Can bioelectrical stimulation favor orthodontic treatment? A randomized clinical trial to evaluate tooth movement, patient-centered, and inflammatory biomarker outcomes

Exogenous bioelectrical stimulation (BES) modulates the bone remodeling. The aim of this study was to evaluate the effect of BES on clinical, patient-centered, and inflammatory biomarker outcomes of orthodontic tooth movement (OTM). A randomized clinical trial (n=28) matched for sex (8 men and 6 women in each group) were divided in the control group with a sham device, i.e. mouthpiece turned off: OTM + SHAM (mean of 19.4 years old), and the test group: OTM + BES (mean of 20.1 years old). Orthodontic alignment was performed with 0.012-in, 0.014-in, and 0.016-in nickel-titanium (NiTi) wires. BES (10μA/5min) was applied immediately after each wire installation, after 48h, and once a week until the next wire. The canine-to-canine crowding and Little dental irregularity index in mandibular arch was analyzed. Pain perception was measured at 0, 24, 48, and 72h after replacement of the 0.014-in and 0.016-in wires. Inflammatory biomarkers were assessed 48h after replacement of the 0.014-in wire in gingival fluid. The crowding difference (Δc) was greater in the OTM + BES than in the OTM + SHAM after 2- and 3-month evaluations and the Little index was lower in OTM + BES after 3 months of treatment. During the 0.014-in wire alignment, patient pain perception was lower in the OTM + BES than in the OTM + SHAM at 24 and 48h; and lower after 24h in 0.016-in wire alignment. BES treatment increased IL-6 and decrease IL-10 levels in gingival fluid after 48h of dental alignment. Exogenous bioelectrical stimulation can accelerate initial orthodontic tooth movement, decrease patient pain perception and modulate the inflammatory biomarkers.