The effect of low intensity pulsed ultrasound (LIPUS) on orthodontic tooth movement: a preliminary study
Bibliographic record
Abstract
INTRODUCTION Low-Intensity Pulsed Ultrasound (LIPUS) has been introduced as a promising adjunct in orthodontic care, with growing evidence suggesting it may accelerate tooth movement, reduce unwanted side effects of orthodontic treatment (specifically orthodontically induced tooth root resorption [OITRR]), and potentially can enhance bone remodeling. LIPUS delivers mechanical stimulation to periodontal tissues, which has been shown to increase cellular activity and promote localized bone metabolism. These biological effects make LIPUS a potential, non-invasive option for improving orthodontic outcomes. This study evaluated the clinical effects of daily LIPUS application, delivered by the LIPUS Aevo System™ (SmileSonica, Inc., Edmonton, AB, Canada), a home-based medical device on OITRR, bone density and treatment duration in patients treated with clear aligners. METHODS This prospective and retrospective hybrid study included participants who are treated orthodontically using Invisalign ™ system. Participants were divided into three groups: a control group (Invisalign only), a 10-minute LIPUS- treated group, and a 15-minute LIPUS- treated group. All patients were treated at a private orthodontic clinic in Edmonton, Alberta. Participants in the LIPUS-treated groups used the Aevo System device daily during treatment, with usage monitored digitally through a mobile application. A minimum usage (adherence to the protocol [instructions]) rate of 67% was required for inclusion in the final analysis. Root resorption was assessed using before and after treatment cone-beam computed tomographic radiographs (CBCT) scans, measuring the distance from the pulp horn to the root apex of anterior maxillary teeth in standardized sagittal views. Bone density was assessed in the maxillary and mandibular regions by analyzing standardized axial slices at five specific sites, measuring the average Hounsfield units represented in grayscale values. The degree of dental crowding was quantified using Little’s Irregularity Index, measured on mandibular casts before and after treatment. Statistical analysis was performed using one-way ANOVA for between-group comparisons and repeated measures ANOVA for within-subject bone density changes. RESULTS A total of 15 participants were included in the final analysis. Root resorption was significantly lower in both LIPUS groups compared to controls, with the 15-minute group showing the least resorption (p = 0.001). Maxillary bone density showed a general increase in the LIPUS groups, while the control group showed decreased bone density; however, these differences were not statistically significant (p = 0.7). Mandibular bone density decreased in all groups, though the reduction was more pronounced in the control group (p = 0.5). All groups showed a reduction in anterior crowding, as measured by Little’s Index, but there were no significant differences between groups. CONCLUSION Within the limitations of this study, the use of LIPUS as an adjunct to clear aligner therapy was associated with a significant reduction in root resorption and favorable trends in maxillary bone density. These results suggest a potential protective effect of LIPUS on dental and periodontal structures during orthodontic treatment. While improvements in bone density and alignment were not statistically significant, the biological trends observed support further investigation. LIPUS may represent a valuable, patient-friendly addition to aligner-based orthodontics, particularly in reducing treatment side effects. More extensive, long-duration studies are needed to validate these initial results and fully assess the clinical benefits of daily LIPUS use. Also, furhter studies with larger size are recommended to support this study results or otherwise recommend other results compared to this study results.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".