semin Orthod [Internet]. 2015;21(3):195–202.
• Yuhan DM, Shetty S, Nambiar S, Philip N, Ashith MV. Accelerated orthodontics-surgical, mechanical and
pharmacological methods. Eur J Mol Clin Med. 2020;7(10):1293-306.

30. REFERENCES
• Cruz DR, Kohara EK, Ribeiro MS, Wetter NU. Effects of low-intensity laser therapy on the orthodontic
movement velocity of human teeth: A preliminary study. Lasers Surg Med. 2004;35(2):117–20
• Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on
orthodontic tooth movement. J Indian Orthod Soc 2017;51:81-6.
• Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on
orthodontic tooth movement. J Indian Orthod Soc 2017;51:81-6.
• Asiry MA. Biological aspects of orthodontic tooth movement: A review of literature. Saudi journal of
biological sciences. 2018 Sep 1;25(6):1027-32.
• Shapiro E, Roeber FW, Klempner LS. Orthodontic movement using pulsating force-induced
piezoelectricity. Am J Orthod. 1979;76(1):59–66.
• Aljabaa A, Almoammar K, Aldrees A, Huang G. Effects of vibrational devices on orthodontic tooth
movement: A systematic review. American Journal of Orthodontics and Dentofacial Orthopedics. 2018

31. REFERENCES
• Pavlin D, Anthony R, Raj V, Gakunga PT. Cyclic loading (vibration) accelerates tooth movement in orthodontic
patients: a doubleblind, randomized controlled trial. Semin Orthod 2015;21:187-94.
• Buckley MJ, Banes AJ, Levin LG et al. Osteoblasts increase their rate of division and align in response to cyclic,
mechanical tension in vitro. Bone Min.
• Kochar GD, Londhe SM, Varghese B, Jayan B,Kohli S, Kohli VS. Effect of low-level laser therapy on orthodontic
tooth movement. J Indian Orthod Soc 2017;51:81-6.
• El-Bialy T, Lam B, Aldaghreer S, Sloan AJ. The effect of low intensity pulsed ultrasound in a 3D ex vivo
orthodontic model. J Dent
• El-Bialy T, Farouk K, Carlyle TD, Wiltshire W, Drummond R, Dumore T, Knowlton K, Tompson B. Effect of low
intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption: a prospective multi-center
randomized controlled trial. Journal of Clinical Medicine. 2020 Mar 16;9(3):804.
• Akagi, H.; Nakanishi, Y.; Nakanishi, K.; Matsubara, H.; Hirose, Y.; Wang, P.L.; Ochi, M. Influence oflow-intensity
pulsed ultrasound stimulation on expression of bone-related genes in rat bone marrow cells.J. Hard Tissue Biol.
2016, 25, 1–5.