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Alshayea E, Aldweesh A, Albalbeesi H, Aldosari M. Comparative assessment between chewing gum, bite wafers, and ibuprofen in pain control following separators placement among orthodontic patients. Saudi Dent J 2024; 36:1010-1014. [PMID: 39035560 PMCID: PMC11255942 DOI: 10.1016/j.sdentj.2024.04.010] [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: 01/20/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 07/23/2024] Open
Abstract
Objective This study aimed to evaluate the efficiency of chewing gum and using bite wafers in reducing pain after the placement of separators in orthodontic patients and to compare that efficiency with ibuprofen use. Additionally, this study evaluated the effect of non-pharmacological pain control methods on the frequency of separators falling out. Methods The study sample comprised 105 female patients between 15 and 35 years of age. The patients were randomly selected and classified into three groups (35 each). Each group was given either ibuprofen, viscoelastic bite wafers, or chewing gum immediately after the placement of separators and every 8 h for 1 week, as needed. The patients were asked to record their pain perception using a visual analog scale following separator placement at 2 h, 6 h, bedtime, 24 h, and at 2, 3, and 7 days. Analysis of variance testing was used for the data analysis. Results Among the three studied groups, there were no significant differences in pain perception at any time point. The patients experienced significantly higher pain scores at bedtime and 24 h after separator placement. In addition, there were statistically significant findings in pain perception at different time points within each pain relief method (p = 0.000, p < 0.05). Conclusion The use of chewing gum and bite wafers in alleviating orthodontic pain was beneficial and comparable to ibuprofen use following the placement of separators before orthodontic treatment among orthodontic patients.
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Affiliation(s)
- Eman Alshayea
- Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Aljazi Aldweesh
- Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hana Albalbeesi
- University Dental Hospital, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Aldosari
- Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Li J, Li S, Chen H, Feng J, Qiu Y, Li L. The effect of physical interventions on pain control after orthodontic treatment: A systematic review and network meta-analysis. PLoS One 2024; 19:e0297783. [PMID: 38386625 PMCID: PMC10883545 DOI: 10.1371/journal.pone.0297783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/12/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE Pain is a frequent adverse reaction during orthodontic treatment, which can significantly reduce treatment compliance and compromise the expected treatment effect. Physical interventions have been used to alleviate pain after orthodontic treatment, but their effectiveness is controversial. This study used a network meta-analysis to assess the efficacy of various physical interventions typically used in managing pain after orthodontic treatment, with a view to provide evidence-based recommendations for representative interventions for orthodontic pain relief during peak pain intensity. METHODS A systematic search of six electronic databases, from their respective inception dates, was conducted to identify relevant literature on the efficacy of various typical physical interventions for managing pain after orthodontic treatment. Literature screening was performed according to the Cochrane System Evaluator's Manual. Stata 16.0 was used to assess heterogeneity, inconsistency, publication bias, and sensitivity to generate an evidence network diagram and conduct a network meta-analysis. RESULTS In total, 771 articles were reviewed to collect literature on interventions, including low-level laser therapy (LLLT), vibration, acupuncture, and chewing. Of these, 28 studies using a visual analog scale (VAS) as an outcome indicator were included. The results showed that LLLT, vibration, acupuncture, and chewing effectively relieved the pain symptoms in patients after orthodontic treatment. At 24 h post-treatment, LLLT (surface under the cumulative ranking curve [SUCRA] = 80.8) and vibration (SUCRA = 71.1) were the most effective interventions. After 48 h of treatment, acupuncture (SUCRA = 89.6) showed a definite advantage as the best intervention. CONCLUSION LLLT, vibration, acupuncture, and chewing can alleviate pain associated with orthodontic treatment. Among these interventions, acupuncture was found to be the most effective at 48 h after orthodontic treatment. In addition, acupuncture demonstrated long-lasting and stable pain-relieving effects. However, further studies are needed to determine the most suitable equipment-specific parameters for acupuncture in relieving pain associated with orthodontic treatment.
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Affiliation(s)
- Junxiong Li
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Siyu Li
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Hongjun Chen
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jingzhe Feng
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ya Qiu
- Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Lihua Li
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
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Rodríguez-Montaño R, Ponce-Gómez YI, Lomelí-Martínez SM, Sifuentes-Franco S, Ruiz-Gutiérrez ADC, Bayardo-González RA, Martínez-Rodríguez VMDC, Meléndez-Ruíz JL, Gómez-Sandoval JR. Comparison of the Effects of Ketorolac and Acetaminophen on RANK-L Levels in the Gingival Crevicular Fluid during Orthodontic Tooth Movement: A Pilot Study. APPLIED SCIENCES 2024; 14:1464. [DOI: 10.3390/app14041464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Background: Patients usually present pain due to the release of different inflammatory mediators such as prostaglandin E2 and RANK-L. Analgesics such as acetaminophen and ketorolac can inhibit RANK-L expression and this can affect orthodontic treatment by decreasing bone remodeling and slowing orthodontic dental movement. Several studies have reported a decrease in dental movement after administering some non-steroidal anti-inflammatory drugs. Proposal: The objective was to evaluate the RANK-L levels and a possible modulation by administering acetaminophen and ketorolac in patients starting orthodontic treatment. Methodology: A double-blind, randomized clinical trial was carried out with 24 subjects divided into three study groups: calcined magnesia as a placebo, acetaminophen, and ketorolac. Gingival crevicular fluid was obtained at four time points: before pharmacological intervention, at 24 h, at 48 h, and on the 5th day. RANK-L concentrations were evaluated through ELISA analysis. Also, interproximal space generated by the elastic separator at the end of the study was recorded in the different study groups using the visual analog scale. Results: An increase in RANK-L at 24 h was observed in the placebo group compared to the ketorolac and acetaminophen groups. However, no significant differences were observed in the interproximal space at day 5 in the three study groups. Conclusion: Patients who do not take analgesics at the start of orthodontic treatment have higher levels of RANK-L. Therefore, the use of ketorolac or acetaminophen could decrease bone remodeling and interfere with orthodontic dental movement.
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Affiliation(s)
- Ruth Rodríguez-Montaño
- Department of Health and Illness as an Individual and Collective Process, University Center of Tlajomulco, University of Guadalajara (CUTLAJO-UdeG), Tlajomulco, Santa Fé Highway Km. 3.5 No.595 Lomas de Tejeda, Tlajomulco de Zuniga 45641, Jalisco, Mexico
- Research Institute of Dentistry, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | - Yesenia Isahy Ponce-Gómez
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | - Sarah Monserrat Lomelí-Martínez
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
- Department of Medical and Life Sciences, University of Guadalajara (CUCiénega-UdeG), 1115 Ave. Universidad, Ocotlán 47810, Jalisco, Mexico
| | - Sonia Sifuentes-Franco
- Department of Health Sciences, Centro Universitario de los Valles, University of Guadalajara (CUValles-UdeG), Highway to Guadalajara Km. 45.5, Ameca 46600, Jalisco, Mexico
| | - Alondra del Carmen Ruiz-Gutiérrez
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | - Rubén Alberto Bayardo-González
- Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | | | - José Luis Meléndez-Ruíz
- Ortodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
| | - Juan Ramón Gómez-Sandoval
- Research Institute of Dentistry, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
- Periodontics Program, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
- Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico
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Davoodi NS, Tayebi A, Rahimipour K, Zarei M, Mozaffari A, Mirzadeh M, Mousavi R, Bayat N. Efficacy of a mobile phone application for the improvement of oral hygiene of patients undergoing fixed orthodontic treatment : A randomized controlled clinical trial. J Orofac Orthop 2023:10.1007/s00056-023-00492-0. [PMID: 37658907 DOI: 10.1007/s00056-023-00492-0] [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: 09/12/2022] [Accepted: 07/05/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES This study aimed to assess the efficacy of a mobile phone application (app) to improve oral hygiene of patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS This randomized controlled clinical trial was conducted with a total of 60 patients undergoing fixed orthodontic treatment in two groups: intervention and control (n = 30 each). A previously designed mobile app (Labkhand) was used by patients in the intervention group. Orthodontic plaque index (OPI) and modified gingival index (MGI) were recorded in the two groups at baseline (first session or T0), and after 1 (T1) and 3 (T2) months. The number of debonded/broken brackets was also recorded, and pain score of the patients was assessed at nine time points. Data were analyzed using the χ2 test, paired t‑test, and repeated measures analysis of variance (ANOVA; α = 0.05). RESULTS The two groups demonstrated no significant difference in OPI and MGI at T0 (P > 0.05). OPI and MGI at T1 and T2 were significantly lower in the intervention group than in the control group (P < 0.05). The number of patients with broken brackets in the intervention group was significantly lower than that in the control group (P = 0.017). The two groups reported no significant difference in pain score (P > 0.05). CONCLUSION The Labkhand mobile app successfully improved oral hygiene indices of patients undergoing fixed orthodontic treatment, and decreased the frequency of broken brackets after 1 and 3 months of use.
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Affiliation(s)
- Nima Sheikh Davoodi
- Department of Orthodontics, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali Tayebi
- Department of Orthodontics, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Kasra Rahimipour
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahban Zarei
- University of Pacific Arthur Dugoni School of Dentistry, San Francisco, CA, USA
| | - Asieh Mozaffari
- Periodontology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Monirsadat Mirzadeh
- Community Medicine, Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Reza Mousavi
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Bayat
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Hussein S, Ismail H. Influence of Reminder on Enhancing Compliance in Patients with Fixed Orthodontic Appliance Treatment (a Randomized Controlled Clinical Trial). Patient Prefer Adherence 2023; 17:1759-1769. [PMID: 37492635 PMCID: PMC10364827 DOI: 10.2147/ppa.s418109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
Purpose Patient compliance during orthodontic treatment has a significant effect on the aims, outcome, and duration of the treatment. The aim of this study is to evaluate the influence of reminders on enhancing orthodontic patient compliance. Patients and Methods Twenty-six subjects undergoing orthodontic treatment with fixed appliances were randomly assigned into two groups: control (Ct) and intervention (In) groups. The oral hygiene parameters of plaque index (PI), bleeding index (BI), and white spot lesion (WSL) with appointment adherence and bracket fracture were recorded at base line (T0), 2 months (T1), 4 months (T2), and 6 months (T3). In group participants received weekly reminders and subjects' compliances were classified into poor, fair, and excellent compliance. Results Statistically significant differences were found in PI level at T2 between Ct and In groups (p-value = 0.006), whereas a non-significant difference was found for BI (p-value>0. 05). There was a statistically significant increase in WSL for the Ct group across the study time points (p-value = 0.03), while no significant change in WSL was detected for the In group (p-value>0.05). The compliance levels of In and Ct groups were excellent and fair, respectively. Conclusion The study suggests that weekly reminders can enhance the oral hygiene status in patients with orthodontic appliances (POA) and elevate the level of compliance to excellent. Registration number ClinicalTrials.gov NCT05331820.
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Affiliation(s)
- Shara Hussein
- Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, University of Sulaimani, Sulaimanyah, Iraq
| | - Hadi Ismail
- Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, University of Sulaimani, Sulaimanyah, Iraq
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Lam J, Freer E, Miles P. Comparative assessment of treatment efficiency and patient experience between Dental Monitoring and conventional monitoring of clear aligner therapy: A single-center randomized controlled trial. Am J Orthod Dentofacial Orthop 2023; 163:456-464. [PMID: 36990528 DOI: 10.1016/j.ajodo.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 03/29/2023]
Abstract
INTRODUCTION This 2-arm randomized controlled clinical trial (RCT) aimed to assess the effect of Dental Monitoring (DM) on the efficiency of clear aligner therapy (CAT) and patient experience compared with conventional monitoring (CM) used for regularly scheduled clinical appointments. METHODS Fifty-six patients with full permanent dentition treated with CAT participated in this RCT. Patients were recruited from a single private practice and treated by 1 experienced orthodontist. Randomization was performed with permutated blocks of 8 patients assigned to either a CM or DM group with allocations concealed in opaque, sealed envelopes. It was not feasible to blind subjects or investigators. The primary treatment efficiency outcome assessed was the number of appointments. Secondary outcomes included the time to reach the first refinement, the number of refinements, the total number of aligners, and treatment duration. The patient experience was assessed using a visual analog scale questionnaire administered at the end of CAT. RESULTS No patients were lost to follow-up. There was no significant difference in the number of refinements (mean = 0.1; 95% confidence interval [CI], -0.2 to 0.5; P = 0.43) and the number of total aligners (median = 5; 95% CI, -1 to 13; P = 0.09). There was a significant difference in the number of appointments, with the DM group requiring 1.5 fewer visits (95% CI, -3.3, -0.7; p = 0.02) as well as overall treatment duration, with the DM group taking 1.9 months longer (95% CI, 0.0-3.6; P = 0.04). There was a difference between study groups regarding the importance of face-to-face appointments, with the DM group not perceiving face-to-face appointments as important (P = 0.03). CONCLUSIONS DM with CAT resulted in 1.5 fewer clinical appointments and a longer treatment duration of 1.9 months. There were no significant intergroup differences in the number of refinements or total aligners. CM and DM groups had similarly high levels of satisfaction with CAT. REGISTRATION The trial was registered at Australian New Zealand Clinical Trials Registry (ACTRN12620000475943). PROTOCOL The protocol was published before trial commencement. FUNDING This research did not receive any grant from funding agencies.
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Affiliation(s)
- Jonathan Lam
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia.
| | - Elissa Freer
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Peter Miles
- Private practice, Caloundra, Queensland, Australia
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Jabr L, Altuhafy M, Barmak AB, Rossouw PE, Michelogiannakis D. Comparative assessment of chewing sugar-free gum and conventional analgesic drugs in alleviating self-reported pain associated with fixed orthodontic appliances: A systematic review and meta-analysis. J Orthod 2022; 50:215-228. [PMID: 36550619 DOI: 10.1177/14653125221144059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the effect of chewing sugar-free gum towards alleviating self-reported orthodontic treatment (OT) pain compared with conventional analgesic drugs (CADs). SEARCH SOURCES An unrestricted search of indexed databases and manual searching was performed up to September 2021. DATA SELECTION Randomised controlled trials (RCTs) comparing the impact of chewing gum and CADs on relieving self-reported orthodontic pain were included. DATA EXTRACTION Data screening, extraction and risk of bias (RoB) assessment were performed by two authors. Meta-analyses were performed using a random-effects model. The quality of available evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS Nine RCTs were included. Eight RCTs used the Visual Analogue Scale for self-reported pain assessment, while one RCT used the Numeric Rating Scale. Five RCTs had a high RoB and four RCTs had a moderate RoB. Power analysis for sample size estimation was performed in six RCTs. Separate meta-analyses were performed by pooling quantitative data from five RCTs that compared self-reported orthodontic pain between chewing gum and ibuprofen groups for the following timepoints: baseline; immediately; 2 hours; 6 hours; bedtime; 24 hours; 2 days; 3 days; 5 days; and 7 days after the placement of orthodontic appliances. None of the timepoints individually indicated a difference in self-reported pain scores between chewing sugar-free gum and ibuprofen groups. The overall level of evidence was very low. CONCLUSION Chewing sugar-free gum is a potentially useful alternative to CADs towards pain alleviation during fixed OT.
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Affiliation(s)
- Luay Jabr
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Maryam Altuhafy
- Department of Orofacial Pain and Temporomandibular Joint Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Abdul Basir Barmak
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Paul Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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Karaman A, Sapan Z. Evaluation of temporomandibular disorders, quality of life, and oral habits among dentistry students. Cranio 2020:1-7. [PMID: 33325334 DOI: 10.1080/08869634.2020.1857615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To evaluate temporomandibular disorders (TMD), quality of life, and oral habits in dentistry students.Methods: The study was performed with 480 students (287 females, 193 males). The Fonseca Questionnaire, Oral Health Impact Profile-14 (OHIP-14), and Oral Behaviors Checklist (OBC) were used.Results: The mean scores of the fifth-year students from Fonseca TMD, OHIP-14, and OBC were statistically significantly higher than those of the students in other years of study. The mean Fonseca score of female students was higher than those of the males. There was a statistically significant difference regarding the OHIP-14 scores based on the Fonseca TMD scores. A statistically significant difference regarding OBC was present based on the Fonseca TMD scores.Conclusion: The prevalence of TMDs was higher among the senior dentistry students. Necessary measures should be taken in the dentistry educational system to raise students' quality of life, improve joint disorders, and eliminate current oral habits.
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Affiliation(s)
- Ahmet Karaman
- Department of Orthodontics, Istanbul Aydın University, Istanbul, Turkey
| | - Zeynep Sapan
- Department of Orthodontics, Istanbul Aydın University, Istanbul, Turkey
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Effectiveness of mobile phone applications in improving oral hygiene care and outcomes in orthodontic patients. J Oral Biol Craniofac Res 2020; 11:26-32. [PMID: 33344158 DOI: 10.1016/j.jobcr.2020.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/26/2020] [Accepted: 11/06/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives To assess the effectiveness of mobile phone applications in improving oral hygiene care and oral health outcomes in patients undergoing fixed orthodontic treatment. Materials and methods PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, and Web of Science were systematically searched for original studies published between January 2000 and March 2020. The eligibility criteria being: (i) observational study [cross-sectional, case-control, cohort study, or RCTs] that reported mobile phone application as an intervention or exposure for oral hygiene care. Standard Protocol Items Recommendations for Interventional Trials (SPIRIT) statement was used for quality assessment of interventional studies. The comprehensive search strategy yielded 154 studies after the removal of duplicates. Based on eligibility criteria only 5 studies were included in the data extraction phase. Results This review finds that smartphone applications have a significant short term effect in the improvement of oral hygiene when measured using plaque index and gingival index scores. The mean plaque index and gingival index reduced significantly in three out of five studies. The intervention groups [62%] had a lower level of plaque at a 12-week interval as compared to the control group [72%]. Short term follow-ups showed greater improvement in oral hygiene following smartphone application administration. Conclusion Within the available evidence, a recommendation can be made for the use of mobile applications in the orthodontic process [oral hygiene] care. Clinical relevance Further research for the development of patient-centered applications for patient safety, clinical decision making, and increasing their effectiveness in the treatment of orthodontic patients are required.
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Almuzian M, Rizk MZ, Ulhaq A, Alharbi F, Alomari S, Mohammed H. Effectiveness of different debonding techniques and adjunctive methods on pain and discomfort perception during debonding fixed orthodontic appliances: a systematic review. Eur J Orthod 2020; 41:486-494. [PMID: 30934051 DOI: 10.1093/ejo/cjz013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pain is an unpleasant side-effect that can be experienced during orthodontic procedures including debonding of fixed appliances. Pain experience can vary depending on the appliance, debonding technique, as well as adjunctive measures used. OBJECTIVES The primary objective of this systematic review was to assess the effectiveness of different debonding techniques and adjunctive methods on pain/discomfort perception during debonding procedure (PDP) of fixed orthodontic appliances. The secondary objective was to assess the effects of anatomic location and gender on PDP of fixed orthodontic appliances. SEARCH METHODS Multiple electronic databases were searched from inception to August 2018. Reference lists of the included articles were manually screened. SELECTION CRITERIA Randomized clinical trials (RCTs) and controlled clinical trials were included. DATA COLLECTION AND ANALYSIS Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers according to Cochrane guidelines, with disputes resolved by a third reviewer. Clinical heterogeneity in study design and methodology prevented quantitative synthesis of the data. RESULTS The search yielded 198 articles after the removal of duplicates. Seven studies were included in the final review with a total of 307 participants aged 12-60 years. Of the four studies comparing different debonding instruments of labial fixed appliances, two studies showed that the lift-off debonding instrument (LODI) produced lower PDP levels than ligature cutting pliers. Three studies compared adjunctive measures to reduce PDP of labial fixed appliances. Finger pressure and bite wafers significantly reduced PDP levels. Analgesics administration (ibuprofen + paracetamol tablets) 1 hour prior to debonding also reduced PDP. PDP was significantly higher in anterior segments and in females. LIMITATIONS The authors acknowledge that there was clinical heterogeneity among the included studies and that the potential effect of diurnal variation on pain during debonding was not considered in any of the included trials. CONCLUSIONS AND IMPLICATIONS There is weak evidence indicating that using the LODI may reduce PDP of labial fixed appliances. Adjunctive measures such as an intrusive force with finger pressure, bite wafers, and preoperative analgesia may further aid PDP control. Further well-designed parallel-group RCTs taking into consideration the diurnal variation in pain are required. REGISTRATION PROSPERO (CRD42017084474). FUNDING None. CONFLICT OF INTEREST The authors declare that there is no conflict of interest.
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Affiliation(s)
- Mohammed Almuzian
- Edinburgh Dental Institute, University of Edinburgh, UK.,Glasgow Orthodontic Academy, UK.,Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Australia
| | | | - Aman Ulhaq
- Edinburgh Dental Institute, University of Edinburgh, UK
| | - Fahad Alharbi
- Department of Preventive Dental Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Sawsan Alomari
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Hisham Mohammed
- Edinburgh Dental Institute, University of Edinburgh, UK.,Glasgow Orthodontic Academy, UK
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11
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Tran J, Lou T, Nebiolo B, Castroflorio T, Tassi A, Cioffi I. Impact of clear aligner therapy on tooth pain and masticatory muscle soreness. J Oral Rehabil 2020; 47:1521-1529. [PMID: 32898936 DOI: 10.1111/joor.13088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/18/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical findings suggest that orthodontic treatment with clear aligners (clear aligner therapy/CAT) may cause masticatory muscle soreness in some patients. OBJECTIVE This multi-site prospective study investigated tooth pain and masticatory muscle soreness and tenderness in patients undergoing CAT and explored whether psychological traits affected these outcomes. METHODS Twenty-seven adults (22F, 5M; mean age ± SD=35.3 ± 17.6 years) about to start CAT were recruited at three clinics. During CAT, they reported on 100-mm visual analogue scales their tooth pain, masticatory muscle soreness and stress three times per day over 4 weeks (week 1 = baseline; week 2 = dummy aligner; week 3 = first active aligner; week 4 = second active aligner). Pressure pain thresholds (PPTs) were measured at the masseter and temporalis at baseline and after week 4. Mixed models were used to evaluate the outcome measures over time. RESULTS Clear aligner therapy caused mild tooth pain, which was greater with the passive than the first and second active aligners (both P < .001). Mild and clinically not relevant masticatory muscle soreness was produced by all aligners (all P < .05), with the first active aligner producing less soreness than the dummy aligner (P < .001). PPTs did not change significantly after 4 weeks. Both tooth pain and masticatory muscle soreness were affected by stress and trait anxiety, whilst muscle soreness was affected also by oral behaviours. CONCLUSIONS In the short term, CAT produces tooth pain and masticatory muscle soreness of limited significance. Frequent oral behaviours are related to increased masticatory muscle soreness during CAT. The medium- and long-term effects of CAT should be further explored.
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Affiliation(s)
- Johnny Tran
- Division of Graduate Orthodontics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Tiantong Lou
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Bianca Nebiolo
- Department of Orthodontics, Dental School, University of Turin, Turin, Italy
| | | | - Ali Tassi
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,Centre for The Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
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12
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Saki M, Zarif Najafi H. The COVID-19 pandemic suggests opportunities for researchers to investigate pertinent topics in orthodontics. Angle Orthod 2020; 90:742-744. [PMID: 32937660 DOI: 10.2319/0003-3219-90.5.742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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Kaklamanos EG, Makrygiannakis MA, Athanasiou AE. Do analgesics used for the pain experienced after orthodontic procedures affect tooth movement rate? A systematic review based on animal studies. Orthod Craniofac Res 2020; 23:143-150. [DOI: 10.1111/ocr.12357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/11/2019] [Accepted: 11/05/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Eleftherios G. Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine Mohammed Bin Rashid University of Medicine and Health Sciences Dubai United Arab Emirates
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14
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Abstract
As any pharmaceutical substance may influence the events associated with orthodontic tooth movement, it is of importance for the clinician to be able to recognize any prospective patient's history and patterns of medicinal consumption. This review presents the effects of various commonly prescribed medications on the rate of orthodontic tooth movement. The article concludes that it remains, to a degree, unclear which types of medication may have a clinically significant effect in everyday clinical scenarios. However, since both prescription and over-the-counter medication use have recently increased significantly among all age groups, good practice suggests that it is important to identify patients consuming medications and consider the possible implications in orthodontic therapy.
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Affiliation(s)
| | - Eleftherios G Kaklamanos
- 2 Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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15
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Makrygiannakis MA, Kaklamanos EG, Athanasiou AE. Does long-term use of pain relievers have an impact on the rate of orthodontic tooth movement? A systematic review of animal studies. Eur J Orthod 2018; 41:468-477. [DOI: 10.1093/ejo/cjy079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/08/2018] [Accepted: 11/14/2018] [Indexed: 11/12/2022]
Abstract
Summary
Background
Pain relief drugs are used and misused widely and may theoretically affect the events leading to orthodontic tooth movement.
Objective
To systematically investigate and appraise the quality of the available evidence regarding the effect of pain relief medications on the rate of orthodontic tooth movement.
Search methods
Search without restrictions in eight databases (including grey literature) and hand searching until October 2018.
Selection criteria
Animal controlled studies investigating the effect of pain relievers on the rate of orthodontic tooth movement.
Data collection and analysis
Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE’s risk of bias tool.
Results
Fourteen studies were finally identified, most of which at unclear risk of bias. Ibuprofen and loxoprofen did not show any significant effects on the rate of orthodontic tooth movement, whereas indomethacin, ketorolac, morphine, and high doses of etoricoxib were found to decrease it. Inconsistent or conflicting effects were noted after the administration of acetaminophen, acetylsalicylic acid, celecoxib, meloxicam, and tramadol. The quality of the available evidence was considered at best as low.
Conclusions
Long-term consumption of pain relievers may affect the rate of orthodontic tooth movement. The orthodontist should be capable of identifying patients taking pain relievers independently of orthodontic treatment and consider the possible implications.
Trial registration
PROSPERO (CRD42017078208).
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Affiliation(s)
- Miltiadis A Makrygiannakis
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Eleftherios G Kaklamanos
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Athanasios E Athanasiou
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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