Adjunctive Vibration In Fixed Orthodontics: Frequency-Dependent Effects – A Systematic Review And Narrative Synthesis

Objective: To evaluate whether adjunctive vibration accelerates orthodontic tooth movement (OTM) and reduces pain in patients with fixed appliances. Methods:A systematic search of PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, ClinicalTrials.gov,and WHO ICTRP (inception to 28 October 2025) identified 1420 records.After deduplication, 987 were screened, 92 full texts assessed, and 8 studies included ( 5RCTs, 3 nonrandomized; n=341).Risk of bias was assessed using RoB 2 and ROBINS-I.Meta-analysis was planned but not feasible due to heterogeneity in study designs, vibration protocols, and outcome measures.A narrative synthesis was performed instead.Results: Low-frequency vibration (LFV, ~30 Hz, e.g., AcceleDent, 20 min/day) showed no acceleration or pain reduction.High-frequency vibration (HFV, ~120-133 Hz, e.g., VPro5 at 120 Hz, PBM Vibe at 133 Hz, 3-5 min/day) showed modest benefits: 20-30% pain reduction at 48-72 h (e.g., mean VAS score 3.2 1.5 vs 4.5 1.8 in control, 95% CI -1.9 to -0.7, p<0.05 in one study [10]) (p<0.05),transient acceleration during early alignment/canine retraction, and subjectively reported improved seating/compliance.No increased root resorption or adverse events were reported. Conclusions:Adjunctive vibration demonstrates frequency-dependent effects.LFV is ineffective, while HFV offers promising context-specific benefits.Larger RCTs are required for validation.