Effectiveness of adjunctive interventions for accelerating orthodontic tooth movement: a systematic review of systematic reviews

This study was aimed to summarise published systematic reviews (SRs) that assess the effects of adjunctive interventions on the acceleration of orthodontic tooth movement (OTM). Electronic and manual searches were performed up to August 2016. Systematic reviews investigating the impact of adjunctive techniques on the promotion of OTM were included. The methodological quality of the included reviews was evaluated using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) scale. The quality of evidence for each intervention was assessed using GRADE. The Jadad decision algorithm was used to select a study to provide body evidence from discordant reviews on the same intervention. A total of 11 SRs were included in this study. AMSTAR scores ranged from 4 to 10 of 11. The quality of evidence ranged from very low to low. The short-term (1-3 months) effects of low-level laser therapy (LLLT, 5 and 8 J cm-2 ) and corticotomy were supported by low-quality evidence. The evidence regarding the efficacy of photobiomodulation, pulsed electromagnetic field, interseptal bone reduction, two vibrational devices (Tooth Masseuse and Orthoaccel) and electrical current was of very low quality. Relaxin injections and extracorporeal shock waves were reported to have no impact on OTM according to low- and very low-quality evidence, respectively. Based on currently available information, we conclude that low-quality evidence indicates that LLLT (5 and 8 J cm-2 ) and corticotomy are effective to promote OTM in the short term. Future high-quality trials are required to determine the optimal protocols, as well as the long-term effects of LLLT and corticotomy, before warranting recommendations for orthodontics clinics.