Vibration does not speed up extraction space closure

I have blogged previously on appliances claiming to accelerate tooth movement and shorten orthodontic treatment. One of these is micro-vibration and an appliance using this principal is AcceleDent. I have previously researched this topic during initial alignment and now Part 2 has been published on extraction space closure.


I strongly believe in an evidence-supported approach to clinical practice and this study (as with all my research) was conducted in my orthodontic practice to answer the clinical question of whether this was a worthwhile technique to consider implementing for my own patients. Forty Class II adolescent patients planned to have premolar extractions in the upper arch were randomly assigned to using either the AcceleDent appliance or no appliance. The extraction space closure was measured over time so a rate of movement in mm/month could be calculated. So what did I find? There was no clinically (0.05 mm per month) or statistically significant difference in the rate of space closure (P = 0.74). Compliance was found to reduce over time and this is the subject of another paper to be published in the Journal of Clinical Orthodontics. However, even when compliance was accounted for there was still no clinically meaningful difference in the rate of space closure.

This article appears in the American Journal of Orthodontics and Dentofacial Orthopedics and anyone clicking on this link before February 14, 2018 will be taken directly to the final version of my article on ScienceDirect. No sign up, registration or fees are required – you can simply click, read and hopefully enjoy.

https://authors.elsevier.com/a/1WHqw3AGXGWWNM

DOES THE ACCELEDENT AURA APPLIANCE SPEED UP THE INITIAL ALIGNMENT OF TEETH WITH BRACES?

This summary of my recent clinical trial published in the American Journal of Orthodontics & Dentofacial Orthopedics demonstrated no effect of the AcceleDent Aura vibrational appliance during the initial alignment of teeth with fixed appliances.

VIBRATION & ACCELERATED ORTHODONTICS - CLAIMS VERSUS EVIDENCE

Claims of faster treatment with 'special' quick or fast braces or appliances such as AcceleDent, OrthoPulse and others are appearing more and more in the market place and on Google. The companies hope their product can shorten treatment and heavily advertise so - but what is the evidence?

When you are paying up to $1000 or even more for something you want to be sure or pretty sure it works... or not care about the $1000! Some clinicians and patients use the special brace or appliance and feel their treatment went faster and extol the virtues of the appliance while others do not see a difference, shrug their shoulders and move on. When we are told something is better/faster we look for that difference - some remember the ones that worked (the Believers) while others remember the ones that didn't (the Naysayers) and so we now have two camps, both with a biased perspective! This happened with self-ligating brackets where initially it was felt by some that they shortened treatment (and appeared in the media saying so) but later research revealed that in fact they were not (see my previous Blog on Braces claiming to be Fast)!

Currently some state that you can use #Invisalign clear aligners every week instead of every two weeks (as the manufacturers currently recommend) when using #vibration or other appliances. However many patients get away with weekly wear without these appliances anyway while others won't. There are current studies that suggest vibration accelerates tooth movement with braces while a better designed prospective trial finds no difference. I am currently running a randomized clinical trial on the vibration appliance, AcceleDent and the results of this will be available for publication later this year (2015) to further examine any effect of vibration during initial alignment and space closure so this will be discussed in a future Blog. Although the idea of vibration holds some merit, the evidence supporting it is currently of a lower quality while the higher level evidence from a prospective randomized trial finds no difference. More research is obviously required to clarify the debate and will be forthcoming over the next couple of years but it is the quality of the evidence that is important to answering this question.

Dr Peter Miles is the orthodontist at Newwave Orthodontics in Caloundra, Australia and teaches orthodontics part-time at the University of Queensland and is a visiting lecturer at Seton Hill University in the USA. Peter is one of the editors and authors of the orthodontic textbook, 'Evidence-Based Clinical Orthodontics'. Importantly, he has no financial interest in any products discussed in these Blogs.