The effect of orthodontic separator and short-term fixed orthodontic appliance on inflammatory mediators and somatosensory function

Correlation between salivary cytokine profiles and white spot lesions in adolescent patients receiving clear aligner orthodontic treatment

BACKGROUND

To explore the relationship between changes in salivary cytokine levels and the occurrence of white spot lesions in adolescents receiving clear aligner orthodontic treatment and investigate the predictive value of various factors for lesion occurrence.

METHODS

We retrospectively analyzed sixthy eight adolescent in the permanent dentition period, who received clear aligner orthodontics in our hospital were randomly divided into two groups according to the occurrence or aggravation of white spot lesions after treatment. The general condition of the oral cavity was analyzed, saliva was collected, and inflammation-related cytokines with varying transcription levels between groups were screened by transcriptome analysis. The expression levels of inflammatory cytokines in the saliva of the patients in the two groups were measured, and the risk factors for white spot lesions were screened by correlation analysis and binary logistic regression analysis. The value of the independent and combined application of risk factors for predicting the occurrence of white spot lesions in adolescent patients after invisible orthodontic treatment was analyzed by receiver operating characteristic (ROC) curve analysis.

RESULTS

Transcriptome and GO and KEGG pathway analyses showed that there were differences in the transcription levels of inflammatory cytokines such as CXCL1, CXCL2, CXCL8, CCL3, CCL4, IL-1β and IL-2 between groups. The levels of CXCL8, CCL3, CCL4, IL-1β and IL-2 in the saliva of patients with white spot lesions were significantly higher in patients after invisible orthodontic treatment (P < 0.05). Correlation analysis and binary logistic regression analysis showed that elevated levels of CXCL8, IL-1β and IL-2 were independent risk factors for the occurrence of white spot lesions (P < 0.05). CXCL8 had the highest independent predictive value for the occurrence of white spot lesions (AUC = 0.773, P < 0.05), and the combination of IL-1β and IL-2 was also of high value in predicting the occurrence of white spot lesions.

CONCLUSION

After invisible orthodontic treatment, the oral microenvironment, including inflammatory cytokine levels, in adolescent patients changes; in particular, the levels of inflammatory cytokines such as CXCLs and ILs change. CXCL8 expression is significantly associated with the occurrence of white spot lesions and is an important potential target for the prevention and treatment of white spot lesions in the future.

A multidimensional investigation of the relationship between skin-mediated somatosensory signals, emotion regulation and behavior problems in autistic children

Introduction

Autistic children may have abnormal sensory perception, emotion dysregulation and behavior problems. The aim of this cross-sectional study was to explore the relationship between skin-mediated somatosensory signals and emotion/behavior difficulties in autistic children and adolescents, in comparison typically developing peers (TDP).

Methods

Thirty-eight autistic children and adolescents and 34 TDP completed a multidimensional assessment consisting of the measurement of somatosensory thresholds of touch, pain and temperature, a task on emotion knowledge and parent-reported questionnaires on sensory reactivity, emotion regulation and behavior.

Results

Autistic children had higher pain sensitivity, less sensory reactive behaviors and more behavior problems than their TDP. In contrast to TDP, several somatosensory thresholds of autistic children correlated with emotion regulation and behavior problems.

Discussion

Sensory dysfunction may affect the development of emotional processing and behavior in autistic children and adolescents. This knowledge can lay the foundation for future studies on co-occurring alterations in corresponding neural networks and for the implementation of early interventions, including sensory rehabilitation therapy, for promoting regulated behaviors in autistic children and adolescents.

Human Interleukin-1β Profile and Self-Reported Pain Monitoring Using Clear Aligners with or without Acceleration Techniques: A Case Report and Investigational Study

INTRODUCTION

There is a growing demand for more aesthetic, comfortable, and faster orthodontic treatments, and clear aligners emerged as a solution to fulfill this need. However, the effectiveness of clear aligners to treat complex malocclusions is yet contentious. The use of acceleration methods could improve the efficacy of clear aligners by stimulating cells' mechanobiology through numerous pathways, but this hypothesis is still poorly explored.

OBJECTIVE

We aimed to monitor the release profile of an inflammatory marker-the interleukin-1β-and to evaluate its relationship with self-reported pain scores with and without the use of acceleration techniques during an orthodontic treatment requiring difficult tooth movements with clear aligners. Case Report. Here, we report a case of a 46-year-old female patient who presented functional and aesthetic complaints. Intraoral examination revealed a diminished overjet and overbite, rotation of teeth 45 and 24, absence of teeth 25, 35, and 36, buccolingual dislocation of tooth 21, a tendency to a Class III malocclusion, and a 2 mm left deviation of the lower midline. This study is divided into three stimulation phases: no stimulation, mechanical vibration stimulation, and photobiomodulation. Interleukin-1β levels in gingival crevicular fluid samples from the pressure side of six selected teeth were evaluated at four time points after the orthodontic treatment onset. Pain monitoring in those teeth was performed using a visual analogue scale at the same time points.

RESULTS

Interleukin-1β protein production peaked 24 h after treatment onset. Complex movements were associated with increased self-reported pain.

CONCLUSION

Clear aligners show limitations in solving complex tooth movements, even when combined with acceleration. The development of customized and programmable stimulation microdevices integrated into "smart aligners," which could be designed to specifically stimulate the direction of movement and stimulation parameters and could constitute a solution to optimize the orthodontic tooth movement with clear aligners.

Effects of acute pain and strain of the periodontium due to orthodontic separation on the occlusal tactile acuity of healthy individuals

OBJECTIVES

The aim of this study was to assess whether pain and strain of the periodontal ligament (PDL), induced by orthodontic separation, alter the somatosensory ability to perceive small thicknesses between occluding teeth (occlusal tactile acuity, OTA).

METHODS

The OTA was tested at baseline (T0), using 9 aluminum foils (range 8-72 μm), randomly placed between the molar teeth, and 1 sham test (without foil), asking the participants whether they felt the foil between their teeth. Afterwards, orthodontic separators were placed, and subjects were randomly assigned to one of the two experimental groups: Group Pain (GP: 18 males; 14 females mean age 25.22 ± 2.28 years) had separators removed after 24 h; Group Strain (GS: 14 males; 17 females, mean age 24.03 ± 3.06 years) had separators removed after 7 days. The OTA measurement was repeated in both groups immediately after orthodontic separators removal (T1). A within-group comparison (T1 vs T0) was performed for each testing thickness (ANOVA for repeated measurements, with Bonferroni correction for multiple testing) (p < 0.005).

RESULTS

GP showed statistically significant reduction of the OTA at T1, as compared to T0, for the thicknesses 24 μm (p = 0.004) and 32 μm (p = 0.001). No significant reduction was observed in GS (all p > 0.005).

CONCLUSIONS

Acute periodontal pain tends to disturb the tactile ability of the teeth, while strain of the PDL in absence of painful sensation determines a return to OTA baseline values.

CLINICAL RELEVANCE

The reduction of OTA might explain the uncomfortable occlusal sensation referred by patients during acute periodontal pain.

Evaluation of pain intensity in patients treated with aligners and conventional fixed appliances: Randomized clinical trial

OBJECTIVE

This randomized clinical trial aimed to compare the pain intensity in patients treated with orthodontic aligners and conventional fixed appliances.

SETTING AND SAMPLE POPULATION

This study was a randomized clinical trial. The sample comprised 39 patients randomly allocated into 2 groups: OA (orthodontic aligners, n = 20) and FA (Fixed Appliance, n = 19).

MATERIAL AND METHODS

The pain intensity was measured by the visual analogue scale (VAS) in the following periods: T0 (baseline), T1 (seven days after appliance placement) and seven days after each return on the first (T2), third (T3) and sixth (T4) months. The following variables were also investigated in the baseline: conditioned pain modulation, anxiety levels, hypervigilance and catastrophizing. The VAS measurements between groups were compared by the Mann-Whitney test. Comparisons between periods within each group were performed by the Friedman test. Data regarding catastrophizing and hypervigilance were compared by the t test. All tests were applied at a significance level of 5%, with 95% confidence interval.

RESULTS

Both groups presented similar levels of anxiety, hypervigilance, catastrophizing and conditioned pain modulation. Both groups did not differ concerning the pain intensity in all periods. The intragroup evaluation revealed statistical differences between days in the FA group at all moments evaluated, for the OA group, similar findings between days were found for the T1 evaluation; however, at the 6-month period (T4), the pain levels varied over these days without statistical difference. Higher levels of pain were observed in the first seven days after appliance placement.

CONCLUSION

The pain intensity, usually mild, was not influenced by the appliance design, although different patterns of reported pain seem to occur between groups.

Effects of ibuprofen and low-level laser therapy on orthodontic pain by means of the analysis of interleukin 1-beta and substance P levels in the gingival crevicular fluid

OBJECTIVE

The goal of this study was to compare the effects of ibuprofen and low-level laser therapy in alleviating orthodontic pain observed after elastomeric separator placement (ESP) by means of the analysis of interleukin 1‑beta (IL-1β) and substance P (SP) levels in gingival crevicular fluid (GCF) and visual analog scale (VAS).

MATERIALS AND METHODS

A total of 60 subjects requiring ESP for the banding of maxillary first molars were randomly assigned to the ibuprofen, laser, and control groups. The ibuprofen and control groups received, respectively, 400 mg ibuprofen and placebo lactose tablets orally 1 h before ESP; the laser group received a single low-level laser irradiation session immediately after ESP. GCF samples were collected immediately after ESP (day 0) and on days 1, 3, and 7. Pain intensity was evaluated using the VAS immediately after ESP (baseline) and at hours 2 and 6, as well as on days 1, 3, and 7.

RESULTS

Although IL-1β levels increased significantly on days 1, 3, and 7 compared to day 0, intergroup comparison results revealed insignificant differences. SP levels indicated insignificant within-group differences. Only the SP levels of the ibuprofen group showed a significant decrease on days 0 and 1 compared to the laser and control groups. In all groups, VAS scores increased from baseline to a peak level on day 1, followed by a significant decrease on days 3 and 7. Intergroup comparison results of VAS scores indicated less pain intensity in the ibuprofen group compared to the control group at baseline.

CONCLUSIONS

Only the ibuprofen group exhibited significant decreases in SP levels on days 0 and 1, as well as in VAS scores at baseline.