Non-Cochrane · intervention · PM41699579
Efficacy of low-intensity pulsed ultrasound in orthodontic tooth movement and pain perception in human studies: a systematic review and meta-analysis.
Shahri Arsalan, Kazemi Hanieh, Bardideh Erfan, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-07888-5
Findings
Population Orthodontic patients of any age undergoing active appliance-based treatment
2 findings
| Adjunctive low-intensity pulsed ultrasound (LIPUS) | Sham/placebo ultrasound or identical orthodontic mechanics without LIPUS | Pain intensity (VAS 0-10) 24 h · Pain after separator placement, initial archwire placement or canine retraction activation · Overall | MD -0.76 [-2.86, 1.33] -0.76 [-2.86, 1.33] VAS points (0-10) Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 195 participants |
| Adjunctive low-intensity pulsed ultrasound (LIPUS) | Sham/placebo ultrasound or identical orthodontic mechanics without LIPUS | Pain intensity (VAS 0-10) 24 h · Pain after separator placement, initial archwire placement or canine retraction activation · Sensitivity analysis excluding Al-Hanbali 2024 | MD -0.145 [-0.799, 0.509] -0.145 [-0.799, 0.509] VAS points (0-10) Low Downgraded: risk of bias, imprecision 3 studies · 98 participants |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al-Hanbali 2024 The effectiveness of low-level laser therapy and low-intensity pulsed ultrasound in reducing pain induced by orthodontic separation: a… PMID:38308275 | 2024 | 1 other review | Pain intensity (VAS 0-10) | not extracted yet |
| El-Bialy 2020 Effect of Low Intensity Pulsed Ultrasound (LIPUS) on Tooth Movement and Root Resorption: A Prospective Multi-Center Randomized Controlled… PMID:32188053 | 2020 | 1 other review | not stated | not extracted yet |
| Al-Dboush 2021 Impact of photobiomodulation and low-intensity pulsed ultrasound adjunctive interventions on orthodontic treatment duration during clear… PMID:34407180 | 2021 | this review only | not stated | not extracted yet |
| Badiee 2021 Efficacy of Low-Intensity Pulsed Ultrasound for Orthodontic Pain Control: A Randomized Clinical Trial. PMID:35965719 | 2021 | this review only | Pain intensity (VAS 0-10) | not extracted yet |
| Bakdach 2022 Effects of toothbrush-generated vibration and ultrasound on pain perception following orthodontic elastomeric separation: a randomized… DOI:10.5114/jos.2022.117335 | 2022 | this review only | not stated | not extracted yet |
| Farzanegan 2022 Effect of ibuprofen and low-intensity pulsed ultrasound on the reduction of pain after initial archwire placement: a double-blind… DOI:10.17126/joralres.2022.001 | 2022 | this review only | Pain intensity (VAS 0-10) | not extracted yet |
| Kaur 2020 Shortening of Overall Orthodontic Treatment Duration with Low-Intensity Pulsed Ultrasound (LIPUS). PMID:32370099 | 2020 | this review only | not stated | not extracted yet |
| Maurya 2019 Effects of low-level laser and low-intensity pulsed ultrasound therapy on treatment duration and pain perception. PMID:31009384 | 2019 | this review only | Pain intensity (VAS 0-10) | not extracted yet |
| Qamruddin 2021 Biostimulatory Effects of Low-Intensity Pulsed Ultrasound on Rate of Orthodontic Tooth Movement and Associated Pain, Applied at 3-Week… PMID:34035871 | 2021 | this review only | not stated | not extracted yet |
| Sorout 2025 Effect of low-intensity pulsed ultrasound on the duration of mandibular anterior crowding correction and pain perception in adults… PMID:40197943 | 2025 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Orthodontic patients of any age undergoing active appliance-based treatment (fixed appliances, clear aligners) | Adolescents and adults in active orthodontic treatment (n=11 studies) |
| Intervention | Adjunctive LIPUS during active orthodontic treatment | LIPUS via intra-oral mouthpiece, extra-oral transducer or ultrasonic toothbrush (n=11 studies) |
| Comparison | Matched controls or contralateral quadrants receiving the same orthodontic mechanics without LIPUS or with sham/placebo | Sham LIPUS, no LIPUS, vibration, low-level laser or ibuprofen arms (n=11 studies) |
| Outcomes | Rate of orthodontic tooth movement or total treatment duration; patient-reported pain intensity on VAS | Pain at 24 h VAS pooled (4 RCTs, 191 patients); tooth movement/treatment duration narrative (7 studies) |
| Study designs | Human RCTs and cohort or case-control clinical studies | 9 RCTs and 2 retrospective cohorts |
| Timing | Predefined follow-up intervals for pain; per unit time for tooth movement | Pain at 24 h; follow-up up to 24 weeks or treatment completion |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Yes | Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | RCT: Yes · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: No | RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |