A Novel Protocol to Accelerate Functional Orthopedic Treatment Using Low-Intensity Pulsed Ultrasound in Patients With Skeletal Class II Malocclusion: A Preliminary Clinical Report

TL;DR

A new low-intensity ultrasound protocol was tested to speed up orthodontic treatment in children with jaw misalignment, showing promising results in reducing treatment time and improving jaw positioning.

Contribution

A modified low-intensity pulsed ultrasound protocol is proposed as a practical alternative to daily ultrasound for functional orthodontic treatment.

Findings

The mean active treatment duration was 170.80 ± 19.76 days with significant skeletal improvements observed.

Dentoalveolar changes included reduced overjet and overbite, with vertical stability maintained.

Ultrasound application was applied less frequently over time without compromising effectiveness.

Abstract

Background and objective: This preliminary study aimed to evaluate the effectiveness of a novel, clinically feasible low-intensity pulsed ultrasound (LIPUS) protocol in accelerating functional orthodontic treatment using removable appliances.

Methods: Five patients (mean age: 11.10 ± 0.41 years) diagnosed with Class II Division 1 malocclusion underwent functional orthodontic treatment supplemented with the LIPUS, US PRO 2000™ 2nd Edition device (Current Solutions, Austin, Texas, United States). Ultrasound stimulation was applied twice weekly during the first month, once every two weeks during the second month, and once every three weeks thereafter until completion of active treatment. The primary outcomes assessed were the duration of active treatment and dentoskeletal changes.

Results: The mean duration of active treatment was 170.80 ± 19.76 days. Significant sagittal skeletal improvements were observed, including forward mandibular repositioning, reflected by an increase in the SNB angle "the Sella-Nasion plane to Point B angle" (mean difference (MD) = +1.32°), accompanied by a slight reduction in the SNA angle "the Sella-Nasion plane to Point A angle" (MD = −0.54°), a decrease in the ANB angle "the difference between SNA and SNB angles" (MD = −1.98°), an increase in the SNPog angle "the Sella-Nasion plane to Point Pog angle" (MD = +0.94°) further confirmed anterior mandibular displacement. Vertical skeletal parameters remained largely stable, with no evidence of adverse vertical effects. Dentoalveolar changes included controlled retroclination of the maxillary incisors, proclination of the mandibular incisors, and clinically relevant reductions in overjet (MD = −4.38 mm) and overbite (MD = −1.06 mm).

Conclusions: The modified LIPUS protocol produced favorable skeletal and dentoalveolar effects while maintaining vertical stability, suggesting it may represent a practical alternative to conventional daily ultrasound application during functional orthodontic treatment.

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