Enhancing bone remodeling and accelerating tooth movement with photobiomodulation in middle-aged adults

Although age is not a contraindication for orthodontic treatment, it can be considered more challenging in mature adult patients, mainly due to a less responsive bone metabolism and reduced osteoblastic activity compared to young patients. In orthodontics, photobiomodulation (PBM) has shown positive results in bone remodeling during tooth movement. This study seeks to assess the effect of PBM can have a positive effect on bone remodeling, stimulating bone formation in middle-aged individuals and allowing for a better periodontal condition. Bone structure and the length of the roots were evaluated using cone beam computed tomography images before and after tooth movement and PBM in patients aged between 40 and 60 years. In addition, we aimed to evaluate the expression of the markers receptor activator of NFκB (RANK), osteoprotegerin (OPG), and osteopontin (OPN) presented in the crevicular fluid using the enzyme-linked immunosorbent assay test. Tooth movement was performed by intruding upper molars with two mini-implants as anchorage bilaterally. One side received PBM with light-emitting diode (LED) light and the contralateral side was used as control (no irradiation). The PBM equipment specially designed for this study consisted of six LEDs of 5 mW each, for 7 minutes, totaling 2 J, 3 times a week, for 5 months. The PMB group showed greater tooth movement (p < 0.05), an increase of 74% on average for bone height. PBM induced a significant increase in RANK expression at month 3 (p < 0.05), and the expression of OPG and OPN showed a significant increase in the fifth month of movement (p < 0.05) in the PBM group. PBM may represent an adjunct therapeutic approach during tooth movement in more mature patients, leading to a more responsive bone metabolism and favoring more comprehensive orthodontic treatment.