Impact of LIPUS on Patient Experience During Orthodontic Treatment with Clear Aligners

Abstract

INTRODUCTION Clear aligners offer an aesthetic solution for treating dental malocclusions. The Introduction of Low-Intensity Pulsed Ultrasound (LIPUS) technology shows promise in enhancing patient experience through orthodontic treatment. LIPUS has been found to speed up tooth movement, potentially reducing treatment times and improving outcomes. This study investigates the impact of LIPUS in enhancing patient experience with clear aligners. METHODS This retrospective study analyzed records from 68 individuals, divided equally into two groups: 34 in the LIPUS-treated group and 34 in the control group; all met specific selection criteria. The inclusion criteria were patients aged 12 and older, treated exclusively with clear aligners, and those who used LIPUS with a minimum adherence rate of 67%. Exclusion criteria included compromised medical conditions, extraction treatments, and supernumerary teeth. The American Board of Orthodontics Discrepancy Index (ABODI) was employed to classify malocclusion complexity into four categories: mild (0-10), moderate (11-20), complex (21-30), and very complex (31-100). Both groups were matched based on age, biological sex, and type of malocclusion. The study evaluated the impact of LIPUS technology by measuring treatment duration, the number of refinements and non-used discarded aligners, and the impacts on bone radio density during treatment with clear aligners. Records were collected and analyzed from a private orthodontic practice. Bone radio density measurements (Hounsfield units) were taken using CBCT scans before and after treatment, with standardized sagittal and coronal views. Statistical analyses included Independent Samples t-test, Mann-Whitney U Tests, and paired t-test to compare the LIPUS and control groups. RESULTS In this study, the treatment duration was significantly shorter in the LIPUS group, averaging 544.68 ± 238.97 days compared to 964.82 ± 417.9 days in the Control group, reducing treatment time by approximately 43.58% (p < 0.001). The number of days per tray change was significantly lower in the LIPUS group (5.42 ± 1.02 vs. 10.17 ± 3.18, p < 0.001). The LIPUS group also needed fewer refinements (additional aligners) (1.56 ± 1.11 vs. 2.41 ± 1.28, p = 0.0045) and had fewer discarded non-used trays (7.56 ± 11.91 vs. 11.18 ± 13.39, p = 0.04). The LIPUS group ended treatment with significantly more unused trays (5.06 ± 7.71 vs. 1.41 ± 4.36, p = 0.02). Additionally, the LIPUS group showed more bone radio density, as indicated by increased Hounsfield unit in the maxillary alveolar bone (p < 0.001). No side effects were reported in the LIPUS group. CONCLUSIONS Within the limitations of this study, the application of LIPUS in combination with clear aligners showed promising potential in reducing the number of refinements required and decreasing the number of non-used discarded aligners. It also suggested a possible reduction in overall treatment duration and more bone radio density in the maxillary alveolar bone within the studied sample. These preliminary findings indicate that LIPUS may enhance the efficiency and stability of orthodontic treatment, though further research is needed to confirm these effects across broader and more diverse populations.