Effect of Er,Cr: YSGG laser-assisted micro-osteoperation on orthodontic treatment time in patients with lower front teeth crowding

INTERVENTION: Intervention1: Er,Cr:YSGG laser assisted micro Osseous perforation with conventional fixed orthodontic therapy: Participants will receive conventional fixed orthodontic treatment using 0.022‐inch MBT prescription brackets along with Er,Cr:YSGG laser‐assisted micro‐osseous perforation at the time of bracket bonding. Under local anesthesia, perforations will be created on the buccal cortical plate of the mandibular anterior region at selected interradicular sites using an Er,Cr:YSGG laser (2780 nm). Standard postoperative care and follow‐up will be provided Control Intervention1: Conventional fixed orthodontic therapy: Participants will receive conventional fixed orthodontic treatment using 0.022‐inch MBT prescription brackets following the standardized archwire sequence without laser‐assisted micro‐osseous perforation. Standard postoperative instructions and follow‐up schedule will be followed. CONDITION: Health Condition 1: K088‐ Other specified disorders of teethand supporting structures PRIMARY OUTCOME: Duration of mandibular anterior decrowdingTimepoint: Baseline, 4 weeks, 8 weeks, 12 weeks, and at achievement of complete mandibular anterior alignment SECONDARY OUTCOME: Gingival crevicular fluid interleukin 1 beta concentrationTimepoint: Baseline, 7 days Gingival crevicular fluid OPG concentrationTimepoint: Baseline, 7 days Gingival crevicular fluid RANKL concentrationTimepoint: Baseline, 7 days Landry wound healing indexTimepoint: Postoperative 3,7,14 days Number of archwire activation visits required to achieve alignmentTimepoint: At completion of mandibular anterior decrowding Visual analogue scale pain scoreTimepoint: Immediate post operative, 24 hours, 72 hours, 7 days INCLUSION CRITERIA: Systemically healthy adults aged 18 to 35 years Mild to moderate mandibular anterior crowding Good periodontal health Complete permanent dentition No previous orthodontic treatment