Comparing Circumferential Supracrestal Fiberotomy with Surgical Scalpel Versus Photobiomodulation in Orthodontic Relapse Reduction: A Clinical Trial.

Objective: This investigation aimed to compare the efficacy of circumferential supracrestal fiberotomy (CSF) with surgical scalpel, laser CSF, and photobiomodulation for reduction of relapse after orthodontic tooth rotation. Background: Relapse is the tendency of teeth to move back to their preoperative position after removal of orthodontic appliances. Materials and methods: This randomized controlled clinical trial was conducted on 90 rotated teeth at the final stages of fixed orthodontic treatment. The teeth were randomly divided into six groups (n = 15) of (1) control (no intervention), (2) photobiomodulation alone (wavelength of 940 nm, 0.2 W, and 4 J/cm²), (3) conventional CSF, (4) laser CSF (wavelength of 940 nm, 1.5 W, and 4 J/cm², and power density of 160 mW/cm²), (5) conventional CSF plus photobiomodulation, and (6) laser CSF plus photobiomodulation. Measurements were made on clinical photographs and dental casts using the AutoCAD software. Level of pain of patients was measured within the first 24 h after fiberotomy using a visual analog scale. Data were analyzed by ANOVA and Kruskal-Wallis test (α = 0.05). Results: The magnitude (p = 0.014) and percentage (p = 0.035) of relapse were significantly different among the six groups, and they were the highest in the control group followed by photobiomodulation alone, laser CSF, conventional CSF, conventional CSF plus photobiomodulation, and finally, laser CSF plus photobiomodulation. Moreover, photobiomodulation plus laser CSF and photobiomodulation plus conventional CSF had significantly different results from the other groups. The six groups had no significant difference in sulcus depth changes, gingival recession (difference in primary and secondary crown height), or pain score (p > 0.05). Conclusions: This study suggests that utilizing photobiomodulation combined with laser CSF or conventional CSF can be effective in reducing relapse. However, further clinical trials are required to support this idea. Iranian Registry of Clinical Trials (IRCT20210621051653N1).