Effects of the photobiomodulation using different energy densities on the periodontal tissues under orthodontic force in rats with type 2 diabetes mellitus

Abstract

To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm(2), 320 J/cm(2), and 640 J/cm(2) on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm(2) strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm(2). Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars. This distance was larger in the diabetic groups (D: 39.98 +/- 1.97, 160 J-LD: 34.84 +/- 6.01, 320 J-LD: 29.82 +/- 1.73, and 640 J-LD: 35.47 +/- 4.56) than in the normoglycemic groups (N: 21.13 +/- 1.19; 160 J-LN: 22.69 +/- 0.72, 320 J-LN: 22.28 +/- 0.78, and 640 J-LN: 24.56 +/- 2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 +/- 0.82; p < 0.01) and 640 J-LN (13.62 +/- 1.33; p < 0.05) groups than with D (9.82 +/- 1.17) and 160 J-LD (9.77 +/- 1.10) groups. Therefore, the energy density of 640 J/cm(2) provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm(2.).