Orthodontic Acceleration Devices: Evidence and Reality

Why tooth movement takes time

Orthodontic tooth movement is a biological process, not a mechanical one. Force applied by braces or aligners triggers an inflammatory response in the periodontal ligament (PDL), which stimulates osteoclasts and osteoblasts to resorb and deposit bone on either side of the tooth root. This cellular remodelling process has an inherent rate limit — roughly 1 mm per month under optimal conditions. Acceleration devices aim to upregulate this biological activity, either by increasing the frequency of mechanical stimulation, triggering local bone trauma, or using light or vibration to enhance cellular activity. The key question is whether any of them meaningfully speed this process in clinical practice.

High-frequency vibration: VPro5 and AcceleDent

High-frequency vibration (HFV) devices — including the VPro5 (Propel) and AcceleDent (OrthoAccel) — deliver low-level vibration at frequencies of 30 Hz (AcceleDent) or 120 Hz (VPro5), typically for 5 to 20 minutes per day. The theoretical basis is that vibration enhances PDL cellular activity and increases bone remodelling rate. In practice, the clinical trial evidence is weak. The 2016 Cochrane systematic review on AcceleDent found very low-quality evidence and no clinically significant reduction in treatment time in controlled trials. Multiple RCTs since then have similarly failed to demonstrate meaningful time savings. The VPro5, despite aggressive marketing, has no published RCT evidence demonstrating treatment-time reduction. Both devices are sold directly to patients in the UK for £200 to £600. Independent clinical organisations including the BOS have not endorsed these devices.

Micro-osteoperforations: Propel

Micro-osteoperforations (MOPs) involve creating small perforations in alveolar bone adjacent to teeth using a device such as the Propel system. This induces a localised regional acceleratory phenomenon (RAP) — an upregulation of bone remodelling activity in the surrounding bone. Several RCTs have shown meaningful reductions in tooth movement time for specific tooth movements (particularly canine retraction) when MOPs are used. A 2019 systematic review found moderate evidence supporting MOPs for reducing canine retraction time by 30 to 44%. MOPs are performed chairside by the orthodontist and are not patient-administered devices. They are available in some UK private practices at an additional cost of £100 to £300 per session. The procedure is mildly uncomfortable and requires local anaesthetic for some patients.

Photobiomodulation and low-level laser therapy

Photobiomodulation (PBM), also called low-level laser therapy (LLLT), uses light energy to stimulate cellular activity in periodontal tissues. In vitro studies show it can increase osteoblast and osteoclast activity. Small RCTs have reported 20 to 30% reductions in treatment time for specific tooth movements, but study populations are generally small, follow-up is short, and protocols vary widely between studies, making direct comparisons difficult. A 2020 systematic review rated the overall evidence as low to moderate quality. PBM devices for home use (such as the Biolux OrthoPulse) are marketed in the UK at approximately £500 to £800. In-practice PBM is available at a small number of UK specialist practices. The GDC and BOS have not issued guidance specifically endorsing PBM as standard care.

Surgical acceleration: corticotomy and PAOO

Surgically assisted acceleration involves deliberately injuring alveolar bone to trigger a robust RAP. Corticotomy (cutting the cortical plate of bone) and piezoelectric micro-osteotomy are the most common techniques. Periodontally accelerated osteogenic orthodontics (PAOO) combines corticotomy with bone grafting. These procedures can reduce treatment time substantially — by 50 to 60% in some published case series — but they are invasive, require a surgical procedure under local anaesthetic, carry risks (pain, swelling, infection, gingival recession), and increase overall treatment cost significantly. They are typically used for adult patients with complex tooth movements where rapid treatment is a clinical priority, not for routine cases.

Cost comparison and realistic expectations

VPro5 or similar HFV devices: £200 to £600, evidence weak, no endorsement from BOS. AcceleDent: £300 to £500, Cochrane review inconclusive. MOPs (Propel): £100 to £300 per session, some RCT support for specific movements. PBM home device: £500 to £800, moderate evidence, protocols inconsistent. Surgical acceleration: £1,500 to £3,000+, best evidence for time reduction but most invasive. For most patients, the honest answer is that well-executed orthodontic treatment, consistent aligner wear (for aligners), and attending appointments on time will have more impact on treatment duration than any commercially available acceleration device.

Questions to ask before purchasing

Before buying an acceleration device, ask your orthodontist whether they recommend it for your specific case, what their clinical experience with it is, and whether there are published RCTs supporting its use for the tooth movements you need. Ask what realistic time savings you can expect in weeks, not percentages. Ask whether the device is an adjunct to their protocol or something you are purchasing independently. A clinician who cannot point to peer-reviewed evidence or who endorses a device they have no clinical experience with should prompt further questions.

Useful related pages

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.