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Chen W, Qu Y, Liu Y, Zhang G, Sharhan HM, Zhang X, Zhang K, Cao B. Effects of fasudil on glial cell activation induced by tooth movement. Prog Orthod 2024; 25:33. [PMID: 39034361 PMCID: PMC11265063 DOI: 10.1186/s40510-024-00518-2] [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: 01/30/2023] [Accepted: 03/14/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Orthodontic pain affects the physical and mental health of patients. The spinal trigeminal subnucleus caudalis (SPVC) contributes to the transmission of pain information and serves as a relay station for integrating orofacial damage information. Recently, glial cells have been found to be crucial for both acute and maintenance phases of pain. It has also been demonstrated that rho kinase (ROCK) inhibitors can manage different pain models by inhibiting glial cell activation. Here, we hypothesized that orthodontic pain is related to glial cells in the SPVC, and Fasudil, a representative rho/rock kinase inhibitor, can relieve orthodontic pain by regulating the function of glial cells and the related inflammatory factors. In this study, we constructed a rat model of tooth movement pain and used immunofluorescence staining to evaluate the activation of microglia and astrocytes. Quantitative real-time PCR was used to detect the release of related cytokines and the expression of pain-related genes in the SPVC. Simultaneously, we investigated the effect of Fasudil on the aforementioned indicators. RESULTS In the SPVC, the expression of c-Fos peaked on day 1 along with the expression of OX42 (related to microglial activation), CD16 (a pro-inflammatory factor), and CD206 (an anti-inflammatory factor) on day 3 after tooth movement, followed by a gradual decrease. GFAP-staining showed that the number of activated astrocytes was the highest on day 5 and that cell morphology became complex. After Fasudil treatment, the expression of these proteins showed a downward trend. The mRNA levels of pro-inflammatory factors (IL-1β and TNF-α) peaked on day 3, and the mRNA expression of the anti-inflammatory factor TGF-β was the lowest 3 days after tooth movement. Fasudil inhibited the mRNA expression of pain-related genes encoding CSF-1, t-PA, CTSS, and BDNF. CONCLUSION This study shows that tooth movement can cause the activation of glial cells in SPVC, and ROCK inhibitor Fasudil can inhibit the activation of glial cells and reduce the expression of the related inflammatory factors. This study presents for the first time the potential application of Fasudil in othodontic pain.
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Affiliation(s)
- Wenyuanfeng Chen
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China
| | - Yuan Qu
- International Campus, Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, 314400, China
| | - Yining Liu
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China
| | - Guorui Zhang
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China
| | - Hasan M Sharhan
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China
| | - Xinzhu Zhang
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China
| | - Kunwu Zhang
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China
| | - Baocheng Cao
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, 222 TianShui South Road, Lanzhou City, 730000, China.
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Gao Y, Wang R, Liu Q, Zhou B, Qiao H. Effect of acetaminophen on relieving orthodontic pain with clear aligner based on GAD-7: A retrospective research. Heliyon 2024; 10:e23292. [PMID: 38163203 PMCID: PMC10756994 DOI: 10.1016/j.heliyon.2023.e23292] [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: 07/20/2022] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Patients may have uncomfortable feelings during orthodontic treatment, which can directly lead to dissatisfaction. So in order to improve the patient's sense of pleasure during the treatment, it would be of great benefit if orthodontic pain can be relieved. Materials and methods We included 150 patients wearing clear aligners from 18 to 30 years old during 2018-2020. Then designed following groups to determine the effectiveness of both verbal behavior modification and combination therapy with acetaminophen in reducing treatment pain: Group A, generalized anxiety disorder 7 (GAD-7) scored 0-4; Group B, GAD-7 scored 5-9; Group C, GAD-7 scored 10-14; and Group D, GAD-7 scored 15-21. Results There was a difference in the visual analog scale (VAS) between verbal behavior modification with and without a 300-mg acetaminophen tablet oral QD in Group A (received the intervention at 8 h and 1 d), Group B at 8 h and 1 d, Group C at 8 h, 1 d, 2 d, and 3 d, and Group D at 8 h, 1 d, 2 d, 3 d, and 4 d. After 8 h, 1 d, 2 d, 3 d, and 4 d in patients with verbal behavior modification, VAS was markedly increased in Group D compared with Group A, B and C. Furthermore, after 8 h and 1 d in patients with verbal behavior modification and 300-mg acetaminophen tablet oral QD, VAS was strongly enhanced in Group D. Conclusions Dental anxiety is strongly associated with pain in orthodontic patients receiving clear aligners. Acetaminophen administration may be a benefit in orthodontic pain that results from clear aligners, especially in the group with more GAD-7.
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Affiliation(s)
- Yunan Gao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Rui Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qiong Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bo Zhou
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hu Qiao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Antrobus MR, Brazier J, Callus P, Herbert AJ, Stebbings GK, Day SH, Kilduff LP, Bennett MA, Erskine RM, Raleigh SM, Collins M, Pitsiladis YP, Heffernan SM, Williams AG. Concussion-Associated Gene Variant COMT rs4680 Is Associated With Elite Rugby Athlete Status. Clin J Sport Med 2023; 33:e145-e151. [PMID: 35350037 DOI: 10.1097/jsm.0000000000001030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 02/22/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Concussions are common match injuries in elite rugby, and reports exist of reduced cognitive function and long-term health consequences that can interrupt or end a playing career and produce continued ill health. The aim of this study was to investigate the association between elite rugby status and 8 concussion-associated risk polymorphisms. We hypothesized that concussion-associated risk genotypes and alleles would be underrepresented in elite rugby athletes compared with nonathletes. DESIGN A case-control genetic association study. SETTING Institutional (university). PARTICIPANTS Elite White male rugby athletes [n = 668, mean (SD) height 1.85 (0.07) m, mass 102 (12) kg, and age 29 (7) years] and 1015 nonathlete White men and women (48% men). INTERVENTIONS Genotype was the independent variable, obtained by PCR of genomic DNA using TaqMan probes. MAIN OUTCOME MEASURE Elite athlete status with groups compared using χ 2 and odds ratio (OR). RESULTS The COMT rs4680 Met/Met (AA) genotype, Met allele possession, and Met allele frequency were lower in rugby athletes (24.8%, 74.6%, and 49.7%, respectively) than nonathletes (30.2%, 77.6%, and 54.0%; P < 0.05). The Val/Val (GG) genotype was more common in elite rugby athletes than nonathletes (OR 1.39, 95% confidence interval 1.04-1.86). No other polymorphism was associated with elite athlete status. CONCLUSIONS Elite rugby athlete status is associated with COMT rs4680 genotype that, acting pleiotropically, could affect stress resilience and behavioral traits during competition, concussion risk, and/or recovery from concussion. Consequently, assessing COMT rs4680 genotype might aid future individualized management of concussion risk among athletes.
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Affiliation(s)
- Mark R Antrobus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Sport and Exercise Science, University of Northampton, Northampton, United Kingdom
| | - Jon Brazier
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Peter Callus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Adam J Herbert
- School of Health Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Georgina K Stebbings
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Stephen H Day
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Liam P Kilduff
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Mark A Bennett
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Robert M Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - Stuart M Raleigh
- School of Health Sciences, Coventry University, Coventry, United Kingdom
| | - Malcolm Collins
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa ; and
| | - Yannis P Pitsiladis
- FIMS Reference Collaborating Centre of Sports Medicine for Anti-Doping Research, University of Brighton, Brighton, United Kingdom
| | - Shane M Heffernan
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Alun G Williams
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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Inauen DS, Papadopoulou AK, Eliades T, Papageorgiou SN. Pain profile during orthodontic levelling and alignment with fixed appliances reported in randomized trials: a systematic review with meta-analyses. Clin Oral Investig 2023; 27:1851-1868. [PMID: 36879148 PMCID: PMC10159949 DOI: 10.1007/s00784-023-04931-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To assess the pain profile of patients in the levelling/alignment phase of orthodontic treatment, as reported from randomized clinical trials. MATERIALS AND METHODS Five databases were searched in September 2022 for randomized clinical trials assessing pain during levelling/alignment with a visual analogue scale (VAS). After duplicate study selection, data extraction, and risk-of-bias assessment, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression, and certainty analyses. RESULTS A total of 37 randomized trials including 2277 patients (40.3% male; mean age 17.5 years) were identified. Data indicated quick pain initiation after insertion of orthodontic appliances (n = 6; average = 12.4 mm VAS), a quick increase to a peak at day 1 (n = 29; average = 42.4 mm), and gradually daily decrease the first week until its end (n = 23; average = 9.0 mm). Every second patient reported analgesic use at least once this week (n = 8; 54.5%), with peak analgesic use at 6 h post-insertion (n = 2; 62.3%). Patients reported reduced pain in the evening compared to morning (n = 3; MD = - 3.0 mm; 95%CI = - 5.3, - 0.6; P = 0.01) and increased pain during chewing (n = 2; MD = 19.2 mm; 95% CI = 7.9, 30.4; P < 0.001) or occlusion of the back teeth (n = 2; MD = 12.4 mm; 95% CI = 1.4, 23.4; P = 0.3), while non-consistent effects were seen for patient age, sex, irregularity, or analgesic use. Subgroup analyses indicated increased pain among extraction cases and during treatment of the lower (rather than the upper) arch, while certainty around estimates was moderate to high. CONCLUSIONS Evidence indicated a specific pain profile during orthodontic levelling/alignment, without signs of consistent patient-related influencing factors.
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Affiliation(s)
- Deborah Susanne Inauen
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Alexandra K Papadopoulou
- Division of Orthodontics, Faculty of Medicine, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, The University of Sydney, Sydney, Australia
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland.
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Pain Relief in Dental Local Anaesthesia with Vibrational Devices: Much Ado about Nothing? A Scoping Review. J Clin Med 2023; 12:jcm12041448. [PMID: 36835982 PMCID: PMC9966315 DOI: 10.3390/jcm12041448] [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: 12/31/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
In recent years, vibrational devices have been introduced in order to reduce patient discomfort in some situations such as orofacial pain, orthodontic therapy, and injection of local anaesthetics. This article aims to review the clinical experience given by the use of these devices in local anaesthesia. The literature search was carried out on the main scientific databases for articles up to November 2022. Eligibility criteria were established, and pertinent articles selected. The results were classified by author, year, type of study, sample size and characteristics, purpose of use, type of vibrational device used, protocol used, and outcomes. Nine relevant articles were found. These are split mouth randomized clinical trials which evaluate the reduction in pain perception with different devices and different protocols of use in children, during procedures which require local analgesia by injection, compared with traditional local anaesthesia with premedication based on anaesthetic gels. Different objective and subjective scales of pain and discomfort perception were used. Although results are promising, some data, such as those relating to vibrational intensity and frequency, are not clear. Evaluations on samples varying by age and context of use are necessary to fully define the indications for this type of aid during oral rehabilitation procedures.
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Santos LLD, Conti ACDCF, Fernandes TMF, Garlet GP, Almeida MRD, Oltramari PVP. Influence of anxiety and catastrophizing on pain perception in orthodontic treatment and its association with inflammatory cytokines. Braz Oral Res 2023; 37:e010. [PMID: 36629593 DOI: 10.1590/1807-3107bor-2023.vol37.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/02/2022] [Indexed: 01/11/2023] Open
Abstract
Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman's correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression.
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Affiliation(s)
- Lucineide Lima Dos Santos
- Universidade Norte do Paraná - Unopar, Dental School, Department of Orthdontics, Londrina, PR, Brazil
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Markowitz K, Mukherjee PM. OVER THE COUNTER ANALGESICS ARE EFFECTIVE IN TREATING ORTHODONTIC PAIN. J Evid Based Dent Pract 2022; 22:101773. [PMID: 36494116 DOI: 10.1016/j.jebdp.2022.101773] [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: 12/14/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION The efficacy of analgesics in controlling orthodontic pain: a systematic review and meta- analysis. Cheng C, Xie T, Wang J. BMC Oral Health 2020; 20:259. SOURCE OF FUNDING The systematic review was funded by grants from the National Natural Science Foundation of China (No. 81771114 and No. 81970967). The authors have no actual or potential conflicts of interest. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
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