1
|
Chan V, Shroff B, Kravitz N, Carrico C, Hawkins D, Tran P, Lindauer S. Orthodontic pain with fixed appliances and clear aligners: A 6-month comparison. Am J Orthod Dentofacial Orthop 2024:S0889-5406(24)00271-3. [PMID: 39078353 DOI: 10.1016/j.ajodo.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION This prospective study compared pain perception, intensity, and analgesic use among patients treated with fixed appliances (FAs) and clear aligners (CAs) over 6 months. METHODS Digital surveys were collected from 87 adult patients treated with CA or FA from 2 orthodontic offices. The 7-item survey was sent at 3-time points (preappointment, 2-day postappointment, and 7-day postappointment) for each appointment. Wilcoxon, t test, and Fisher exact chi-square tests were performed with significance set at 0.05. RESULTS The FA group had a higher rate and intensity of pain 2 days after the second, third, and fifth appointments (P <0.030). At 7 days postappointment, the FA group had a higher rate and intensity of pain for the first and fifth appointments. Dull pain was reported the most in both groups, with a proportion of FA patients reporting throbbing (31%) or sharp (20%) pain (P = 0.035) at 2 days postappointment. The CA group reported the most pain at rest, whereas the FA group reported chewing as the most painful (P = 0.002). The FA group had a higher rate of analgesic consumption after the first appointment (P = 0.037). CONCLUSIONS Both the FA and CA groups experienced similar rates and intensities of pain 2 days after the delivery of appliances at the first appointment. Although CA pain intensity remained minimal, FA pain peaked 2 days postappointment whenever a new orthodontic stimulus was introduced and remained elevated 7 days postappointment when that stimulus was a new archwire material.
Collapse
Affiliation(s)
- Victor Chan
- Department of Orthodontics, Virginia Commonwealth University, Richmond, Va
| | - Bhavna Shroff
- Department of Orthodontics, Virginia Commonwealth University, Richmond, Va.
| | | | - Caroline Carrico
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Daniel Hawkins
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University, Richmond, Va
| | - Phuong Tran
- Department of Orthodontics, Virginia Commonwealth University, Richmond, Va
| | - Steven Lindauer
- Department of Orthodontics, Virginia Commonwealth University, Richmond, Va
| |
Collapse
|
2
|
Shaadouh RI, Hajeer MY, Mahmoud GA, Almasri IA, Jaber ST, Alam MK. Patient-reported outcomes during accelerating the en-masse retraction of the upper anterior teeth using low-intensity electrical stimulation: a randomized controlled trial. Prog Orthod 2024; 25:17. [PMID: 38735912 PMCID: PMC11089026 DOI: 10.1186/s40510-024-00517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/20/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Low-intensity electrical stimulation (LIES) is considered a relatively recent technology that has received little attention in orthodontics as a method of acceleration. This study aimed to evaluate patient-reported outcome measures when LIES is used to accelerate the en-masse retraction of the upper anterior teeth. MATERIALS AND METHODS The sample consisted of 40 patients (8 males, 32 females; mean age 21.1 ± 2.3 years), with Class II division I malocclusion who required extraction of the first premolars to retract upper anterior teeth. They were randomly assigned to the LIES group (n = 20) and the conventional en-masse retraction group (CER; n = 20). Patient responses regarding pain, discomfort, burning sensation, swelling, chewing difficulty, speech difficulty, and painkillers' consumption were recorded at these nine assessment times: 24 h (T1), 3 days (T2), and 7 days (T3) after force application, then in the second month after 24 h (T4), 3 days (T5), and 7 days (T6) of force re-activation, and finally after 24 h (T7), 3 days (T8), and 7 days (T9) of force re-activation in the third month. RESULTS The mean values of pain perception were smaller in the LIES group than those in the CER group at all assessment times with no statistically significant differences between the two groups except during the second and third months (T5, T6, T8, and T9; P < 0.005). However, discomfort mean values were greater in the LIES group with significant differences compared to CER group during the first week of the follow-up only (T1, T2, and T3; P < 0.005). Burning sensation levels were very mild in the LIES group, with significant differences between the two groups at T1 and T2 only (P < 0.001). Speech difficulty was significantly greater in the LIES group compared to CER group at all studied times (P < 0.001). High levels of satisfaction and acceptance were reported in both groups, without any significant difference. CONCLUSION Both the LIES-based acceleration of en-masse retraction of upper anterior teeth and the conventional retraction were accompanied by mild to moderate pain, discomfort, and chewing difficulty on the first day of retraction. These sensations gradually decreased and almost disappeared over a week after force application or re-activation. TRIAL REGISTRATION ClinicalTrials.gov, ClinicalTrials.gov, NCT05920525. Registered 17 June 2023 - retrospectively registered, http://clinicaltrials.gov/study/NCT05920525?term=NCT05920525&rank=1 .
Collapse
Affiliation(s)
- Rashad I Shaadouh
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria.
| | - Ghiath A Mahmoud
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Imad Addin Almasri
- Department of Applied Statistics, Faculty of Economics, University of Damascus, Damascus, Syria
| | - Samer T Jaber
- Department of Orthodontics, Faculty of Dentistry, Al-Wataniya Private University, Hama, Syria
| | - Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| |
Collapse
|
3
|
Souza GLN, de Campos França E, de Araújo Lombardi M, da Costa GC, da Rocha NB, Abreu LG. Impact of treament with orthodontic aligners on the oral health-related quality of life. BMC Oral Health 2024; 24:419. [PMID: 38580945 PMCID: PMC10996220 DOI: 10.1186/s12903-024-04183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND There is an increasing interest in information on the effects of orthodontic aligners on the oral health-related quality of life (OHRQoL) of people. AIM To compare the impact of orthodontic aligners versus conventional fixed appliances on OHRQoL, using a validated tool and controlling for sociodemographic and clinical variables. METHOD Sixty-one individuals participated in this study. Group 1 (G1) consisted of 33 individuals under treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals under treatment with conventional fixed appliances. OHRQoL was evaluated with the Oral Health Impact Profile (OHIP-14) in which 14 items are distributed across seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The higher the score, the more negative is the perception of the individual regarding his/her OHRQoL. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect Size (ES) and Minimal Clinically Important Difference (MCID) were also determined. RESULTS Participants' mean age was 30.69 years. Individuals in G1 had a significantly lower score for physical pain and the total score of OHIP-14 compared to individuals in G2 (p < 0.05). The ES was large (ES = 0.74) for physical pain and moderate (ES = 0.46) for the total score. The ES was moderate for physical disability (ES = 0.50). The difference between groups for physical pain (1.30) and for physical disability (0.90) was greater than the MCID (0.87 and 0.88, respectively). Poisson regression showed that G2 individuals showed a score for physical pain 1.39 times higher than those of G1 in the adjusted model (OR = 1.39, [1.03-1.89], p = 0.031). CONCLUSION Those under treatment with orthodontic aligners have a more positive perception of OHRQoL compared to those wearing fixed appliances.
Collapse
Affiliation(s)
- Gabriela Luiza Nunes Souza
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Najara Barbosa da Rocha
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, Pampulha, Belo Horizonte, 6627, MG, Brazil.
| |
Collapse
|
4
|
Sadvandi G, Kianfar AE, Becker K, Heinzel A, Wolf M, Said‐Yekta Michael S. Systematic review on effects of experimental orthodontic tooth displacement on brain activation assessed by fMRI. Clin Exp Dent Res 2024; 10:e879. [PMID: 38558512 PMCID: PMC10982672 DOI: 10.1002/cre2.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Orthodontic treatment is often accompanied by discomfort and pain in patients, which are believed to be a result of orthodontic tooth displacement caused by the mechanical forces exerted by the orthodontic appliances on the periodontal tissues. These lead to change blood oxygen level dependent response in related brain regions. OBJECTIVE This systematic review aims to assess the impact of experimental orthodontic tooth displacement on alterations in central nervous system activation assessed by tasked based and resting state fMRI. MATERIALS AND METHODS A literature search was conducted using online databases, following PRISMA guidelines and the PICO framework. Selected studies utilized magnetic resonance imaging to examine the brain activity changes in healthy participants after the insertion of orthodontic appliances. RESULTS The initial database screening resulted in 791 studies. Of these, 234 were duplicates and 547 were deemed irrelevant considering the inclusion and exclusion criteria. Of the ten remaining potential relevant studies, two were excluded during full-text screening. Eight prospective articles were eligible for further analysis. The included studies provided evidence of the intricate interplay between orthodontic treatment, pain perception, and brain function. All of the participants in the included studies employed orthodontic separators in short-term experiments to induce tooth displacement during the early stage of orthodontic treatment. Alterations in brain activation were observed in brain regions, functional connectivity and brain networks, predominantly affecting regions implicated in nociception (thalamus, insula), emotion (insula, frontal areas), and cognition (frontal areas, cerebellum, default mode network). CONCLUSIONS The results suggest that orthodontic treatment influences beyond the pain matrix and affects other brain regions including the limbic system. Furthermore, understanding the orthodontically induced brain activation can aid in development of targeted pain management strategies that do not adversely affect orthodontic tooth movement. Due to the moderate to serious risk of bias and the heterogeneity among the included studies, further clinical trials on this subject are recommended.
Collapse
Affiliation(s)
- Gelareh Sadvandi
- Department of OrthodonticsRWTH Aachen University HospitalGermany
| | | | - Kathrin Becker
- Department of Dentofacial Orthopedics and OrthodonticsCharité Universitätsmedizin BerlinBerlinCC03Germany
| | - Alexander Heinzel
- Department of Nuclear MedicineMartin‐Luther‐University Halle‐WittenbergHalleGermany
| | - Michael Wolf
- Department of OrthodonticsRWTH Aachen University HospitalGermany
| | | |
Collapse
|
5
|
Wang S, Ko CC, Chung MK. Nociceptor mechanisms underlying pain and bone remodeling via orthodontic forces: toward no pain, big gain. FRONTIERS IN PAIN RESEARCH 2024; 5:1365194. [PMID: 38455874 PMCID: PMC10917994 DOI: 10.3389/fpain.2024.1365194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Orthodontic forces are strongly associated with pain, the primary complaint among patients wearing orthodontic braces. Compared to other side effects of orthodontic treatment, orthodontic pain is often overlooked, with limited clinical management. Orthodontic forces lead to inflammatory responses in the periodontium, which triggers bone remodeling and eventually induces tooth movement. Mechanical forces and subsequent inflammation in the periodontium activate and sensitize periodontal nociceptors and produce orthodontic pain. Nociceptive afferents expressing transient receptor potential vanilloid subtype 1 (TRPV1) play central roles in transducing nociceptive signals, leading to transcriptional changes in the trigeminal ganglia. Nociceptive molecules, such as TRPV1, transient receptor potential ankyrin subtype 1, acid-sensing ion channel 3, and the P2X3 receptor, are believed to mediate orthodontic pain. Neuropeptides such as calcitonin gene-related peptides and substance P can also regulate orthodontic pain. While periodontal nociceptors transmit nociceptive signals to the brain, they are also known to modulate alveolar bone remodeling in periodontitis. Therefore, periodontal nociceptors and nociceptive molecules may contribute to the modulation of orthodontic tooth movement, which currently remains undetermined. Future studies are needed to better understand the fundamental mechanisms underlying neuroskeletal interactions in orthodontics to improve orthodontic treatment by developing novel methods to reduce pain and accelerate orthodontic tooth movement-thereby achieving "big gains with no pain" in clinical orthodontics.
Collapse
Affiliation(s)
- Sheng Wang
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, United States
| | - Ching-Chang Ko
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, United States
| | - Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
| |
Collapse
|
6
|
Negruțiu BM, Vaida LL, Judea-Pusta C, Romanec C, Moca AE, Costea CP, Staniș CE, Rus M. Orthodontic Pain and Dietary Impact Considering Age Groups: A Comparative Study. J Clin Med 2024; 13:1069. [PMID: 38398382 PMCID: PMC10889229 DOI: 10.3390/jcm13041069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: orthodontic treatment can frequently be associated with discomfort and pain, a significant factor contributing to treatment discontinuation. (2) Methods: This study, conducted on 160 orthodontic patients across different age groups, aimed to explore the influence of age on patients' responses to treatment, particularly regarding changes in dietary patterns and weight loss. The patients were categorized into three age groups and assessed through a questionnaire about pain perception, pain latency, dietary changes, and weight loss associated with orthodontic appliances. (3) Results: Younger patients (6-12 years) reported lower pain levels, shorter pain latency and fewer alterations in dietary habits compared to adults (over 18 years). Females over 18 represented a significant portion of the sample, suggesting a self-driven inclination towards orthodontic treatment for aesthetic reasons. Fixed orthodontic appliances induced more significant pain than removable ones. Adults experienced more changes in dietary habits and weight loss than younger individuals. (4) Conclusions: the results provide valuable insights for orthodontic practitioners aiming to mitigate adverse effects and improve overall patient experience during treatment.
Collapse
Affiliation(s)
- Bianca-Maria Negruțiu
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Claudia Judea-Pusta
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cristian Romanec
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cristina Paula Costea
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | | | - Marius Rus
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| |
Collapse
|
7
|
Alvarado-Lorenzo A, Antonio-Zancajo L, Baptista H, Colino Gallardo P, Albaladejo-Martinez A, Garcovich D, Alcon S. Comparative analysis of periodontal pain and quality of life in patients with fixed multibracket appliances and aligners (Invisalign®): longitudinal clinical study. BMC Oral Health 2023; 23:850. [PMID: 37951878 PMCID: PMC10638788 DOI: 10.1186/s12903-023-03565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUNDS The aim of this longitudinal clinical study is to analyse and compare according to location, degree and type, the pain presented by patients during their first year of treatment, as well as the quality of oral life after the placement of two types of orthodontic appliances: conventional brackets and removable Invisalign ® aligners. METHODS The sample consisted of 140 patients grouped into 2 study groups of 70 patients each. The first group (brackets group- BG), with fixed multibracket appliances, using the MBT technique and a 0.022" slot. The second group (invisaling group- IG), in treatment with removable aligners (IG), using the Invisalign ® system. They were providen with a questionnare where they had to record the degree (mild, moderate or intense), the type and location of the pain monthly during the first year of treatment. The second form was the Spanish version of the OHIP-14, oral quality of life questionnaire, which was provided the twelfth month after the start of treatment. RESULTS In both groups, we found that the most frequent location of pain occurred during the first phase: mandibular for the IG group and maxillary in the BG group. Throughout the whole analysis, the intensity was mild-moderate with lower values in the conventional brackets' group. The BG group reported acute pain while the IG group reported sensitive pain during the first month; later both reported sensitive pain. CONCLUSIONS There are differences in terms of periodontal pain in its degree, location, and type according to the different orthodontic techniques used. TRIAL REGISTRATION The study was approved by the bioethics committee of the University of Salamanca (USAL_20/516).
Collapse
Affiliation(s)
| | | | - Hugo Baptista
- Department of Oral Surgery, Universidad de Salamanca, Salamanca, 37007, Spain
| | | | | | - Daniele Garcovich
- Department of Dentistry, Universidad Europea de Valencia, Valencia, 46010, Spain
| | - Silvia Alcon
- Department of Oral Surgery, Universidad de Salamanca, Salamanca, 37007, Spain
| |
Collapse
|
8
|
Jha A, Shree R, Jha S, Sinha G, Hassan Z, Kumari K. A Comparative Assessment of Acceptance of Different Types of Functional Appliances. Cureus 2023; 15:e48862. [PMID: 38111447 PMCID: PMC10726087 DOI: 10.7759/cureus.48862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Background Modern clinical orthodontics' functional appliances, a well-established modality of treatment, exhibit an amazing diversity of design. Clinical findings show that people have difficulty adjusting to these devices due to their size and unfixed positioning inside the mouth and that patient adaptation may vary based on the type of orthodontic functional appliance employed. Despite the fact that they appear to inflict more pain and soreness than, for example, removable plates, the effects of various orthodontic functional appliances on patients' acclimation have not yet been researched. Aim The current study's goal was to assess how different functional appliances' shapes and designs affected patients' willingness to accept them. Materials and methods About 20 adult volunteers (10 males and 10 females, age 18-32 years) with marked Class II division 1 malocclusion and not familiar with orthodontic appliances were selected as test subjects. Impressions for working casts were taken, and construction bites were prepared for the fabrication of eight functional appliances of various designs for each individual test subject. These appliances had eight design variations. There were three tests: one for speech effects, one for initial acceptance, and one for final acceptance after wearing different scales. Results Overall, the correlation between the quality of speech and pronunciation after wearing the appliance and the type of functional appliance was statistically significant. The quality of speech and pronunciation after wearing the appliance was maximum in frequency range 1 (FR1), while it was minimum in the medium-size activator. The difference was statistically significant (p=0.001). Overall, the correlation between the comfort and acceptability of functional appliances after wearing them and the type of functional appliance was statistically significant. The acceptance of functional appliances after wearing was maximum in FR1, while it was minimum in the medium-size activator. The difference was statistically significant (p=0.001). Overall, the correlation between the type of functional appliance and initial acceptance was significant statistically, with the maximum initial acceptance in medium-sized activators and the minimum initial acceptance in small bionators (p=0.001). Conclusion The study's findings show that patient acceptance of various kinds of functional appliances varies significantly.
Collapse
Affiliation(s)
- Anju Jha
- Department of Pediatric and Preventive Dentistry, Patna Dental College and Hospital, Patna, IND
| | - Richa Shree
- Department of Orthodontics and Dentofacial Orthopaedics, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Sovendu Jha
- Department of Orthodontics and Dentofacial Orthopaedics, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Goldi Sinha
- Department of Orthodontics and Dentofacial Orthopaedics, Vishalnath Hospital, Hazipur, IND
| | - Zainab Hassan
- Department of Orthodontics and Dentofacial Orthopaedics, Sanjeevani Dental Clinic, Patna, IND
| | - Kajol Kumari
- Department of Orthodontics and Dentofacial Orthopaedics, New Apollo Oral and Dental Care Center, Hajipur, IND
| |
Collapse
|
9
|
Sultan H, Pervez H, Maqsood S, Zeeshan WS. Evaluation of pain experienced by orthodontic patients following elastomeric separator insertion: A cross-sectional study. Korean J Orthod 2023; 53:298-306. [PMID: 37746775 PMCID: PMC10547595 DOI: 10.4041/kjod22.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Pain following the insertion of separators and archwires varies with age, sex, race, ethnicity, threshold, and health status. This study aimed to evaluate the characteristics of pain in orthodontic patients after the insertion of elastomeric separators, its effects on daily life, and its association with age and sex in a population not previously studied in this regard. Methods A cross-sectional study of 130 patients undergoing orthodontic treatment included collecting data on demographics, pain experienced following the placement of separators, time of onset, duration, characteristics, change in dietary pattern or chewing side, intake of analgesics, and severity of pain on the Wong Baker's scale. The results are reported as counts and percentages. Associations between sex and age were evaluated using Pearson's chi-square test. Results Among the 130 patients, 56.2% were 9-20 years old, 63.8% experienced pain following the insertion of separators, 22.9% had their first episode of pain at 4 hours, 56.6% experienced intermittent pain, and 37.3% experienced discomfort; 18.1% males and 81.9% females experienced pain following the insertion of separators. Pearson's chi-square test showed a significant association between pain and sex (P = 0.04). Most patients (37.3%) reported "hurts little more" for pain intensity on Wong Baker's scale and 21.7% reported all four quadrants as sites of pain. Conclusions The pain experienced after separator insertion was associated with sex and age. Females experienced more pain than males and patients between the age range of 21 and 36 years suffered more pain during mastication than between 9 and 20 years old.
Collapse
Affiliation(s)
- Hareem Sultan
- Department of Orthodontics, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Hana Pervez
- Department of Orthodontics, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Sidra Maqsood
- Department of Orthodontics, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Wajeeh Syed Zeeshan
- Department of Orthodontics, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| |
Collapse
|
10
|
Consuelo VM, Chiara F, Francesca SM, Patrizia D, Andrea S. The Use of Questionnaires in Pain Assessment during Orthodontic Treatments: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1681. [PMID: 37763800 PMCID: PMC10538163 DOI: 10.3390/medicina59091681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
Pain is a complex multidimensional feeling combined with sensorial and emotional features. The majority of patients undergoing orthodontic treatment report various degrees of pain, which is perceived as widely variable between individuals, even when the stimulus is the same. Orthodontic pain is considered the main cause of poor-quality outcomes, patients' dissatisfaction, and lack of collaboration up to the interruption of therapy. A deep understanding of pain and how it influences a patient's daily life is fundamental to establishing proper therapeutic procedures and obtaining the correct collaboration. Because of its multifaced and subjective nature, pain is a difficult dimension to measure. The use of questionnaires and their relative rating scales is actually considered the gold standard for pain assessment. Choosing the most appropriate instrument for recording self-reported pain depends on a patient's age and cognitive abilities. Although several such scales have been proposed, and a lot of them are applied, it remains uncertain which of these tools represents the standard and performs the most precise, universal, and predictable task. This review aims to give an overview of the aspects which describe pain, specifically the pain experienced during orthodontic treatment, the main tool to assess self-perceived pain in a better and more efficient way, the different indications for each of them, and their correlated advantages or disadvantages.
Collapse
Affiliation(s)
- Vitale Marina Consuelo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (V.M.C.); (S.M.F.); (S.A.)
| | - Falzinella Chiara
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (V.M.C.); (S.M.F.); (S.A.)
| | - Sfondrini Maria Francesca
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (V.M.C.); (S.M.F.); (S.A.)
| | - Defabianis Patrizia
- Department of Surgical Sciences, C.I.R. Dental School, Section of Pediatric Dentistry, University of Turin, 10124 Turin, Italy;
| | - Scribante Andrea
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (V.M.C.); (S.M.F.); (S.A.)
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciencies, University of Pavia, 27100 Pavia, Italy
| |
Collapse
|
11
|
Hansson S, Josefsson E, Lindsten R, Magnuson A, Bazargani F. Pain and discomfort during the first week of maxillary expansion using two different expanders: patient-reported outcomes in a randomized controlled trial. Eur J Orthod 2023; 45:271-280. [PMID: 36331513 PMCID: PMC10230245 DOI: 10.1093/ejo/cjac067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Quad Helix (QH) is the appliance most preferred by orthodontists to correct unilateral posterior crossbite in the early mixed dentition while other orthodontists suggest rapid maxillary expansion (RME) on deciduous teeth in these patients. OBJECTIVES To evaluate and compare perceived pain intensity, discomfort, functional jaw impairment, and analgesic consumption during the first week of treatment with either RME or QH appliances. TRIAL DESIGN Two-arm parallel group, two-centre, randomized controlled trial. MATERIAL AND METHODS Seventy-two patients, mean age 9.5 (SD ±0.8) years, with unilateral posterior crossbite requiring maxillary expansion were randomly allocated to either the RME (22 boys, 14 girls) or QH (22 boys, 14 girls) group. Validated questionnaires were used to assess pain intensity, discomfort, jaw function impairment, and analgesic consumption, on the first, fourth, and seventh days after appliance insertion and activation. BLINDING Due to clinical limitations, only the outcome assessors were blinded to the groups to which the patients were allocated. RESULTS Seventy patients completed the questionnaires. Pain from the tongue and chafe from the appliance were significantly higher in the QH group on the first day of treatment (P = 0.003 and P = 0.000, respectively). On the fourth day, the chafe from the appliance was still significantly higher in the QH group (P = 0.007). Speech was affected in both groups on day 1; this impairment continued and was significantly higher in the RME group days 4 and 7. No significant difference in analgesic consumption was found between the groups at any time. The analgesic consumption was highest at day 1 of treatment. HARMS No harm was observed in any patient. LIMITATIONS Double blinding was not possible due to the clinical limitations. CONCLUSION During the initial 4 days of treatment, pain from the tongue and chafe from the appliance caused the most reported inconvenience in the patients in the QH group. A majority of reported visual analogue scale values were in the lower mid-range, suggesting low to moderate pain and discomfort in both groups. CLINICAL TRIAL REGISTRATION NCT04458506.
Collapse
Affiliation(s)
- Stina Hansson
- Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Eva Josefsson
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Rune Lindsten
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anders Magnuson
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Farhan Bazargani
- Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| |
Collapse
|
12
|
Supakomonnun S, Mitrirattanakul S, Chintavalakorn R, Saengfai NN. Influence of functional and esthetic expectations on orthodontic pain. J Orofac Orthop 2023; 84:141-146. [PMID: 34586434 DOI: 10.1007/s00056-021-00355-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate the effect of orthodontic treatment outcome (OTO) expectations on the level of pain intensity experienced after orthodontic elastomeric separation (OES). MATERIALS AND METHODS A total of 100 orthodontic patients (74 female and 26 male, age 14 years and above) from the Faculty of Dentistry, Mahidol University were enrolled. Before OES, questionnaires were administered to obtain patients' expectations regarding various aspects of OTO as well as OES pain expectations. Real-time self-reported pain intensity from OES at the maxillary and mandibular first permanent molars was obtained before and immediately after separator placement and at 6 h, 24 h, and then every day until day 7 after OES. Data were analyzed for the relationship between OTO expectations and OES pain intensity. The level of significance was set at 0.05. RESULTS The maximum OES pain intensity occurred on day 2 after OES and gradually decreased to the pretreatment level on day 7. The degree of facial, tooth alignment, masticatory function improvement expectations, and a high level of OES pain expectations were significantly associated with the severity of OES pain after separator placement. CONCLUSION Esthetic and functional expectations of OTO were significantly associated with OES pain intensity. Thus, knowledge about esthetic and functional expectations may help to predict patient's pain response to orthodontic treatment.
Collapse
Affiliation(s)
- Sawita Supakomonnun
- Residency Training Program in Orthodontics, Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Phayathai, Ratchathewi District, 10400, Bangkok, Thailand
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Phayathai, Ratchathewi District, 10400, Bangkok, Thailand
| | - Rochaya Chintavalakorn
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Phayathai, Ratchathewi District, 10400, Bangkok, Thailand
| | - Nuntinee Nanthavanich Saengfai
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Phayathai, Ratchathewi District, 10400, Bangkok, Thailand.
| |
Collapse
|
13
|
Reis CLB, Pingueiro-Okada EM, Luiz KG, Pedroso GL, Matsumoto MAN, de Menezes LM, Küchler EC, Nascimento GC, Stuani MBS. Orthodontic pain: c-Fos expression in rat brain nuclei after rapid maxillary expansion. J World Fed Orthod 2023; 12:3-8. [PMID: 36344400 DOI: 10.1016/j.ejwf.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this in vivo study was to quantitatively evaluate pain after rapid maxillary expansion (RME) in young rats by analyzing the activation of nociception-related structures, that is, the caudalis, interpolaris, and oralis subnuclei, according to the Fos expression. METHODS A total of 65 Wistar rats were assigned to three groups: control group (n = 15) with no treatment, positive control group (n = 25), and experimental group (n = 25) with RME. The experimental animals were euthanized at 6, 12, 24, 48, and 72 hours after RME, and the brain was later carefully collected. Coronal sections through the spinal trigeminal caudalis, spinal trigeminal interpolaris, and spinal trigeminal oralis were cut (thickness of 40 µm) on a cryostat and processed for Fos immunohistochemistry. Images from the sections were captured under light microscopy, and ImageJ software was used to count Fos-like immunoreactive neurons. The Analysis of variance (ANOVA) and Tukey test were used for statistical analysis, and the significance level was set at 5%. RESULTS RME induced incisor distalization and opening of the midpalatal suture, as well as neuronal activation of the spinal trigeminal nucleus. The experimental group demonstrated significantly more Fos-positive neurons in subnuclei caudalis and subnuclei interpolaris 6 hours after the maxillary expansion. The Fos immunoreactivity significantly decreased at 12 hours and increased again at 24 and 48 hours (P < 0.001). CONCLUSIONS The RME increases the neural activation of brain regions involved in the nociception region, as determined by the Fos expression. The most intense Fos-like immunoreactive expression was detected in the brain 6 hours after the start of the palatal expansion.
Collapse
Affiliation(s)
- Caio Luiz Bitencourt Reis
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Elaine Machado Pingueiro-Okada
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Kelly Galisteu Luiz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Leite Pedroso
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Mirian Aiko Nakame Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Luciane Macedo de Menezes
- Pontifical Catholic University of Rio Grande do Sul, PUCRS. Dental Program - School of Health and Life Sciences, Rio Grande do Sul, Brazil
| | - Erika Calvano Küchler
- Department of Orthodontics, University Medical Centre of Regensburg, Regensburg, Germany
| | - Glauce Crivelaro Nascimento
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Maria Bernadete Sasso Stuani
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil.
| |
Collapse
|
14
|
Al-Jewair T, Farsaii A. LOW-LEVEL LASER THERAPY MAY REDUCE PAIN ASSOCIATED WITH ORTHODONTIC SEPARATOR PLACEMENT. J Evid Based Dent Pract 2022; 22:101752. [PMID: 36162900 DOI: 10.1016/j.jebdp.2022.101752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Farzan, A. K. Khaleghi (2021). "The Effectiveness of Low-Level Laser Therapy in Pain Induced by Orthodontic Separator Placement: A Systematic Review." J Lasers Med Sci 12: e29. SOURCE OF FUNDING None. TYPE OF STUDY/DESIGN Systematic review.
Collapse
|
15
|
Aiyar A, Shimada A, Svensson P. Assessment of masticatory efficiency based on glucose concentration in orthodontic patients - a methodological study. J Oral Rehabil 2022; 49:954-960. [PMID: 35899420 PMCID: PMC9542905 DOI: 10.1111/joor.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/20/2022] [Accepted: 07/15/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Treatment for malocclusion can cause discomfort and pain in the teeth and periodontium, which may impair masticatory efficiency. The glucose concentration method is widely used to assess masticatory efficiency for its convenience in the clinical situation, although its validity has not been shown. OBJECTIVE The aims were to determine the validity of the glucose concentration method and investigate if this method can be applicable to orthodontic patients with braces. DESIGN Sixteen healthy individuals (7 men, 9 women, and 26±5 years old) and 16 patients with malocclusions needing orthodontic treatment (5 men, 11 women, and 26±4 years old) participated. Glucose concentration was measured after 5-, 10-, and 15-s mastication of gummy jelly and compared to Hue values obtained from the color-changing gum method (reference method). In addition, all participants were asked to fill out the Oral Health Impact Profile questionnaire (OHIP) to assess differences in perception related to the mouth before and after the placement of braces. RESULTS Glucose concentrations were strongly correlated to measures of the two-color chewing gum methods (R2 =0.965). Both the glucose extraction and chewing gum hue value were the smallest for 5 s chewing cycles and increased as the number of chewing strokes increased for the 15 s chewing cycles. (Hue: R2 = 0.510, P < 0.001; glucose: R2 = 0.711, P < 0.001) Masticatory efficiency assessed by both methods was significantly lower in orthodontic patients compared to controls (P<0.05), even though it was not affected by bonding (P>0.09). In addition, OHIP scores in physical pain dimension and psychological disability were higher in orthodontic patients than in the control group (P<0.005). CONCLUSION Measurement of glucose concentration was confirmed as a reliable and convenient method for assessing masticatory efficiency. Furthermore, it appears that this method is applicable to patients with braces whose perception in the oral cavity could change.
Collapse
Affiliation(s)
- Akila Aiyar
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | - Akiko Shimada
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University.,Department of Geriatric Dentistry, Osaka Dental University, Japan
| | - Peter Svensson
- Section for Orofacial Pain and Jaw function, Department of Dentistry and Oral Health, Aarhus University, Denmark.,Faculty of Odontology, Malmö University, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON)
| |
Collapse
|
16
|
Do different orthodontic pliers used in bracket debonding have different effects on pain and sensitivity? A prospective split-mouth study. Clin Oral Investig 2022; 26:6551-6561. [PMID: 35776201 DOI: 10.1007/s00784-022-04604-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The assessment of whether different orthodontic pliers used in bracket debonding have different effects on pain and sensitivity experience. MATERIALS AND METHODS Thirty-three patients (17 females, 16 males) with metal brackets were included in the study. Compressed air and freshly melted ice water were applied to each tooth (6-6) in upper and lower arch before bracket debonding (T0), just after debonding (T1), and 1 week after debonding (T2). Bracket remover plier (BRP) and Weingart plier (WP) were used to debond brackets. A numeric rating scale (NRS) was used to assess sensitivity for each tooth at T0, T1, and T2. Tooth pain was assessed for each tooth using NRS during bracket debonding. RESULTS Statistically higher pain scores were found in teeth U4 (upper first premolar) (p = 0.017) and L6 (lower first molar) (p = 0.026) in Weingart plier group. No statistically significant difference was found during debonding in the other teeth between groups. Statistically high sensitivity score was found at T1 time point in tooth U3 (upper canine) by applying air stimulus in Weingart plier group (p = 0.024). There was no statistically significant difference between the sensitivity scores measured at T2 time point by applying air and cold stimuli between groups. CONCLUSIONS Although the debonding pain scores were statistically significant in two teeth and the sensitivity score in one tooth, there was no clinical significance between the two pliers in terms of pain and sensitivity. CLINICAL RELEVANCE Both debonding pliers gave clinically similar results in terms of pain and sensitivity.
Collapse
|
17
|
Pain Perception during Orthodontic Treatment with Fixed Appliances. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study aimed to determine the intensity of pain perception in patients undergoing fixed orthodontic treatment. We analyzed the severity of pain concerning four routine procedures: the placement of separating elastics, ring cementations, arch activations, and elastic tractions. Our study consisted of a sample of 100 patients between 12 and 35 years old during the initial months of orthodontic treatment with fixed appliances. The patients completed a questionnaire meant to assess their pain sensation perception. The study sample was divided according to age and sex. By determining the intensity of pain felt during the four orthodontic procedures, we found that the most painful one was the ring cementation in all four age groups. The therapeutic-arch-activation procedure ranked second, with a higher mean value (2.66) in the 18–24 age group; the least painful was considered the elastic traction procedure, with a higher value (1.33) in the group over 30 years old. The most painful period was during the first 3–4 days after procedures. Most patients showed moderate pain after following the studied orthodontic interventions and required analgesic medication, the most frequently used being Nurofen, ketonal or paracetamol. The level of pain felt was significantly higher in men than in women. Patients suffer differently from the intensity of perceived pain as they grow older.
Collapse
|
18
|
Jaber ST, Hajeer MY, Burhan AS, Latifeh Y. The Effect of Treatment With Clear Aligners Versus Fixed Appliances on Oral Health-Related Quality of Life in Patients With Severe Crowding: A One-Year Follow-Up Randomized Controlled Clinical Trial. Cureus 2022; 14:e25472. [PMID: 35663697 PMCID: PMC9156343 DOI: 10.7759/cureus.25472] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To compare the level of oral health-related quality of life (OHRQoL) between patients receiving clear aligners or fixed appliances within one year of follow-up using Oral Health Impact Profile 14 (OHIP-14), a validated self-administered questionnaire. Materials and methods A single-centered, two-arm parallel-group randomized controlled clinical trial was conducted on 36 adult patients (19 females, 17 males; age range: 18 to 25 years) who had severe crowding and require orthodontic treatment with first premolars extraction. The patients were equally and randomly divided into two groups: The clear aligners (CA) group and the fixed appliances (FA) group. OHRQoL was assessed using the OHIP-14 tool at various times during comprehensive orthodontic therapy: baseline (T0), one week (T1), two weeks (T2), one month (T3), 6 months (T4), and 12 months (T5) after starting the active orthodontic treatment. Mann-Whitney U test or Friedman test were used to detect significant differences. The level of significance was set at 5%. Results All of the selected patients entered the statistical analysis stage. There were no significant differences between the CA and FA groups for the psychological discomfort, psychological disability, social disability, and handicap (P˃0.05) at almost all assessment times. For the functional limitation, physical pain, physical disability, and the overall score, there were significant differences between the studied groups (P˂0.05), with the FA group having higher mean scores than the CA group in all of the assessment times. Conclusion Patients' treatment with clear aligners has less impact on OHRQoL than those treated using conventional fixed appliances during the first year of treatment.
Collapse
|
19
|
Abstract
During orthodontic treatment, pain is a subjective experience influenced by several factors. Orthodontic patients consume analgesics at different rates to alleviate this pain. Correlations between orthodontic pain and analgesic consumption were analyzed. Predictive factors to analgesics consumption were not statistically analyzed. This study was conducted to identify the predictive factors for analgesic consumption after initiation of orthodontic treatment with fixed appliances. Two hundred and eighty-six patients involved in this study kept a seven-day diary in which they recorded pain intensity (using a 0–10 numerical rating scale), analgesic consumption, localization of pain, pain triggers, and pain characteristics. Univariable analyses identified potential predictive factors: age, gender, pain intensity, pain localization, pain while chewing, pain at rest, night pain, headache, pulsating pain, sharp pain, dull pain, and tingling. Logistic regression was conducted to create a model that could predict analgesic consumption. Multivariate analyses demonstrated that analgesic consumption was increased by increased age, increased intensity of pain, and presence of a headache. Overall, the model explained 33% of analgesic requirement variability. Age, intensity of pain, and headache proved to be predictors of analgesic consumption. Knowledge of such factors may help clinicians identify orthodontic patients who will consume analgesics on their own.
Collapse
|
20
|
Celebi F, Bicakci AA, Kelesoglu U. Effectiveness of low-level laser therapy and chewing gum in reducing orthodontic pain: A randomized controlled trial. Korean J Orthod 2021; 51:313-320. [PMID: 34556585 PMCID: PMC8461383 DOI: 10.4041/kjod.2021.51.5.313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 11/25/2022] Open
Abstract
Objective The purpose of this study was to evaluate the effects of chewing gum and low-level laser therapy in alleviating orthodontic pain induced by the initial archwire. Methods Patients with 3–6 mm maxillary crowding who planned to receive non-extraction orthodontic treatment were recruited for the study. Sixty-three participants (33 females and 30 males) were randomly allocated into three groups laser, chewing gum, and control. In the laser group, a gallium aluminum arsenide (GaAlAs) diode laser with a wavelength of 820 nm was used to apply a single dose immediately after orthodontic treatment began. In the chewing gum group, sugar-free gum was chewed three times for 20 minutes—immediately after starting treatment, and at the twenty-fourth and forty-eighth hours of treatment. Pain perception was measured using a visual analog scale at the second, sixth, and twenty-fourth hours, and on the second, third, and seventh days. Results There were no statistically significant differences between the groups at any measured time point (p > 0.05). The highest pain scores were detected at the twenty-fourth hour of treatment in all groups. Conclusions Within the limitations of the study, we could not detect whether low-level laser therapy and chewing gum had any clinically significant effect on orthodontic pain. Different results may be obtained with a higher number of participants or using lasers with different wavelengths and specifications. Although the study had a sufficient number of participants according to statistical analysis, higher number of participants could have provided more definitive outcomes.
Collapse
Affiliation(s)
- Fatih Celebi
- Department of Orthodontics, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Ali Altug Bicakci
- Department of Orthodontics, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Ufuk Kelesoglu
- Department of Orthodontics, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| |
Collapse
|
21
|
Lin W, Farella M, Antoun JS, Topless RK, Merriman TR, Michelotti A. Factors associated with orthodontic pain. J Oral Rehabil 2021; 48:1135-1143. [PMID: 34273191 PMCID: PMC9292641 DOI: 10.1111/joor.13227] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/09/2021] [Accepted: 06/19/2021] [Indexed: 12/02/2022]
Abstract
Background Pain experienced at teeth during orthodontic treatment varies largely over time, with the reasons for its interindividual variability being largely unknown: age, sex, clinical activations, psychosocial factors and genetic polymorphisms of candidate genes are putative factors that may account to explain this variability. We aimed to investigate the effect of clinical, demographic, psychological and genetic factors on pain levels experienced during fixed orthodontic treatment. Methods A convenience sample of 183 patients undergoing full‐fixed orthodontic treatment were recruited. Participant's pain levels were assessed seven times over a three‐day period via a smartphone app. Clinical, demographic and psychological data were collected via questionnaires. This included the Pain Catastrophising Scale (Child version), the Corah Dental Anxiety Scale and the State and Trait Anxiety Inventory. Participants provided a DNA sample either in the form of blood or saliva, which were used for genotyping COMT gene rs6269, rs4680, rs4646310, NR3C1 gene rs2963155 and the HTR2A gene rs9316233. Results Bond ups had the greatest influence on perceived levels of pain experienced on teeth during orthodontic treatment, accounting for over 20% of total variance in pain response. High‐pain responders had higher scores on pain catastrophising (magnification subscale). Self‐reported pain during fixed orthodontic treatment was not influenced by sex, age, time into treatment, anxiety, nor by polymorphisms of COMT, HTR2A or NR3C1 genes. Conclusions Pain on teeth resulting from orthodontic fixed appliances is stronger during bonds‐up and in patients with high catastrophising scores. Demographics, type of clinical activations and the genetic polymorphisms investigated in this research had little or no impact on perceived pain levels. We investigated putative factors influencing orthodontic pain using ecological momentary assessment in 183 study participants. The findings suggest that bond ups had the greatest influence on perceived levels of pain experienced on teeth during orthodontic treatment, accounting for over 20% of total variance in pain response. High‐pain responders had higher scores on pain catastrophising (magnification subscale). Self‐reported pain during fixed orthodontic treatment was not influenced by sex, age, time into treatment, anxiety, nor by polymorphisms of COMT, HTR2A or NR3C1genes.
Collapse
Affiliation(s)
- Wei Lin
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Mauro Farella
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.,Department of Surgical Sciences, University of Cagliari, Sardinia, Italy
| | - Joseph S Antoun
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Ruth K Topless
- Department of Biochemistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ambra Michelotti
- Department of Neuroscience, Reproductive Science and Oral Science, University of Naples Federico II, Naples, Italy
| |
Collapse
|
22
|
Canigur Bavbek N, Bozkaya E, Isler SC, Elbeg S, Uraz A, Yuksel S. Assessment of salivary stress and pain biomarkers and their relation to self-reported pain intensity during orthodontic tooth movement: a longitudinal and prospective study. J Orofac Orthop 2021; 83:339-352. [PMID: 34170330 DOI: 10.1007/s00056-021-00311-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/24/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this prospective study was to evaluate the relationship between pain intensity and concentrations of salivary pain and stress biomarkers during orthodontic tooth movement. METHODS Eighteen patients (8 males, 10 females; mean age 14.57 ± 2.39 years) who needed orthodontic treatment with maxillary premolar extraction and segmental canine distalization participated in this study. Baseline samples were collected (T1), and orthodontic attachments were placed to maxillary first molars, second premolars, and canines. Then extractions were performed. After 1‑month follow-up, canine distalization started with a segmental wire (T2). Concentrations of salivary α‑amylase (sAA), cortisol, secretory immunoglobulin A (sIgA) and chromogranin A (CgA) were examined at T1, T2, and on days 4 (T3), 7 (T4), 14 (T5), and 30 (T6) after starting retraction. Participants also scored their pain on a visual analogue scale (VAS). Pain catastrophizing behavior and dental anxiety levels of the participants were evaluated by the Pain Catastrophizing Scale (PCS) and Corah's Dental Anxiety Scale (C-DAS), respectively. Repeated measure ANOVA, Mann-Whitney U test and Spearman's rank correlation coefficient analysis were used for statistical evaluations (p < 0.05). RESULTS The maximum values for sAA were seen at T1. Males had higher sAA levels than females with statistical differences at T1, T3, and T4. No significant differences for cortisol, sIgA, and CgA concentrations were observed. The highest mean VAS score was recorded at T3. No correlations were detected between any salivary biomarkers, VAS, C‑DAS, and PCS scores. CONCLUSIONS The stress of starting orthodontic treatment increased sAA levels more than the pain that was experienced during orthodontic tooth movement. Being male was a predictor of higher sAA concentrations. Orthodontic tooth movement did not cause significant alterations in salivary pain and stress biomarkers.
Collapse
Affiliation(s)
- Nehir Canigur Bavbek
- Department of Orthodontics, Faculty of Dentistry, Gazi University, 82nd Road No:2 Emek Cankaya, 06510, Ankara, Turkey.
| | - Erdal Bozkaya
- Department of Orthodontics, Faculty of Dentistry, Gazi University, 82nd Road No:2 Emek Cankaya, 06510, Ankara, Turkey
| | - Sila Cagri Isler
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sehri Elbeg
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ahu Uraz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sema Yuksel
- Department of Orthodontics, Faculty of Dentistry, Gazi University, 82nd Road No:2 Emek Cankaya, 06510, Ankara, Turkey
| |
Collapse
|
23
|
Abed Al Jawad FH, Alhashimi NA. Evaluation of self-perceived pain and jaw function impairment in children undergoing slow and rapid maxillary expansion: A prospective clinical trial. Angle Orthod 2021; 91:725-732. [PMID: 34033675 DOI: 10.2319/020221-100.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate and compare perceived pain and jaw function impairment during the first 4 weeks with slow maxillary expansion (SME) using quadhelix and rapid maxillary expansion (RME) using conventional banded hyrax. MATERIALS AND METHODS Sixty patients aged 10.2 to 15 years were enrolled and consecutively recruited to either the quadhelix group (QG) or hyrax group (HG). A questionnaire was used to evaluate pain, jaw function impairment, and analgesic consumption in the first 7 days, at 2 weeks, and at 4 weeks. RESULTS Fifty-five patients (43 girls and 12 boys) completed the questionnaire at all time points (27 in the QG and 28 in the HG). Except at 4 hours, there were no significant differences between the groups regarding pain from teeth, tongue, and palate. Patients started to adapt after day 3. Patients in the HG group reported significantly higher scores for difficulty in swallowing (moderate to severe) during the first 6 days. In both groups, minimal effects were found on speech and the majority of patients did not experience difficulty in yawning or laughing. There was no significant difference in analgesic consumption between the groups. No correlations were found between age, gender, or malocclusion type and any of the investigated outcomes. CONCLUSIONS Quadhelix for SME and conventional banded hyrax for RME were well tolerated by patients after 1 week. The decision to use either appliance could be based on factors not related to patient experiences.
Collapse
|
24
|
Comparative Analysis of Periodontal Pain According to the Type of Precision Orthodontic Appliances: Vestibular, Lingual and Aligners. A Prospective Clinical Study. BIOLOGY 2021; 10:biology10050379. [PMID: 33924818 PMCID: PMC8145976 DOI: 10.3390/biology10050379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
The objective of this prospective clinical study was to analyze the pain (intensity, location and type) that patients presented after the placement of different types of orthodontic appliances: conventional, low friction, lingual and aligners. The sample consisted of 120 patients divided into four groups: conventional (CON), low friction (LF), lingual (LO) and aligners (INV). The participants were given the Short-Form McGill Pain Questionnaire (Ortho-SF-MPQ), where they had to record the pain intensity (no pain, mild, moderate or intense) and the periodontal location at different time points, from the first 4 h to 7 days after the start of treatment. In all the study groups, the most frequent location was both anterior arches, with maximum values between 56.7% (CON group at 24 h) and 30% (LO group at 4 h). The "whole mouth" and "complete lower arch" locations were indicated only by the patients in the lingual group. Regarding pain intensity, the patients reported a higher percentage of mild-moderate pain during the first 3 days of treatment (96.7% in LO at 4 h, 86.7% in CON, 83.3% in LF and 90% in INV at 24 h); later, the reported pain decreased to no pain/mild pain, especially in the lingual group, until reaching values close to zero at 7 days post-treatment. The most frequent type of pain was acute in the low friction and lingual groups (with maxima of 60% and 46.7% at 24 h, respectively). On the contrary, in the conventional (36.7% at 4 h) and Invisalign (40% at 24 h) groups, the sensitive type was the most frequent. There are differences regarding periodontal pain in its intensity, location and type according to the use of different orthodontic techniques.
Collapse
|
25
|
Antonarakis GS, Ameur S, Giannopoulou C, Kiliaridis S. Perception of pain in Class II malocclusion children treated with cervical headgear: a randomized controlled trial. Eur J Orthod 2021; 43:222-228. [PMID: 32812021 DOI: 10.1093/ejo/cjaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The aims of this study were: 1. to evaluate the experience of pain perceived by children during separator placement and headgear wear; 2. to find possible associations between the perceived intensity of pain and the levels of Substance P (SP) and interleukin-1 beta (IL-1β) in the gingival crevicular fluid (GCF) during these procedures; 3. to identify other factors, such as previous pain experience, which could be associated to the patients' perceived discomfort or pain during treatment. TRIAL DESIGN Nine-month parallel-group randomized controlled trial. METHODS Forty Class II malocclusion children (8-12 years) were included, half of which received a cervical headgear while the other half did not receive any treatment during the study period. Baseline pain data were recorded including previous experience to general and dental pain, Corah's Dental Anxiety Scale, and baseline pain using a visual analogue scale (VAS). Elastic separators were placed in children for 1 week, followed by molar band and cervical headgear placement. Children were seen at various time points throughout the 9-month period where at each appointment, a VAS assessment of pain as well as GCF sampling was carried out to quantify the levels of SP and IL-1β. Multiple regression analysis was performed to ascertain the influence of factors including sex, age, time, headgear wear, and baseline pain data on pain severity. RESULTS Pain severity and SP and IL-1β levels in the GCF follow a similar pattern, with peaks being observed 1 day after orthodontic elastic separator placement. Pain was more severe after the placement of orthodontic separators than following cervical headgear wear. With regard to pain predictors, pain is more severe in older children, those with a worse previous general pain experience, and those with higher levels of IL-1β, particularly after elastic separator placement. CONCLUSIONS Orthodontic pain and discomfort following orthodontic separator placement and cervical headgear wear depends on factors including age, previous pain experience, and the level of IL-1β in the GCF.
Collapse
Affiliation(s)
- Gregory S Antonarakis
- Division of Orthodontics and University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Sofian Ameur
- Division of Orthodontics and University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Catherine Giannopoulou
- Division of Periodontology, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics and University Clinics of Dental Medicine, University of Geneva, Switzerland
| |
Collapse
|
26
|
Jaeger R, Schmidt F, Naziris K, Lapatki BG. Evaluation of orthodontic loads and wire-bracket contact configurations in a three-bracket setup: Comparison of in-vitro experiments with numerical simulations. J Biomech 2021; 121:110401. [PMID: 33894471 DOI: 10.1016/j.jbiomech.2021.110401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/08/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
So far, no practicable procedure exists to quantify the orthodontic loads applied to teeth in vivo. Dentists therefore rely on experience and simplified mechanical in-vitro experiments comprising deflection of orthodontic wires. Predicting the mechanical behaviour of orthodontic wires during clinical therapy requires understanding of the different contact states at multi-bracket-wire interfaces. This study experimentally investigates the effect of different bracket-wire contact configurations in a three-bracket setup and uses two numerical approaches to analyse and complement the experimental data. Commonly used round stainless-steel wires (diameter: 0.012″ and 0.016″) and titanium-molybdenum alloy wires (diameter: 0.016″ and 0.018″) were tested. All six force-moment components were measured separately for each of the three brackets. The results indicate that a specific sequence of distinct bracket-wire contact configurations occurs. Several transitions between configurations caused substantial changes of effective wire stiffness (EWS), which were consistent among experimental and numerical methods. The lowest EWS was observed for the configuration in which the wire touched only one wing of the lateral brackets. Taking this stiffness as 100%, the transition to a configuration in which the wire touched two opposing wings of the lateral brackets resulted in an increase of EWS of 300% ± 10%. This increase was independent of the wire type. Additional contacts resulted in further increases of stiffness beyond 400%. The results of this combined experimental and numerical study are important for providing a fundamental understanding of multi-bracket-wire contact configurations and have important implications for clinical therapy.
Collapse
Affiliation(s)
- Rudolf Jaeger
- Department of Orthodontics, University of Ulm, Germany.
| | - Falko Schmidt
- Department of Orthodontics, University of Ulm, Germany
| | | | | |
Collapse
|
27
|
Mirhashemi A, Rasouli S, Shahi S, Chiniforush N. Efficacy of Photobiomodulation Therapy for Orthodontic Pain Control Following the Placement of Elastomeric Separators: A Randomized Clinical Trial. J Lasers Med Sci 2021; 12:e8. [PMID: 34084734 DOI: 10.34172/jlms.2021.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Controlling pain in orthodontic patients has gained special attention. This study assessed the efficacy of photobiomodulation therapy (PBMT) for pain control following the placement of elastomeric separators. Methods: This split-mouth single-blind randomized clinical trial evaluated 30 orthodontic patients who required posterior elastomeric separators. The two maxillary quadrants were randomized into the laser and control groups. In the laser quadrant, an 808 nm diode laser (400 mW, 15.60 J/cm2 , 11 seconds, continuous-wave, contact mode) was irradiated to the cervical third of the maxillary first molar roots 24 hours prior to the placement of separators. The control quadrant received placebo radiation by a light-curing unit. The patients received the second laser cycle right before the placement of separators 24 hours later. The level of self-perceived pain was recorded at 0, 2, 6, 24, and 72 hours and 5 days after the intervention in the laser and control quadrants using a visual analog scale (VAS). Data were analyzed using the analysis of variance (ANOVA) and paired-samples t test. Results: The trend of change in the pain score was similar in both groups. The pain score was significantly lower in the laser group than the control group at all-time points (P <0.05) except at time 0. The pain score increased in the first 6 hours and reached its maximum level in 24 hours in both groups. Conclusion: PBMT by an 808 nm diode laser can effectively decrease pain following the placement of elastomeric separators.
Collapse
Affiliation(s)
- AmirHossein Mirhashemi
- Associate Professor, Orthodontic Department, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Seyedreza Rasouli
- Assistant Professor, Department of Orthodontics, School of Dentistry, Shahed University of Medical Sciences, Tehran, Iran
| | - Shiva Shahi
- School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Nasim Chiniforush
- Assistant Professor, Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| |
Collapse
|
28
|
González-Sáez A, Antonio-Zancajo L, Montero J, Albaladejo A, Melo M, Garcovich D, Alvarado-Lorenzo A. The Influence of Friction on Design of the Type of Bracket and Its Relation to OHRQoL in Patients Who Use Multi-Bracket Appliances: A Randomized Clinical Trial. MEDICINA-LITHUANIA 2021; 57:medicina57020171. [PMID: 33671217 PMCID: PMC7922052 DOI: 10.3390/medicina57020171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: The aim of this study was to evaluate the influence of friction on design of the type of bracket, patients’ perception of pain and the impact on their oral health-related quality of life. Materials and Methods: A randomized clinical trial was carried out with 90 patients (62.2% women and 37.8% men) with three kinds of fixed multi-bracket appliances: Conventional (GC), fixed multi-bracket low friction (GS) and self-ligating (GA). The VAS (Visual Analogue Scale) was used to determine pain during the first seven days of treatment at different points in time. The patients were also given the OHIP-14 (Oral Health Impact Profile) questionnaire to analyse their oral health-related quality of life (OHRQoL) after the first 30 days of treatment. The ANOVA test was used for the analysis of the variables and the post hoc Bonferroni test for the comparison between groups. Results: Maximum pain was observed between one and two days after the start of treatment. The GC group showed the greatest degree of pain, with maximum values (4.5 ± 2.0) at 24 h. The self-ligation brackets show lower impact on patients’ oral health-related quality of life (0.8 ± 2.2, p < 0.01). Conclusions: Friction in the type of bracket influences pain and the Oral Health-Related Quality of Life of patients who use multi-bracket fixed orthodontics.
Collapse
Affiliation(s)
- Adriana González-Sáez
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.G.-S.); (J.M.); (A.A.); (A.A.-L.)
| | - Laura Antonio-Zancajo
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.G.-S.); (J.M.); (A.A.); (A.A.-L.)
- Correspondence: ; Tel.: +34-920-30-20-64
| | - Javier Montero
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.G.-S.); (J.M.); (A.A.); (A.A.-L.)
| | - Alberto Albaladejo
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.G.-S.); (J.M.); (A.A.); (A.A.-L.)
| | - María Melo
- Conservative Dentistry and Endodontics, Department of Stomatology, University of Valencia, Gascó Oliag 1, 46010 Valencia, Spain;
| | - Daniele Garcovich
- Department of Dentistry, European University of Valencia, Passeig de lÁlbereda, 7, 46010 Valencia, Spain;
| | - Alfonso Alvarado-Lorenzo
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.G.-S.); (J.M.); (A.A.); (A.A.-L.)
| |
Collapse
|
29
|
Michelogiannakis D, Gajendra S, Pathagunti SR, Sayers MS, Newton JT, Zhou Z, Feng C, Rossouw PE. Patients' and parents' expectations of orthodontic treatment in university settings. Am J Orthod Dentofacial Orthop 2021; 159:443-452. [PMID: 33568276 DOI: 10.1016/j.ajodo.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 01/01/2020] [Accepted: 02/01/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The primary aim was to compare patients' and parents' orthodontic treatment expectations at the Eastman Institute for Oral Health, University of Rochester, Rochester, NY (UR) in the United States. Secondary aims were to assess the association between sociodemographic factors and UR participants' expectations; and compare participants' expectations between UR, Academic Centre for Dentistry Amsterdam (ACTA) and King's College Dental Hospital, London, United Kingdom (KC) (previously published data). METHODS One hundred and forty participants [70 patients and one of their parents (n = 70)] completed a validated questionnaire (10 questions) to measure orthodontic treatment expectations before screening at the Orthodontic Department at UR. Various sociodemographic factors were assessed. The paired t test (for continuous responses) and the Fisher exact test (for categorical responses) were used to compare UR patients' and parents' responses. Two-sample t test and the Fisher exact test were used to compare participants' responses among sociodemographic groups. One-way analysis of variance followed by the Tukey test, and the Fisher exact test were used to compare participants' responses between UR, and ACTA and KC (data collected from previous publications). A multiplicity correction was performed to control the false discovery rate. RESULTS Patients at UR expected less check-up and diagnosis, and less discussion about treatment at the initial visit, more dietary restrictions, and less improvement in smile esthetics and social confidence with orthodontic treatment than parents. Participants' responses differed by sociodemographic factors at UR and between UR, ACTA, and KC. CONCLUSIONS Expectations of orthodontic treatment differ between patients and their parents, are associated with sociodemographic factors, and vary among United States and European University centers.
Collapse
Affiliation(s)
- Dimitrios Michelogiannakis
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
| | - Sangeeta Gajendra
- Division of Community Dentistry and Oral Disease Prevention, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Srinivasa Reddy Pathagunti
- Division of Community Dentistry and Oral Disease Prevention, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Mark Stewart Sayers
- Orthodontic Department, Queen Mary's Hospital Sidcup, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Jonathon Tim Newton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Zhirou Zhou
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Paul Emile Rossouw
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| |
Collapse
|
30
|
Chopra S, Kamboj A. Clinical comparison of pain: Self-ligating versus conventional fixed orthodontic appliance systems. INTERNATIONAL JOURNAL OF ORTHODONTIC REHABILITATION 2021. [DOI: 10.4103/ijor.ijor_9_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
31
|
Marya A, Venugopal A, Vaid N, Alam MK, Karobari MI. Essential Attributes of Clear Aligner Therapy in terms of Appliance Configuration, Hygiene, and Pain Levels during the Pandemic: A Brief Review. Pain Res Manag 2020; 2020:6677929. [PMID: 33488889 PMCID: PMC7787809 DOI: 10.1155/2020/6677929] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.
Collapse
Affiliation(s)
- Anand Marya
- Department of Orthodontics, University of Puthisastra, Phnom Penh, Cambodia
| | - Adith Venugopal
- Department of Orthodontics, University of Puthisastra, Phnom Penh, Cambodia
| | | | - Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Conservative Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150 Kelantan, Malaysia
| |
Collapse
|
32
|
Mendonça DLD, Almeida-Pedrin RR, Pereira NC, Oltramari PVP, Fernandes TMF, Conti ACDCF. The influence of text messages and anxiety on pain perception and its impact on orthodontic patients routine. Dental Press J Orthod 2020; 25:30-37. [PMID: 33206826 PMCID: PMC7668061 DOI: 10.1590/2177-6709.25.5.030-037.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 07/06/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. METHODS The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. RESULTS Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). CONCLUSIONS Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.
Collapse
|
33
|
Domínguez Camacho A, Bravo Reyes M, Velasquez Cujar SA. A systematic review of the effective laser wavelength range in delivering photobiomodulation for pain relief in active orthodontic treatment. Int Orthod 2020; 18:684-695. [PMID: 33060065 DOI: 10.1016/j.ortho.2020.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/24/2020] [Accepted: 08/30/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This systematic review aimed to establish an effective wavelength range for PhotoBioModulation (PBM) to relieve pain in orthodontic treatments. MATERIAL AND METHODS The electronic literature search was carried out in the following databases: PubMed, ISI Web of Science, Scopus, and Cochrane. In the initial search, 255 papers were obtained. Deleting duplicates in the search left 180 items. One manually searched study was included for a total of 181 studies. According to PRISMA guidelines and a thorough analysis of their methodology, the final sample was composed of 13 RCTs. The final statistical analysis was performed in 11 studies. The statistical analysis sought to strengthen the collected data, determining the correlation coefficient (r) for the same time interval (24h) using a scale equivalent to the standard value (0-10cm). Aiming to reduce the effect of heterogeneity, the difference in cm between control group (GC) and experimental group (EG) averages was considered the outcome. This difference was correlated with the wavelength in nm, calculating the Pearson linear correlation coefficient, and calculating a logarithmic correlation. RESULTS The dispersion of the data obtained in the experimental groups at each given wavelength showed that the most significant number of studies were in the ranges of 780-830nm. The correlation between the wavelength and the difference between the control and experimental group averages, either linear (R2=0.0564, r=0.237) or logarithmic (R2=0.0688, r=0.262) was not significant (P>0.90). Therefore, pain reduction after 24h is not significantly dependent of wavelength. CONCLUSION The majority of RCTs related to pain relief in orthodontic treatment showed 780-830nm as the most effective photobiomodulation wavelength range for orthodontic pain relief. However, pain reduction after 24h is not significantly dependent of wavelength. The protocol was registered in PROSPERO (CRD42019119799).
Collapse
Affiliation(s)
| | - Mateo Bravo Reyes
- Universidad del Valle, department of orthodontics, Cl. 4b #36b37, Cali, Colombia.
| | | |
Collapse
|
34
|
AlSayed Hasan MMA, Sultan K, Ajaj M, Voborná I, Hamadah O. Low-level laser therapy effectiveness in reducing initial orthodontic archwire placement pain in premolars extraction cases: a single-blind, placebo-controlled, randomized clinical trial. BMC Oral Health 2020; 20:209. [PMID: 32690001 PMCID: PMC7370482 DOI: 10.1186/s12903-020-01191-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 07/08/2020] [Indexed: 01/01/2023] Open
Abstract
Background The objective of this randomized clinical trial was to evaluate Low-Level Laser Therapy (LLLT) effectiveness in spontaneous and chewing pain reduction following initial orthodontic archwire placement. Methods 26 patients (mean age 20.07 ± 3.13 years) with maxillary Little’s Irregularity Index (LII) of 7 mm or more that indicates first maxillary premolars extraction and no medications intake were eligible for this trial. Patients were randomly assigned with 1:1 ratio using simple randomization technique to receive either LLL or placebo treatment. Blinding was applicable for patients only. In the laser group, patients received a single LLL dose (wavelength 830 nm, energy 2 J/point) in four points (2 buccal, 2 palatal) for each maxillary anterior tooth root. Patients in the placebo group had the same laser application procedure without emitting the laser beam. Patients were asked to score spontaneous and chewing pain intensity by filling out a questionnaire with a 100-mm Visual Analogue Scale (VAS) after 1, 6, 24, 48, and 72 h of treatment application. Independent t-test was used to compare the mean pain scores between the laser and placebo groups for both spontaneous and chewing pain at each studied time point. Results No dropout occurred so the results of the 26 patients were statistically analyzed. Despite some clinical differences observed between the two groups, no statistical significance was found for each studied time point (p > 0.05) for both spontaneous and chewing pain except after 72 h for chewing pain with a VAS score of (18.84 ± 13.44) mm for the laser group compared to (38.15 ± 27.06) mm for the placebo group. Conclusions LLLT, with the suggested parameters, is not effective in pain reduction following initial orthodontic archwire placement. Trial registration Name of the registry:Clinicaltrials.gov Trial registration number:NCT02568436. Date of registration: 26 September 2015 ‘Retrospectively registered’.
Collapse
Affiliation(s)
| | - Kinda Sultan
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Mowaffak Ajaj
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Iva Voborná
- Department of Prosthodontics, Institute of Dentistry and Oral Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Omar Hamadah
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Higher Institute for Laser Researches and Applications, Damascus University, Damascus, Syria
| |
Collapse
|
35
|
Poudel P, Dahal S, Thapa VB. Pain and Oral Health Related Quality of Life among Patients Undergoing Fixed Orthodontic Treatment: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2020; 58:400-404. [PMID: 32788756 PMCID: PMC7580346 DOI: 10.31729/jnma.4817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Fixed orthodontic procedures such as separator placement, archwire placement and activations, application of orthopaedic forces, and debonding of brackets produce pain in patients. This study was conducted to assess pain and oral health-related quality of life among patients undergoing orthodontic treatment. Methods: This descriptive cross-sectional study was conducted among 152 orthodontic patients of a teritary care center from January 2019 to October 2019 after receiving ethical approval from the Institutional Review Committee (Ref. no. 2311201813). Convenience sampling method was done to select the participants. Oral health-related quality of life using "Oral Health Impact Profile-14" and pain experienced during the first month of fixed orthodontic treatment were assessed. Data analysis for calculation of frequency and proportion was done in Statistical Package of Social Sciences. Results: Mean pain score of the study participants was 5.05±2.07 and their mean oral health impact was 12.71±7.27. Most of the study participants 86 (56.58%), had experienced moderate pain due to orthodontic treatment. Out of the reported impacts, 134 (88.2%) had painful aching in mouth and 127 (83.6%) had difficulty during eating. Least impact was seen in alteration of taste 35 (23%). Conclusions: The pain intensity experienced by patients was variable. Most participants had moderate pain but few patients perceived no pain at all. The participants had at least one or other oral health impacts due to fixed orthodontic treatment. Orthodontists should counsel the patients regarding possible discomfort so that there is no discontinuation of treatment due to pain.
Collapse
Affiliation(s)
- Prakash Poudel
- Department of Orthodontics and Dentofacial Orthopaedics, Kathmandu Medical College, Duwakot, Bhaktapur, Nepal
| | - Sirjana Dahal
- Department of Community and Public Health Dentistry, Kathmandu Medical College, Duwakot, Bhaktapur, Nepal
| | - Vivek Bikram Thapa
- Department of Orthodontics and Dentofacial Orthopaedics, Kathmandu Medical College, Duwakot, Bhaktapur, Nepal
| |
Collapse
|
36
|
Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application: Randomized Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7460938. [PMID: 32596367 PMCID: PMC7273483 DOI: 10.1155/2020/7460938] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022]
Abstract
Purpose The aim of this study was to investigate the effect of Photobiomodulation (PBM) in managing orthodontic pain intensity over time in patients requiring band application on upper first molars. Methods Maxillary first molars were banded. In the trial group, each molar received single-session PBM on two buccal and two palatal points (λ = 830 ± 10 nm; 150 mW, 7.5 J/cm2; spot of 0.1 cm2; 5 sec per point), while the control group received a placebo treatment. All patients were asked to answer five pain rating scales to assess pain intensity at 5 minutes and 1, 12, 24, and 72 hours and completed a survey describing the type of pain and its temporal course in the next 7 days. Results 26 patients (mean age 11.8 years) were randomly assigned to a control or a trial group. The trial group showed significantly lower pain intensities (p < 0.05) at 5 min (M = 0.92, SD = 1.32), 1 h (M = 0.77, SD = 1.01), and 12 h (M = 0.77, SD = 1.54) after band application compared to the control group (5 min: M = 1.62, SD = 1.26; 1 h: M = 1.77, SD = 1.92; and 12 h: M = 1.77, SD = 2.17), whereas no difference between groups (p > 0.05) was found at 24 h (trial: M = 0.62, SD = 1.71; control: M = 1.08, SD = 1.75) and 72 h (trial: M = 0.31, SD = 0.75; control: M = 0.15, SD = 0.55). Patients in the control group reported more frequently the presence of “compressive pain” (58.8%, p < 0.05) from the appliance during the week after the application, while the trial group showed higher frequency of “no pain” (46.2%, p < 0.05). However, PBM did not affect the pain onset (trial: M = 10.86, SD = 26.97; control: M = 5.25, SD = 7.86), peak (trial: M = 15.86, SD = 26.29; control: 6.17, SD = 7.96), and end time (trial: 39.57, SD = 31.33; control: M = 22.02, SD = 25.42) reported by the two groups (p > 0.05). Conclusions PBM might be considered a promising alternative to decrease general pain intensity, although not affecting the typical pain cycle, in terms of the onset, peak, and ending times.
Collapse
|
37
|
Curto A, Albaladejo A, Montero J, Alvarado A. Influence of a Lubricating Gel (Orthospeed®) on Pain and Oral Health-Related Quality of Life in Orthodontic Patients during Initial Therapy with Conventional and Low-Friction Brackets: A Prospective Randomized Clinical Trial. J Clin Med 2020; 9:jcm9051474. [PMID: 32423007 PMCID: PMC7290469 DOI: 10.3390/jcm9051474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/25/2020] [Accepted: 05/13/2020] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate whether statistically significant differences exist regarding pain and the impact on oral quality of life of orthodontic treatment. A conventional brackets system was compared with low-friction brackets. A total of 90 patients (male = 35, female = 55) were chosen for this randomized clinical trial. Pain was assessed at 4, 8, and 24 hours and 2, 3, 4, 5, 6, and 7 days after the start of treatment using the McGill Pain Questionnaire. Oral health-related quality of life (OHRQoL) was assessed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Oral quality of life was assessed at one month, with patients with low-friction brackets describing lower levels of pain. The patients with conventional brackets indicated a worse impact on their quality of life compared to the group with low-friction brackets. Statistically significant differences were found between the groups, with maximum pain observed between the first 24 and 48 hours, and the values of minimum pain are reached after 7 days. The pain and impact on oral quality of life was statistically worse in patients with conventional brackets compared to patients with low-friction brackets. The type of bracket system used was therefore shown to influence patients' perceptions of pain and impact on their OHRQoL.
Collapse
Affiliation(s)
- Adrian Curto
- DDS, Professor in Pediatric Dentistry, Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923294541
| | - Alberto Albaladejo
- DDS, Professor in Orthodontics, Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.A.); (A.A.)
| | - Javier Montero
- DDS, Professor in Prosthodontics, Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain;
| | - Alfonso Alvarado
- DDS, Professor in Orthodontics, Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (A.A.); (A.A.)
| |
Collapse
|
38
|
Kondo M, Shibuta I. Extracellular signal-regulated kinases (ERK) 1 and 2 as a key molecule in pain research. J Oral Sci 2020; 62:147-149. [PMID: 32224567 DOI: 10.2334/josnusd.19-0470] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Pain can be divided into nociceptive, inflammatory, and neuropathic pain. It is important to understanding the molecular mechanism of pain signaling in the development of pain relief therapies. Twenty years ago, extracellular signal-regulated kinases (ERK) 1 and 2, which are members of the mitogen-activated protein kinase superfamily, were identified as molecules activated in neurons by the exposure of peripheral tissues to noxious stimuli. Further studies have revealed that peripheral nerve injury induces ERK activation in glial cells, sensory neurons, and second-order neurons, albeit at different time points. Moreover, inhibition of ERK suppresses pathological pain in animals with peripheral nerve injury. Therefore, ERK is currently recognized as an important molecule in pain signaling and a potential novel target for pain treatment. This review introduces recent advances in revealing the regulation of ERK in pain research.
Collapse
Affiliation(s)
- Masahiro Kondo
- Department of Legal Medicine, Nihon University School of Dentistry
| | - Ikuko Shibuta
- Department of Physiology, Nihon University School of Dentistry
| |
Collapse
|
39
|
Costa EOD, Blagitz MN, Normando D. Impact of catastrophizing on pain during orthodontic treatment. Dental Press J Orthod 2020; 25:64-69. [PMID: 32215479 PMCID: PMC7077947 DOI: 10.1590/2177-6709.25.1.064-069.oar] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/22/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: This study proposed to investigate the influence of catastrophizing and others factors related to pain during orthodontic treatment. Methods: 27 patients with 0.022 x 0.028-in Straight-wire brackets were evaluated during alignment and leveling phase with nickel-titanium wires. Visual Analog Scales measured the intensity of orthodontic pain at six moments after a clinical appointment: 6 first hours; 1, 2, 3, 5, and 7 days. Multiple linear regression and stepwise approach assessed the influence of the following variables on pain: catastrophizing, sex, age, duration of treatment, clinical appointment time (morning or afternoon), and wire diameter. Results: The highest pain intensity was reported 24 hours after activation. These data were used to analyze factors associated with pain level. Age (r = 0.062, p= 0.7586), sex (p= 0.28), catastrophizing (r = -0.268, p= 0.1765), and orthodontic wire diameter (r = 0.0245, p= 0.2181) were not correlated with orthodontic pain in the univariate statistics. Catastrophizing was included in the multiple regression model because it was of great interest. Duration of orthodontic treatment (r = 0.6045, p= 0.0008) and the time when orthodontic appliance was activated (p= 0.0106) showed statistical significant associations with pain, and were also included in the multivariate regression, which showed that about 32% of orthodontic pain could be explained by the duration of treatment (R2= 0.32, p= 0.0475). Catastrophizing (R2= 0.0006, p= 0.8881) and clinical appointment time were not significantly associated with pain (R2= 0.037, p= 0.2710). Conclusions: Pain after activation of fixed orthodontic appliance is not associated with catastrophizing as well as age, sex, orthodontic wire diameter, and period of activation.
Collapse
Affiliation(s)
- Eduardo Oliveira da Costa
- Associação Brasileira de Odontologia - Seção Pará, Curso de Especialização em Ortodontia (Belém/PA, Brazil)
| | - Marco Nassar Blagitz
- Universidade Federal do Pará, Faculdade de Odontologia, Programa de Pós-Graduação em Odontologia (Belém/PA, Brazil)
| | - David Normando
- Associação Brasileira de Odontologia - Seção Pará, Curso de Especialização em Ortodontia (Belém/PA, Brazil).,Universidade Federal do Pará, Faculdade de Odontologia (Belém/PA, Brazil)
| |
Collapse
|
40
|
Diddige R, Negi G, Kiran KVS, Chitra P. Comparison of pain levels in patients treated with 3 different orthodontic appliances - a randomized trial. Med Pharm Rep 2020; 93:81-88. [PMID: 32133451 PMCID: PMC7051823 DOI: 10.15386/mpr-1311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/28/2019] [Accepted: 06/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background and aims To compare pain levels experienced during initial alignment with three different orthodontic appliance types and to correlate pain with male and female differences, if any. Methods A prospective, randomized 3-arm parallel trial allocated 36 adult orthodontic patients into three appliance groups: MBT 0.022" slot (Mini Twin, Ormco, Glendora, USA), self ligating 0.022" slot Damon 3MX (Ormco, Glendora, USA) and clear aligners (Smile align, Mumbai, India). The level of discomfort was assessed through a questionnaire based on the visual analogue scale at four hours, twenty four hours, third and seventh day after appliance placement. Results Patients treated with clear aligners reported less pain than patients treated with conventional and self ligating fixed appliances. Patients treated with MBT conventional appliances showed greater pain levels than Damon appliances. A significantly higher visual analogue scale score was observed at 24 hours and the least visual analogue scale scores on the seventh day post appliance placement. Conclusion During the first week of orthodontic treatment, patients treated with clear aligners reported lower pain than those treated with conventional and self-ligating appliances.
Collapse
Affiliation(s)
- Rajasri Diddige
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, Telangana, India
| | - Gunjan Negi
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, Telangana, India
| | | | - Prasad Chitra
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, Telangana, India
| |
Collapse
|
41
|
Eslamian L, Torshabi M, Motamedian SR, Hemmati YB, Mortazavi SA. The effect of naproxen patches on relieving orthodontic pain by evaluation of VAS and IL-1β inflammatory factor: a split-mouth study. Dental Press J Orthod 2020; 24:27e1-27e7. [PMID: 31994643 PMCID: PMC6986181 DOI: 10.1590/2177-6709.24.6.27.e1-7.onl] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 03/07/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction: Pain related to orthodontic tooth movement is common and cause dissatisfaction and discomfort. Objective: The present study aimed to compare the efficacy of naproxen patches in pain control during orthodontic tooth separation, by means of visual analogue scale (VAS) and interleukin 1β (IL-1β) levels in gingival crevicular fluid (GCF). Methods: In this split-mouth triple-blind clinical trial, with 40 patients following separation, 5% naproxen or placebo patches were randomly placed on the upper right or left first molars every 8 hours. Pain intensity scores were determined after 2 and 6 hours, sleep time, 24 hours, days 2, 3 and 7 by the patients using a 100-mm VAS ruler. IL-1β levels in GCF were evaluated by ELISA at baseline, 1 and 24 hours and 7 days. Paired samples t-tests and two-way repeated measures ANOVA analysis of variance with a significance level of 0.05 were applied. Results: A total number of 30 patients (13 males and 17 females) finished the trial. Significant differences were found in pain scores (p< 0.0001) and IL-1β levels (p= 0.047) between naproxen and placebo groups. Lower pain scores were reported for the patients using naproxen patches at all time points, except 1 hour after separation. IL-1β levels were lower for the patients using naproxen patches only 1 hour after separation (p= 0.047). The peak of pain scores and IL-1β levels were calculated at 24 hours. Conclusion: In the light of VAS scores and IL-1β levels, naproxen patches reduced the pain caused by separator placement.
Collapse
Affiliation(s)
- Ladan Eslamian
- Shahid Beheshti University of Medical Sciences, Dentofacial Deformities Research Center, Department of Orthodontics, School of Dentistry (Tehran, Iran)
| | - Maryam Torshabi
- Shahid Beheshti University of Medical Sciences, Dental Biomaterials Department, School of Dentistry (Tehran, Iran)
| | - Saeed Reza Motamedian
- Shahid Beheshti University of Medical Sciences, Dentofacial Deformities Research Center, Department of Orthodontics, School of Dentistry (Tehran, Iran)
| | - Yasamin Babaee Hemmati
- Guilan University of Medical Sciences, Dental Sciences Research Center, Department of Orthodontics, School of Dentistry (Rasht, Iran)
| | | |
Collapse
|
42
|
Cardoso PC, Espinosa DG, Mecenas P, Flores-Mir C, Normando D. Pain level between clear aligners and fixed appliances: a systematic review. Prog Orthod 2020; 21:3. [PMID: 31956934 PMCID: PMC6970090 DOI: 10.1186/s40510-019-0303-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/13/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess if there is any difference in pain levels between orthodontic treatment with clear aligners or fixed appliances. MATERIALS AND METHODS An electronic search was completed in PubMed, The Cochrane Database, Web of Science, Scopus, Lilacs, Google Scholar, Clinical Trials, and OpenGrey databases without any restrictions until February 2019. All comparative study types contrasting pain levels between clear aligners and fixed appliances were included. The risk of bias (RoB) was assessed using the Newcastle-Ottawa Scale, ROBINS-I-Tool, or ROB 2.0 according to the study design. The level of evidence was assessed through the GRADE tool. RESULTS After removal of duplicates, exclusion by title and abstract, and reading the full text, only seven articles were included. Five were prospective non-randomized clinical trials (CCT), one was a cross-sectional study, and one was a randomized clinical trial (RCT). Two studies presented a high RoB, three a moderate RoB, and two a low RoB (including the RCT). A meta-analysis was not performed because of clinical, statistical, and methodological heterogeneity. Most of the studies found that pain levels in patients treated with Invisalign were lower than those treated with conventional fixed appliances during the first days of treatment. Differences disappeared thereafter. No evidence was identified for other brands of clear aligners. CONCLUSIONS Based on a moderate level of certainty, orthodontic patients treated with Invisalign appear to feel lower levels of pain than those treated with fixed appliances during the first few days of treatment. Thereafter (up to 3 months), differences were not noted. Malocclusion complexity level among included studies was mild. Pain is one of many considerations and predictability and technical outcome are more important, mainly considering that the difference does not seem to occur after the first months of the orthodontic treatment.
Collapse
Affiliation(s)
| | | | - Paulo Mecenas
- Federal University of Pará (UFPA), Belém, Pará, Brazil
| | - Carlos Flores-Mir
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - David Normando
- Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará, 66075-110, Brazil.
| |
Collapse
|
43
|
Jawaid M, Qadeer TA, Fahim MF. Pain perception of orthodontic treatment - A cross-sectional study. Pak J Med Sci 2019; 36:160-165. [PMID: 32063952 PMCID: PMC6994912 DOI: 10.12669/pjms.36.2.619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives: The objectives were to evaluate the intensity of pain perceived 24 hours following insertion of fixed orthodontic appliance components i-e separators, bands and brackets. Methods: This cross-sectional study conducted at a Dental College in Karachi (July 2017-March 2018) investigated the amount of pain perceived during different stages of fixed orthodontic treatment. The inclusion criteria were healthy individuals without systemic disease, age 13-26 years, fixed orthodontic treatment candidates having healthy permanent first molars. The exclusion criteria were missing permanent first molars, patients requiring brass wire separators instead of elastomeric separators and molar tubes instead of bands, ongoing or previous periodontal disease and syndromic patients. Pain intensity was assessed in ninety eight patients using a Numeric Rating scale (NRS) at baseline (T0) before insertion, and 24 hours after insertion (T1) of a component. This procedure was repeated six times, twice each for separators, bands and brackets. Scoring was done on the NRS from 0 to 10 where 0 indicated no pain and 10 indicated worst pain possible. Results: A significant difference in perceived pain was found between baseline and after 24 hours of placement of all components (P-value 0.000). Odds ratio indicated that males were at a greater risk to feel pain than females at baseline and after 24 hours of insertion of all components. Mann-Whitney U test showed that the most painful components at baseline were bands (Mean value=0.56) and after 24 hours were brackets (Mean value 6.25). Conclusions: Significant increase in pain was noted 24 hours after insertion of separators, bands and brackets. The most painful components were bands at baseline and brackets after 24 hours of insertion. There were no significant variations in pain perception based on age. However, males perceived higher pain than females both at baseline and after 24 hours.
Collapse
Affiliation(s)
- Mazia Jawaid
- Mazia Jawaid, BDS. Registrar, Department of Orthodontics. Bahria University Medical and Dental College, Karachi, Pakistan
| | - Tabassum Ahsan Qadeer
- Tabassum Ahsan Qadeer, BDS, FCPS Orthodontics. Associate Professor & Head Department of Orthodontics. Bahria University Medical and Dental College, Karachi, Pakistan
| | - Muhammad Faisal Fahim
- Muhammad Faisal Fahim. M.Sc Statistics. Researcher, Bahria University Medical and Dental College, Karachi, Pakistan
| |
Collapse
|
44
|
Elekdağ-Türk S. Pain and/or Discomfort During Debracketing: A Review. Turk J Orthod 2019; 32:236-240. [PMID: 32110469 DOI: 10.5152/turkjorthod.2019.19045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 06/12/2019] [Indexed: 11/22/2022]
Abstract
The topic of bracket removal and enamel integrity has been extensively investigated. Nevertheless, bracket removal, as far as pain and/or discomfort are concerned, is poorly delineated in the orthodontic literature, i.e., the scarcity of reports in this area is conspicuous. In fact, only six studies were retrieved upon a PubMed search. These clinical studies performed with metal brackets are presented in a chronological order in the present review. Pain and/or discomfort during bracket removal are urgently in need of additional studies. The orthodontists have to be well-informed and updated to convey all the aspects of this procedure to the patient.
Collapse
Affiliation(s)
- Selma Elekdağ-Türk
- Department of Orthodontics, Ondokuz Mayıs University School of Dentistry, Samsun, Turkey
| |
Collapse
|
45
|
Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch—a randomized clinical controlled trial. Lasers Med Sci 2019; 35:487-496. [DOI: 10.1007/s10103-019-02896-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 09/29/2019] [Indexed: 10/25/2022]
Abstract
Abstract
The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0–10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95–4.25), 5.25 (3.37) (95% CI, 3.52–6.98), and 5.75 (2.40) (95% CI, 4.69–6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.
Collapse
|
46
|
Shimazu Y, Kobayashi A, Endo S, Takemura J, Takeda M. Effect of lutein on the acute inflammation-induced c-Fos expression of rat trigeminal spinal nucleus caudalis and C1 dorsal horn neurons. Eur J Oral Sci 2019; 127:379-385. [PMID: 31542898 DOI: 10.1111/eos.12650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2019] [Indexed: 12/19/2022]
Abstract
Although lutein is known to inhibit chronic inflammation, its effect on acute inflammation-induced nociceptive processing in the trigeminal system remains to be determined. The aim of the present study was to investigate whether pretreatment with lutein attenuates acute inflammation-induced sensitization of nociceptive processing in rat spinal trigeminal nucleus caudalis (SpVc) and upper cervical (C1) dorsal horn neurons, via c-Fos immunoreactivity. Mustard oil, a transient receptor potential ankyrin-1 channel agonist, was injected into the whisker pads to induce inflammation. Pretreatment of rats with lutein resulted in significant decreases in the inflammation-induced mean times of face grooming and the thickness of inflammation-induced edema in whisker pads relative to those features in inflamed rats (i.e., rats with no lutein pretreatment). In both the ipsilateral superficial and deep laminae of the SpVc and C1 dorsal horn, there were significantly larger numbers of c-Fos-positive neurons in inflamed rats than in naïve rats, and lutein pretreatment significantly decreased that number relative to inflamed rats. These results suggest that systemic administration of lutein attenuates acute inflammation-induced nocifensive behavior and augmented nociceptive processing of SpVc and C1 neurons that send stimulus localization and intensity information to higher pain centers. These findings support lutein as a potential therapeutic agent for use as an alternative, complementary medicine to attenuate, or even prevent, acute inflammatory pain.
Collapse
Affiliation(s)
- Yoshihito Shimazu
- Department of Life and Food Sciences, Laboratory of Food and Physiological Sciences, School of Life and Environmental Sciences, Azabu University, Sagamihara, Kanagawa, Japan
| | - Ayumu Kobayashi
- Department of Life and Food Sciences, Laboratory of Food and Physiological Sciences, School of Life and Environmental Sciences, Azabu University, Sagamihara, Kanagawa, Japan
| | - Shiori Endo
- Department of Life and Food Sciences, Laboratory of Food and Physiological Sciences, School of Life and Environmental Sciences, Azabu University, Sagamihara, Kanagawa, Japan
| | - Jin Takemura
- Department of Life and Food Sciences, Laboratory of Food and Physiological Sciences, School of Life and Environmental Sciences, Azabu University, Sagamihara, Kanagawa, Japan
| | - Mamoru Takeda
- Department of Life and Food Sciences, Laboratory of Food and Physiological Sciences, School of Life and Environmental Sciences, Azabu University, Sagamihara, Kanagawa, Japan
| |
Collapse
|
47
|
Celebi F, Turk T, Bicakci AA. Effects of low-level laser therapy and mechanical vibration on orthodontic pain caused by initial archwire. Am J Orthod Dentofacial Orthop 2019; 156:87-93. [PMID: 31256846 DOI: 10.1016/j.ajodo.2018.08.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of mechanical vibration and low-level laser therapy on orthodontic pain after placement of the initial archwire. METHODS Sixty subjects with 3-6 mm maxillary dental crowding, a nonextraction fixed treatment plan, and no medical history were included in this study. The subjects were randomly divided into 3 groups, equally distributed by sex. In each subject, preadjusted edgewise appliances were placed in the maxillary arch from the left first molar to the right first molar, and a 0.014-inch round nickel-titanium archwire was fully engaged with elastomeric ties and cut at the end of first molar bondable tube. In group 1 (mean age 13.98 ± 2.68 y), mechanical vibration was performed 3 times: immediately, 24 hours, and 48 hours after engagement of the initial archwire. In group 2 (mean age 14.86 ± 2.06 y), low-level laser therapy was applied once: immediately after the insertion of the initial archwire. Group 3 (mean age 14.41 ± 1.78 y) served as the control group. Pain scores were determined with the use of a visual analog scale (VAS). RESULTS Although no statistically significant differences were found among the groups (P >0.05), the mean VAS scores for the mechanical vibration group were consistently lower than those of the control and low-level laser therapy groups at all measured time points. CONCLUSIONS The mechanical vibration group had lower, though nonsignificant, VAS scores for all measured time points. Additional clinical trials are recommended for more definitive conclusions.
Collapse
Affiliation(s)
- Fatih Celebi
- Department of Orthodontics, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey.
| | - Tamer Turk
- Department of Orthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Ali Altug Bicakci
- Department of Orthodontics, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey
| |
Collapse
|
48
|
Lai TT, Chiou JY, Lai TC, Chen T, Wang HY, Li CH, Chen MH. Perceived pain for orthodontic patients with conventional brackets or self-ligating brackets over 1 month period: A single-center, randomized controlled clinical trial. J Formos Med Assoc 2019; 119:282-289. [PMID: 31208826 DOI: 10.1016/j.jfma.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND/PURPOSE The objective of this 2-arm parallel trial was to test the superiority of self-ligating brackets (SLB) over conventional brackets (CB) in terms of perceived pain for orthodontic patients. METHODS Patients about to undergo treatment were included to fixed appliance placed with CB or SLB. Eligibility criteria included malocclusion patients whose age between 12 to 40 years and suitable for orthodontic fixed appliance treatment. The main outcome was pain intensity measured by visual analog scale (VAS) with all patients followed at 4 h, 24 h, 3 days, 1 week and 1 month. Randomization was accomplished with a computer-generated list of random numbers. Blinding was applicable for outcome assessment only. Data were analyzed using multi-level nonlinear mixed effect model, Friedman's test and Wilcoxon signed rank test with the Bonferroni correction for multiple tests. RESULTS Eight-eight patients were randomized in a 1:1 ratio to either SLB or CB. All patients completed the study, and none were lost to follow-up. There were no drop-outs after randomization. Baseline characteristics were similar between groups. The is no statistical significant difference in pain intensity between CB and SLB at 4 h, 24 h, 3 days, 1 week and 1 month. Data were analyzed on an intention-to-treat basis. No serious harm was observed. CONCLUSION The results of this study indicated no evidence that the pain intensity differs between CB and SLB at 4 h, 24 h, 3 days, 1 week and 1 month.
Collapse
Affiliation(s)
- Tai-Ting Lai
- Division of Orthodontics, Dental Department, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Orthodontics and Detofacial Orthopedics Division, Dental Department, Tri-Service General Hospital, Taipei, Taiwan; School of Dentistry, College of Oral Medicine, Taipei Medical University, Taiwan
| | - Jeng-Yuan Chiou
- School of Health Policy and Management, Chung Shan Medical University, Taiwan
| | - Tai-Cheng Lai
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ted Chen
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, USA
| | - Huey-Yuan Wang
- Division of Orthodontics, Dental Department, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chung-Hsing Li
- Orthodontics and Detofacial Orthopedics Division, Dental Department, Tri-Service General Hospital, Taipei, Taiwan
| | - Min-Huey Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taiwan; Dental Department, National Taiwan University Hospital, Taiwan.
| |
Collapse
|
49
|
|
50
|
Campos LA, Santos-Pinto A, Marôco J, Campos JADB. Pain perception in orthodontic patients: A model considering psychosocial and behavioural aspects. Orthod Craniofac Res 2019; 22:213-221. [PMID: 31021044 DOI: 10.1111/ocr.12315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/17/2019] [Accepted: 04/21/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To estimate the agreement between orthodontic pain perception, evaluated with the visual analog scale (VAS), and psychosocial and behavioural aspects of pain and to estimate the impact of clinical and demographic characteristics on these aspects. DESIGN Cross-sectional design using non-probabilistic sampling. SETTING AND SAMPLE POPULATION Orthodontic patients undergoing treatment at orthodontic clinics (n = 507 [63.3% women], mean age: 26.32 [SD = 11.70] years). MATERIALS AND METHODS Psychosocial and behavioural aspects of pain were evaluated using the Multidimensional Pain Inventory (MPI-Orthodontic). Agreement between the pain impact level assessed according to different methods was estimated using the linear-weighted Kappa (κp ) statistic. Structural models were elaborated to estimate the impact of clinical and demographic characteristics on the psychosocial and behavioural aspects of pain. The fit of the model was evaluated, and the z test (α = 5%) was used to estimate the significance of the impact (β). RESULTS The agreement between VAS and MPI-Orthodontic factors was inadequate (κp = 0.028-0.584). The fit of the structural models was adequate. Women, younger individuals, and those who reported difficulty/pain with feeding exhibited greater perception of both the psychosocial and behavioural aspects. Individuals in lower socioeconomic strata who were not satisfied with treatment and did not seek treatment voluntarily exhibited greater perception of the psychosocial aspect of pain. CONCLUSIONS The impact of orthodontic pain on psychosocial and behavioural aspects of patients' lives is a relevant issue. Clinical and demographic characteristics contributed to these aspects; however, pain intensity as a sole measure may be insufficient for an adequate understanding of pain perception.
Collapse
Affiliation(s)
- Lucas Arrais Campos
- Pediatric Dentistry and Orthodontics Department, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Ary Santos-Pinto
- Pediatric Dentistry and Orthodontics Department, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - João Marôco
- William James Center for Research (WJCR), University Institute of Psychological, Social, and Life Sciences (ISPA), Lisbon, Portugal
| | | |
Collapse
|