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Al Shammary NH. Enhancing Orthodontic Renewal and Retention Techniques: A Systematic Review. Cureus 2024; 16:e58843. [PMID: 38659711 PMCID: PMC11039304 DOI: 10.7759/cureus.58843] [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] [Accepted: 04/23/2024] [Indexed: 04/26/2024] Open
Abstract
Orthodontists have a variety of options available for retainers. Research in Orthodontics focuses on assessing outcomes important to clinicians; however, there is inconsistency in how these outcomes are selected and evaluated. This review sought to assess the effects of different orthodontic retainers on patients' quality of life (QoL). Various approaches were employed in this systematic review, and a thorough search was conducted across six databases. The review involved a comprehensive evaluation of six included studies, highlighting changes in dental structure post-treatment, emphasizing the role of extraction procedures and the quality of debonding in improving retention. The study identified key outcomes for orthodontic clinical trials, highlighting orthodontists' preferences for specific retainer types. Moreover, it discussed the impact of sociocultural influences on retention care. Involving patients actively in discussions about whether to end or extend the retention phase was deemed essential. Noteworthy improvements in occlusal outcomes were linked to extraction treatments. Gender and malocclusion severity influenced QoL before and after orthodontic treatment. The degree of improvement observed in the Class III malocclusion group was comparatively lower than that in the Class I and Class II groups. Orthodontic treatment was found to yield favorable psychological outcomes, as evidenced by notable enhancements in self-esteem and social engagement among individuals. Fixed appliances were shown to negatively affect oral health-related quality of life (OHRQoL), particularly for those with aesthetic and functional concerns. A consensus has been reached on the essential themes and outcomes that should be incorporated in clinical trials related to orthodontic retention for non-cleft and non-surgical cases.
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Affiliation(s)
- Nawaf H Al Shammary
- Department of Preventive Dentistry, College of Dentistry, University of Ha'il, Ha'il, SAU
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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.
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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
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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.
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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;
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de Paiva TT, Barros DMC, Bittencourt RC, Savelli MBB, Lorenzoni DC, de Alcantara Cury-Saramago A, Mattos CT. Pain perception and expectation related to interradicular mini-implants insertion: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:7029-7043. [PMID: 37864604 DOI: 10.1007/s00784-023-05311-9] [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: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants. MATERIALS AND METHODS Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I. RESULTS A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I2 statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94). CONCLUSION Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively. CLINICAL RELEVANCE This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.
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Affiliation(s)
- Thais Teixeira de Paiva
- Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | | | | | | | - Diego Coelho Lorenzoni
- Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | | | - Claudia Trindade Mattos
- Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
- Faculdade de Odontologia, Disciplina de Ortodontia, Rua Mário Santos Braga, 30, 2° andar, sala 214, Centro, Niterói, CEP 24020-140, Brazil.
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Fahd CG, Castro GG, Costa ACS, Costa CPS, Carvalho CN, Pinzan-Vercelino CRM, Ferreira MC. Oral Health-Related Quality of Life among Adolescents in the First 6 Months of Fixed Orthodontic Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7110. [PMID: 38063540 PMCID: PMC10706226 DOI: 10.3390/ijerph20237110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023]
Abstract
Clarification on disabilities that may arise during orthodontic treatment allows patients to have more realistic expectations. This prospective study assessed the impact of fixed orthodontic therapy on adolescents' quality of life over 6 months. A total of 78 adolescents aged 11-17 years were included. Quality of life was measured using the Child Perceptions Questionnaire (CPQ11-14, short form) at five moments: before treatment (T0), one week (T1), one month (T2), three months (T3), and six months (T4) after treatment initiation. Multiple and pairwise comparisons were conducted for CPQ11-14 scores (Friedman and Wilcoxon test; effect size). Changes in the quality of life were assessed as mean differences (T0-T1 and T0-T4) in total and domain scores (Kruskal-Wallis and Mann-Whitney test) (α = 5%). Significant differences were observed between T0 and T4 in the oral symptoms' domain (p < 0.001), and between T0 and T1, T2, T3, and T4 for emotional well-being (p < 0.001 for all). Significant differences in impact were also found between T0 and T2, T3, and T4 with regard to social well-being (p = 0.004, =0.049, and <0.001, respectively). Orthodontic therapy positively impacted the emotional and social aspects of adolescents' quality of life. Negative effects were primarily related to pain, mouth sores, and difficulty biting or chewing. Understanding the symptoms and feelings of orthodontic patients aids professionals in decision-making.
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Affiliation(s)
- Cláudia Gonçalves Fahd
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Gustavo Garcia Castro
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Ana Carla Souza Costa
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Cyrene Piazera Silva Costa
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Ceci Nunes Carvalho
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | | | - Meire Coelho Ferreira
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
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Murakami-Malaquias-Silva F, Perim Rosa E, Malavazzi TCS, Silva T, de Santana Sarmento DJ, Garcez AS, Fernandes MUR, Tortamano A, Ramalho KM, Motta LJ, Fernandes KPS, Bussadori SK, Mesquita-Ferrari RA, Horliana ACRT. Photobiomodulation increases uprighting tooth movement and modulates IL-1β expression during orthodontically bone remodeling. JOURNAL OF BIOPHOTONICS 2023; 16:e202300013. [PMID: 37162171 DOI: 10.1002/jbio.202300013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/11/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
This study investigated the effects of photobiomodulation (PBM) in acceleration of orthodontic movement of inferior molar uprighting movement. Thirty-four individuals, with indication of molar uprighting movement for oral rehabilitation, were randomly divided in two groups: verticalization + PBM (808 nm, 100 mW, 1 J per point, 10 points and 25 J/cm2 ) or verticalization + PBM simulation. Elastomeric chain ligatures were changed every 30 days for 3 months. FBM was performed immediately, 24 h, 72 h, 1 and 2 months after activation. The primary outcome was the amount of uprighting movement. Secondary outcomes were pain, amount of medication, OHIP-14 questionnaire, and cytokine IL-1β. PBM group increase uprighting movement when compared to control after 3 months and modulate IL-1β expression. For pain control, the amount of medication and OHIP-14 no difference were found. This study suggests that PBM accelerates tooth movement during molar uprighting, due to modulation of IL-1β during bone remodeling.
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Affiliation(s)
| | - Ellen Perim Rosa
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Tamiris Silva
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | | | | | - Andre Tortamano
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
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AlJameel AH, Alshehri AM, Alzuhair SH, Al Masud MH, Alasmri AJ, Alkhunefer YA, Almaflehi NS. Adjunctive Dental Procedures and Pain Assessment Among a Group of Patients Attending Dental University Hospital at King Saud University: A Cross-Sectional Study. Cureus 2023; 15:e44809. [PMID: 37809123 PMCID: PMC10558964 DOI: 10.7759/cureus.44809] [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] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Background/purpose A large percentage of people still experience discomfort and pain during dental visits, even with advancements in instrumental techniques that enable dentists to manage patients in a pain-free manner. The aim of this study was to assess the prevalence and levels of pain induced by various dental procedures, including adjunctive dental procedures. Material and methods A structured, custom-made questionnaire composed of 20 questions written in Arabic with accompanying pictures of instruments to simplify instrument identification for the patients was designed. The questionnaire was designed to investigate and determine the factors that cause pain and discomfort during dental procedures and was introduced to adult patients attending their dental appointments at the College of Dentistry. All data were collected using an online link that was distributed to patients attending dental clinics at the Dental University Hospital at King Saud University either through their mobile phones or the researcher's tablet. All data were entered and analyzed using SPSS version 25. Results A total of 158 patients participated in the study. The findings revealed that 50% of participants experienced pain from mouth mirror retraction and 28.48% experienced pain from suction. Participants also reported that the most common instruments associated with pain were the ultrasonic scaler (88.57%) and the periodontal probe (87.88%). Conclusion The findings provided valuable insights into the prevalence of pain during dental procedures and the factors that may contribute to this experience. Adjunctive dental procedures appeared to be causing a high prevalence of pain that could be avoided if dentists/dental assistants were more aware of it. These findings may have important implications for dental practitioners looking to reduce pain and improve patient experience during the provision of dental care.
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Affiliation(s)
- AlBandary H AlJameel
- Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Abdulaziz M Alshehri
- Restorative Dental Science Department, King Saud University, College of Dentistry, Riyadh, SAU
| | - Saud H Alzuhair
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | | | | | | | - Nassr S Almaflehi
- Periodontics and Community Dentistry, King Saud University, Riyadh, SAU
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Vidigal MTC, Mesquita CM, de Oliveira MN, de Andrade Vieira W, Blumenberg C, Nascimento GG, Pithon MM, Paranhos LR. Impacts of using orthodontic appliances on the quality of life of children and adolescents: systematic review and meta-analysis. Eur J Orthod 2022; 44:359-368. [PMID: 35201317 DOI: 10.1093/ejo/cjac003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
BACKGROUND Although there are previous systematic reviews about the oral health-related quality of life (OHRQoL) impact among children and adolescents after orthodontics treatment, there is no definition for the magnitude of these impacts during the therapy. OBJECTIVE To systematically analyse the literature on changes in the quality of life of children and adolescents during orthodontic treatment. LIMITATIONS Almost all the studies included in this review are non-randomized clinical trials, which are susceptible to several biases that affect the certainty of evidence obtained, especially by confounding factors and the lack of a control group. CONCLUSIONS AND IMPLICATIONS Based on very low certainty of evidence, wearing appliances does not seem to have a significant negative impact during the first year of orthodontic treatment. However, the meta-analytic results suggest that functional limitations in the first 3 months of treatment can be slightly more critical for the impact on the oral health quality of life and consequent patient adherence to treatment. FUNDING This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil (CNPq), and Fundação de Amparo à Pesquisa do Estado de Minas Gerais - Brazil (FAPEMIG). REGISTRATION CRD42021234407.
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Affiliation(s)
- Maria Tereza Campos Vidigal
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Caio Melo Mesquita
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Murilo Navarro de Oliveira
- Division of Preventive and Community Dentistry, Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, São Paulo, Brazil
| | - Cauane Blumenberg
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | - Matheus Melo Pithon
- Department of Health I, Southwest Bahia State University, Jequié, Brazil
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Minas Gerais, Brazil
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Juloski J, Vasović D, Vučić L, Pajević T, Glišić B. Orthodontic pain in maxilla and mandible during the first week of orthodontic treatment. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm2201033j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: This investigation aimed to evaluate the intensity of self-reported pain and frequency of self-medication with analgesics during the initial phase of orthodontic treatment with fixed appliances and to compare possible differences between the maxillary and mandibular teeth. Material and Methods: In this observational clinical trial 68 patients had similar orthodontic forces (the same bracket-slot and prescription, archwire size and material, and treatment plan) applied on maxillary and mandibular teeth. The patients recorded pain intensity and use of analgesics for the first seven days of treatment. Comparisons between maxillary and mandibular teeth regarding the pain intensity and self-medication frequency were performed by Wilcoxson Signed Ranks Test and McNamara Test for Matched Pairs, respectively. Results: The patients reported moderate pain in both jaws which decreased significantly with each day of treatment. Still, during the initial three days of treatment intensity of pain for maxillary teeth was significantly lower compared to the mandibular teeth. Patients reported analgesics consumption for both jaws, without a statistically significant difference between them. Conclusions: The patients have reported orthodontic pain of higher intensity in the mandibular arch compared to the maxillary arch during the initial phase of orthodontic treatment with fixed appliances.
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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.
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Pithon MM, Vargas EOA, da Silva Coqueiro R, Lacerda-Santos R, Tanaka OM, Maia LC. Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial. Eur J Orthod 2021; 43:208-214. [PMID: 33367539 DOI: 10.1093/ejo/cjaa075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine. OBJECTIVE To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants. SUBJECTS AND METHODS A total of 44 people, aged 17-49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)-a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg's Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study. RESULTS All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001). LIMITATIONS Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error. CONCLUSIONS The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects. CLINICAL TRIAL REGISTRATION This study was not registered. PROTOCOL The protocol was not published before trial commencement.
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Affiliation(s)
- Matheus Melo Pithon
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil.,Department of Health I, Southwest Bahia State University, Jequié, Bahia, Brazil
| | - Eduardo Otero Amaral Vargas
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Raildo da Silva Coqueiro
- Department of Health I, Southwest Bahia State University, Jequié, Bahia, Brazil.,Center for Studies in Aging, Southwest Bahia State University, Jequiée, Bahia, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Federal University of Juiz de For a-UFJF, Governador Valadares, Brazil
| | - Orlando Motohiro Tanaka
- Graduate Dentistry Program, School of Life Sciences, Orthodontics Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
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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.
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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
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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.
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Casteluci CEVF, Oltramari PVP, Conti PCR, Bonjardim LR, de Almeida-Pedrin RR, Fernandes TMF, de Almeida MR, de Castro Ferreira Conti AC. Evaluation of pain intensity in patients treated with aligners and conventional fixed appliances: Randomized clinical trial. Orthod Craniofac Res 2020; 24:268-276. [PMID: 33058419 DOI: 10.1111/ocr.12431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 10/07/2020] [Indexed: 01/01/2023]
Abstract
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.
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Affiliation(s)
| | | | - Paulo César Rodrigues Conti
- Department of Prosthodontics, Bauru School of Dentistry, Bauru Orofacial Pain Group, University of São Paulo, São Paulo, Brazil
| | - Leonardo Rigoldi Bonjardim
- Section of Head and Face Physiology, Department of Biological Sciences, Bauru School of Dentistry, Bauru Orofacial Pain Group, University of São Paulo, São Paulo, Brazil
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Lyu C, Zhang L, Zou S. The effectiveness of supplemental vibrational force on enhancing orthodontic treatment. A systematic review. Eur J Orthod 2020; 41:502-512. [PMID: 31065683 DOI: 10.1093/ejo/cjz018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVES The results from the literature regarding the influence of supplemental vibrational forces (SVFs) on orthodontic treatment are controversial. Therefore, this systematic review aimed to evaluate whether SVFs have positive effects, such as in accelerating tooth movement, alleviating pain, and preventing root resorption, in orthodontic patients. SEARCH METHODS Searches through five electronic databases (PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central) were complemented by hand searches up to January, 2019. SELECTION CRITERIA Randomized controlled trials and controlled clinical trials reporting on the effects of SVFs in orthodontic patients in English were included. DATA COLLECTION AND ANALYSIS Study selection, data extraction, and a risk of bias assessment were independently performed by two reviewers. Study characteristics and outcomes were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A qualitative analysis of the effects of SVFs on orthodontic tooth movement, pain experience, and root resorption was conducted. RESULTS Thirteen studies, including nine clinical trials, were eligible for inclusion in the systematic review. There was no significant evidence to support the positive effects of SVFs in orthodontic patients, neither in accelerating tooth movement nor in alleviating pain experience. According to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, the quality of the evidence was very low for all the outcomes in the qualitative analysis. LIMITATIONS The results of this systematic review are based on a limited number of studies and the methodological heterogeneity and non-comparability of original outcomes made it difficult to conduct a meta-analysis. CONCLUSIONS There is insufficient evidence to support the claim that SVFs have positive clinical advantages in the alignment of the anterior teeth. The potential positive effects of vibrational forces on space closure, pain experience, and root resorption in orthodontic patients are inconclusive with no sufficient information at present. High-quality clinical trials with larger sample sizes are needed to find more comprehensive evidence of the potential positive effects of vibrational forces. REGISTRATION The protocol for this systematic review was registered on PROSPERO (CRD42018098788). FUNDING This study has not received any contributions from private or public funding agencies. CONFLICT OF INTEREST None.
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Affiliation(s)
- Chunxiao Lyu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of orthodontics, West China Hospital of Stomatology, Chengdu, China
| | - Li Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of orthodontics, West China Hospital of Stomatology, Chengdu, China
| | - Shujuan Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of orthodontics, West China Hospital of Stomatology, Chengdu, China
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Antonio-Zancajo L, Montero J, Albaladejo A, Oteo-Calatayud MD, Alvarado-Lorenzo A. Pain and Oral-Health-Related Quality of Life in Orthodontic Patients During Initial Therapy with Conventional, Low-Friction, and Lingual Brackets and Aligners (Invisalign): A Prospective Clinical Study. J Clin Med 2020; 9:jcm9072088. [PMID: 32635196 PMCID: PMC7408790 DOI: 10.3390/jcm9072088] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to compare pain and its relationship with the oral quality of life of patients with different types of orthodontic appliances: conventional and conventional low-friction brackets, lingual brackets, and aligners. A prospective clinical study was carried out with a sample size of 120 patients (54 men, 66 women) divided into 4 groups of 30 patients each. The modified McGill questionnaire was used to measure pain at 4, 8, and 24 h and 2, 3, 4, 5, 6, and 7 days after the start of treatment, and the Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure the oral-health-related quality of life (OHRQoL) in the first month of treatment. The maximum peak of pain was obtained between 24 and 48 h of treatment. It was found that patients in the lingual orthodontic group described lower levels of pain at all times analyzed, and their scores in the total OHIP-14 indicated less impact on their oral quality of life (1.3 ± 1.2, p < 0.01) compared with the other groups analyzed. There was little difference with the aligners group (Invisalign) (1.7 ± 1.9, p < 0.01). The technique used influences the pain and quality of life of patients at the start of orthodontic treatment.
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Affiliation(s)
- Laura Antonio-Zancajo
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (J.M.); (A.A.); (A.A.-L.)
- Correspondence: ; Tel.: +34-920-302-064
| | - Javier Montero
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (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; (J.M.); (A.A.); (A.A.-L.)
| | | | - Alfonso Alvarado-Lorenzo
- Faculty of Medicine, University of Salamanca, Avenida Alfonso X el Sabio s/n, 37007 Salamanca, Spain; (J.M.); (A.A.); (A.A.-L.)
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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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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.
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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)
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Paes da Silva S, Pitchika V, Baumert U, Wehrbein H, Schwestka-Polly R, Drescher D, Kühnisch J, Wichelhaus A. Oral health-related quality of life in orthodontics: a cross-sectional multicentre study on patients in orthodontic treatment. Eur J Orthod 2019; 42:270-280. [DOI: 10.1093/ejo/cjz064] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Summary
Objective
This study aimed to assess oral health-related quality of life (OHRQoL) in relation to associated covariates in orthodontic patients of different age groups (children, adolescents, and adults) in a cross-sectional study.
Methods
A total of 898 subjects (50.6% females, 49.4% males; mean age 16.89 years) undergoing orthodontic treatment anonymously completed the German version of the Oral Health Impact Profile (OHIP-G14) to assess OHRQoL in addition to completing 23 other items. Descriptive, exploratory statistical analysis and multiple linear regression modelling were performed.
Results
The mean score of the OHIP-G14 was 8.3 for the 6- to 11-year olds, 8.9 for the 12- to 17-year olds, and 12.6 for adults. Physical pain (Subscale 2) was the highest factor in all groups. Additionally, a relevant factor was Subscale 3 (psychological discomfort). A linear regression model showed that, in the adolescent group, aesthetics in combination with pain had a significant negative influence on OHRQoL, whereas, in the adult group, function in combination with pain showed the same significant negative influence. Second, except for the children, fixed appliances had a significant negative effect on OHRQoL compared to removable appliances.
Conclusions
Our study showed that the majority of the 6- to 11-year olds and 12- to 17-year olds reported a good OHRQoL. Nevertheless, adolescents and adults who reported aesthetic/pain and function/pain problems, respectively, as reasons for orthodontic treatment showed a significant occurrence for reduced OHRQoL. Fixed appliances, in comparison with removable appliances, also resulted in a significant reduction in OHRQoL for both groups.
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Affiliation(s)
- Susie Paes da Silva
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Munich, Germany
| | - Vinay Pitchika
- Department of Operative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Uwe Baumert
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Munich, Germany
| | - Heinrich Wehrbein
- Department of Orthodontics, Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Dieter Drescher
- Department of Orthodontics, Heinrich-Heine-University, Duesseldorf, Germany
| | - Jan Kühnisch
- Department of Operative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Wichelhaus
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Munich, Germany
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Pithon MM, Magno MB, da Silva Coqueiro R, de Paiva SM, Marques LS, Paranhus LR, Tanaka OM, Maia LC. Oral health–related quality of life of children before, during, and after anterior open bite correction: A single-blinded randomized controlled trial. Am J Orthod Dentofacial Orthop 2019; 156:303-311. [DOI: 10.1016/j.ajodo.2019.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/27/2022]
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Liu S, Liu L, Jiang Y, Zhou J, Hu H, Wu Z, Long H, Lai W. Effect of endomorphin-2 on orofacial pain induced by orthodontic tooth movement in rats. Eur J Oral Sci 2019; 127:408-416. [PMID: 31365768 DOI: 10.1111/eos.12640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Endomorphin-2 demonstrates potent antinociceptive effects in various pain models. The objectives of the present study were to explore the role of endomorphin-2 in the modulation of orofacial pain induced by orthodontic tooth movement in rats. An orthodontic pain model was established in male Sprague-Dawley rats by ligating coiled springs to mimic orthodontic force (40 g). On days 0, 1, 3, 5, 7, and 14 following orthodontic tooth movement, bite force was recorded as a surrogate measure of orthodontic pain. Ipsilateral trigeminal ganglia, trigeminal nucleus caudalis, and periodontal tissues were harvested for immunostaining. Endomorphin-2, endomorphin-2 + naloxone (a non-selective opioid receptor antagonist), naloxone, and saline were injected into trigeminal ganglia and periodontal tissues to explore the role of endomorphin-2 on orthodontic pain. The results showed that following orthodontic tooth movement, endomorphin-2 expression levels in trigeminal ganglia were elevated on days 1, 3, 5, and 7. Orthodontic pain levels were increased on days 1, 3, and 5. The administration of endomorphin-2 into both trigeminal ganglia and periodontal tissues alleviated orthodontic pain. Moreover, the effects of endomorphin-2 could be blocked by naloxone completely in trigeminal ganglia but only partially in periodontal tissues. Therefore, endomorphin-2 plays an important role in the modulation of orthodontic pain both centrally and peripherally, probably through different pathways.
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Affiliation(s)
- Sixin Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lu Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yanlu Jiang
- West China College of Stomatology, Sichuan University, Chengdu, China
| | - Jing Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Huimin Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhouqiang Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Aimée NR, Damé-Teixeira N, Alves LS, Borges GÁ, Foster Page L, Mestrinho HD, Carvalho JC. Responsiveness of Oral Health-Related Quality of Life Questionnaires to Dental Caries Interventions: Systematic Review and Meta-Analysis. Caries Res 2019; 53:585-598. [PMID: 31280258 DOI: 10.1159/000500855] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 05/08/2019] [Indexed: 11/19/2022] Open
Abstract
This systematic review and meta-analysis were undertaken to assess the responsiveness of validated oral health-related quality of life (OHRQoL) questionnaires to dental caries interventions in children, adolescents, and young adults. Studies eligible were randomized clinical trials (RCTs), controlled clinical trials (CCTs), and prospective case series (PCS), which had OHRQoL questionnaires answered before and after caries intervention(s). The main outcome was improvement in OHRQoL mean scores following caries intervention. Twenty-six studies were selected for the quality assessment and 14 were selected for the meta-analysis. Most of the studies were PCS with a single group pretest and posttest study design (n = 19). Five studies were CCT and only 2 were RCT. The numbers of participants were 3,522 in the control group (baseline = 2,002; final = 1,520) and 5,917 in the test group (baseline = 3,102; final = 2,815). The age of the subjects ranged from 3 to 19 years. All studies showed significant improvement in OHRQoL following caries intervention. Most of nonrandomized studies (n = 15) had low or moderate risk of bias. The meta-analysis showed the effect of caries interventions (standardized weighted mean differences = -1.24; 95% CI: -1.68 to -0.81; p < 0.001). However, high heterogeneity between the studies was found. The Grading of Recommendations Assessment, Development and Evaluation approach classified the quality of evidence as very low and its strength weak. In conclusion, there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures, but the quality of the evidence was very low. In spite of that, caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of OHRQoL.
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Affiliation(s)
- Nicole R Aimée
- Faculty of Health Sciences, University of Brasília (UnB), Brasília, Brazil
| | | | - Luana Severo Alves
- School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Gabriel Á Borges
- Faculty of Health Sciences, University of Brasília (UnB), Brasília, Brazil
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Corradi-Dias L, Paiva SM, Pretti H, Pordeus IA, Abreu LG. Impact of the onset of fixed appliance therapy on adolescents' quality of life using a specific condition questionnaire: A cross-sectional comparison between male and female individuals. J Orthod 2019; 46:195-204. [PMID: 31144564 DOI: 10.1177/1465312519851220] [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] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the impact of the first six months of orthodontic treatment with fixed appliances on the oral health-related quality of life (OHRQoL) of adolescents, comparing boys and girls, using a specific condition questionnaire. DESIGN Cross-sectional. SETTING School of Dentistry of the Federal University of Minas Gerais, Belo Horizonte, Brazil. PARTICIPANTS Adolescents aged 10-17 years. METHODS Forty-six adolescents participated in this study. Adolescents' OHRQoL was evaluated using the Brazilian version of the questionnaire Impact of Fixed Appliances Measure. This questionnaire comprises 43 questions distributed across nine domains: aesthetics; functional limitation; dietary impact; oral hygiene impact; maintenance impact; physical impact; social impact; time constraints; and travel/cost/inconvenience implications. The answer options follow the Likert scale, in the range of 1-5. A higher score indicates a more negative impact on the OHRQoL. Adolescents' malocclusion was assessed using the Dental Aesthetic Index. Information on family income, adolescents' age and tooth extraction was also collected. A directed acyclic graph was used to identify potential confounders. Statistical analysis involved the chi-square test, the Student's t test and the analysis of covariance. The minimal clinically important difference was also calculated. RESULTS Of the 46 participants, 25 were girls and 21 were boys. The female adolescents presented a more negative impact from the orthodontic treatment on the quality of life when compared to the male adolescents (P < 0.001), regardless of the influence of the confounding variables. The most negative repercussions were identified in the domains of oral hygiene (P = 0.002), physical impact (P < 0.001) and social impact (P < 0.001). CONCLUSION The impact of the first six months of orthodontic treatment on OHRQoL is more negative in female individuals than in male individuals. The results of this study may be useful for the oral healthcare provider during the counselling of adolescents undergoing fixed appliance therapy.
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Affiliation(s)
- Larissa Corradi-Dias
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Pretti
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isabela Almeida Pordeus
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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El-Huni A, Colonio Salazar FB, Sharma PK, Fleming PS. Understanding factors influencing compliance with removable functional appliances: A qualitative study. Am J Orthod Dentofacial Orthop 2019; 155:173-181. [DOI: 10.1016/j.ajodo.2018.06.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 06/01/2018] [Accepted: 06/01/2018] [Indexed: 10/27/2022]
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Abstract
Orthodontics is the dental specialty concerned with the position of teeth and the relationship between the maxilla and mandible. Much evidence regarding the characteristics of normal occlusion during childhood/adolescence, the timely referral of children/adolescents to orthodontic treatment, and the impact of orthodontic outcomes on individuals' physical, functioning, and psychosocial well-being exists in the literature. This body of evidence may be helpful for pediatricians and primary care physicians. For those willing to be skilled providers of health care to children/adolescents, knowledge of basic concepts of oral health may contribute to the communication among physicians, the young individual and their parents/caregivers.
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Affiliation(s)
- Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Maranhão, Belo Horizonte, Minas Gerais 30150-331, Brazil.
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Fleming PS, Al-Moghrabi D, Fudalej P, Pandis N. Orthodontic pain: The use of non-pharmacological adjuncts and its effect on compliance. Semin Orthod 2018. [DOI: 10.1053/j.sodo.2018.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Johal A, Ashari AB, Alamiri N, Fleming PS, Qureshi U, Cox S, Pandis N. Pain experience in adults undergoing treatment: A longitudinal evaluation. Angle Orthod 2018; 88:292-298. [PMID: 29509026 DOI: 10.2319/082317-570.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To quantify the intensity and duration of pain experience in adults over the initial three visits of fixed appliance-based orthodontic treatment. A secondary objective was to assess the relationship between pain experience and analgesic use, dental irregularity, gender, and age. MATERIALS AND METHODS A prospective longitudinal study design was adopted. Fifty-eight adults undergoing fixed appliance treatment in five orthodontic practices recorded pain experience at four time points (4 hours, 24 hours, 3 days, and 7 days) following the initial bond-up appointment (T0) and first (T1) and second (T2) routine follow-up adjustment appointments using a visual analogue scale. In addition, subjects recorded the dosage and frequency of analgesic use. RESULTS A slightly greater proportion of women (57%) were recruited, with a mean sample age of 34.69 (SD 12.11) years. Peak pain was experienced between 24 hours and 3 days following appliance placement (T0) and subsequent adjustments (T1 and T2). The highest mean pain score arose at T0 followed by T2 and T1 adjustments, with the difference between pain levels at these appointment intervals being statistically significant ( P < .001). The use of analgesics following each appointment mirrored pain experience, with pain score, appointment, and time point all being significant predictors of analgesic consumption. The level of dental irregularity, gender, or age did not predict pain levels reported. CONCLUSIONS Adults undergoing fixed orthodontic therapy should be advised that they are most likely to experience increased levels of pain for 1 to 3 days following placement of their appliance and subsequent adjustment visits.
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Saloom HF, Papageorgiou SN, Carpenter GH, Cobourne MT. The effect of obesity on orofacial pain during early orthodontic treatment with fixed appliances: a prospective cohort study. Eur J Orthod 2017; 40:343-349. [DOI: 10.1093/ejo/cjx064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Hayder F Saloom
- Department of Orthodontics, King’s College London Dental Institute, London, UK
- Department of Mucosal and Salivary Biology, King’s College London Dental Institute, London, UK
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Spyridon N Papageorgiou
- Department of Orthodontics and Department of Oral Technology, University of Bonn, Bonn, Germany
| | - Guy H Carpenter
- Department of Mucosal and Salivary Biology, King’s College London Dental Institute, London, UK
| | - Martyn T Cobourne
- Department of Orthodontics, King’s College London Dental Institute, London, UK
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Les élastiques intermaxillaires à ancrage osseux dans une malocclusion de Classe II asymétrique : une étude de cas. Int Orthod 2017; 15:263-277. [DOI: 10.1016/j.ortho.2017.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Manni A, Lupini D, Cozzani M. Bone-anchored intermaxillary elastics in an asymmetric Class II malocclusion: A case report. Int Orthod 2017; 15:263-277. [PMID: 28389179 DOI: 10.1016/j.ortho.2017.03.011] [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: 10/19/2022]
Abstract
PURPOSE A 13-year-old male patient, presenting a Class II, division 1 malocclusion and crowding was treated by an innovative technique. METHODS After rapid palatal expansion by a Hyrax appliance, the teeth were bonded with straightwire brackets. Two miniscrews were inserted, one per side, in the mandibular buccal bone between the roots of the mandibular first molar and the second premolar. On the right side, the miniscrew implant was connected to the hook clamped on a 0.021×0.028″ SS wire with a twisted SS ligature in order to maintain the inclination of the frontal incisors during the Class II mechanics. On the left side, where the Class II relationship was more marked, intermaxillary elastics were applied from the upper left hook clamped on the archwire to the lower first molar and a power chain (100g) was stretched from the lower left hook to the miniscrew implant. Class II correction was accomplished using sequential Class II elastics of progressive strength coupled with rectangular stainless steel wires. RESULTS After 22 months of active treatment, the results were balanced facial esthetics and a good occlusion. CONCLUSIONS This dual anchorage set-up of Class II elastics reinforced with TADs produced protrusive action on the mandible with minimal side effects and with no significant change in the vertical dimension during the sagittal correction of the Class II malocclusion.
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Bräscher AK, Zuran D, Feldmann RE, Benrath J. Patient survey on Invisalign ® treatment comparing [corrected] the SmartTrack ® material to the previously used [corrected] aligner material. J Orofac Orthop 2016; 77:432-438. [PMID: 27778051 DOI: 10.1007/s00056-016-0051-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 04/12/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES In 2013, a novel material SmartTrack® was introduced to replace the previous material used for Invisalign® aligners. We conducted this study to test how this transition was accepted by patients during ongoing Invisalign® treatment. METHODS We surveyed a total of 72 patients (68 % women, 32 % men, mean age: 29.3 ± 9.2 years) who had worn the new material for a mean of 6 months. They completed a questionnaire with 25 items that compared both materials in terms of pain, pressure upon insertion, comfort, mucosal irritation, phonetics, discoloration, and taste. RESULTS On a numerical rating scale (NRS) ranging from 0 to 10, the new aligner material was rated by the respondents to cause significantly (p < 0.001) less maximum pain than the old material (2.8 vs. 3.8). Significant reductions were obtained for duration of pain (p < 0.001) and duration of pressure (2.5 vs. 1.9 days; p = 0.001) upon insertion of the aligners. Over 90 % of the respondents indicated less or equal pain during eating, felt that the new material offered a tighter fit, and provided more favorable ratings for impairment, durability, and discoloration. Improved comfort was reported by 50 % of the respondents. CONCLUSIONS The new material was favorably rated by the patients and showed significant reductions in pain intensity, pain duration, and pressure upon insertion. Important clinical parameters like overall comfort and impairment also were improved. The clinical effectiveness of the new material remains to be investigated.
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Affiliation(s)
- Anne-Kathrin Bräscher
- Department of Anesthesiology and Intensive Care Medicine, Pain Management Center, Medical School Mannheim at University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Robert E Feldmann
- Department of Anesthesiology and Intensive Care Medicine, Pain Management Center, Medical School Mannheim at University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Justus Benrath
- Department of Anesthesiology and Intensive Care Medicine, Pain Management Center, Medical School Mannheim at University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
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Long H, Wang Y, Jian F, Liao LN, Yang X, Lai WL. Current advances in orthodontic pain. Int J Oral Sci 2016; 8:67-75. [PMID: 27341389 PMCID: PMC4932774 DOI: 10.1038/ijos.2016.24] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 02/05/2023] Open
Abstract
Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons: the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway—periaqueductal grey and dorsal raphe—has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti-inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviating orthodontic pain in the future.
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Affiliation(s)
- Hu Long
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li-Na Liao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Yang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen-Li Lai
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Are dental researchers asking patient-important questions? A scoping review. J Dent 2016; 49:9-13. [DOI: 10.1016/j.jdent.2016.04.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022] Open
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Wiedel AP, Bondemark L. A randomized controlled trial of self-perceived pain, discomfort, and impairment of jaw function in children undergoing orthodontic treatment with fixed or removable appliances. Angle Orthod 2016; 86:324-330. [PMID: 26185899 PMCID: PMC8603623 DOI: 10.2319/040215-219.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/01/2015] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To compare patients' perceptions of fixed and removable appliance therapy for correction of anterior crossbite in the mixed dentition, with special reference to perceived pain, discomfort, and impairment of jaw function. MATERIAL AND METHODS Sixty-two patients with anterior crossbite and functional shift were recruited consecutively and randomized for treatment with fixed appliances (brackets and archwires) or removable appliances (acrylic plates and protruding springs). A questionnaire, previously found to be valid and reliable, was used for evaluation at the following time points: before appliance insertion, on the evening of the day of insertion, every day/evening for 7 days after insertion, and at the first and second scheduled appointments (after 4 and 8 weeks, respectively). RESULTS Pain and discomfort intensity were higher for the first 3 days for the fixed appliance. Pain and discomfort scores overall peaked on day 2. Adverse effects on school and leisure activities were reported more frequently in the removable than in the fixed appliance group. The fixed appliance group reported more difficulty eating different kinds of hard and soft food, while the removable appliance group experienced more speech difficulties. No significant intergroup difference was found for self-estimated disturbance of appearance between the appliances. CONCLUSIONS The general levels of pain and discomfort were low to moderate in both groups. There were some statistically significant differences between the groups, but these were only minor and with minor clinical relevance. As both appliances were generally well accepted by the patients, either fixed or removable appliance therapy can be recommended.
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Affiliation(s)
- Anna-Paulina Wiedel
- Research Fellow, Department of Oral and Maxillofacial Surgery, Skane University Hospital, Malmö, Sweden
| | - Lars Bondemark
- Professor and Head, Department of Orthodontics, School of Dentistry, University of Malmö, Sweden
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Abreu LG, Melgaço CA, Abreu MHNG, Lages EMB, Paiva SM. Agreement between adolescents and parents or caregivers in rating adolescents' quality of life during orthodontic treatment. Am J Orthod Dentofacial Orthop 2015; 148:1036-42. [PMID: 26672710 DOI: 10.1016/j.ajodo.2015.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 11/27/2022]
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Woodhouse NR, DiBiase AT, Papageorgiou SN, Johnson N, Slipper C, Grant J, Alsaleh M, Cobourne MT. Supplemental vibrational force does not reduce pain experience during initial alignment with fixed orthodontic appliances: a multicenter randomized clinical trial. Sci Rep 2015; 5:17224. [PMID: 26610843 PMCID: PMC4661602 DOI: 10.1038/srep17224] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/27/2015] [Indexed: 01/06/2023] Open
Abstract
This prospective randomized trial investigated the effect of supplemental vibrational force on orthodontic pain during alignment with fixed-appliances. Eighty-one subjects < 20 years-old undergoing extraction-based fixed-appliance treatment were randomly allocated to supplementary (20-minutes/day) use of an intra-oral vibrational device (AcceleDent®) (n = 29); an identical non-functional (sham) device (n = 25) or fixed-appliances only (n = 27). Each subject recorded pain intensity (using a 100-mm visual-analogue scale) and intake of oral analgesia in a questionnaire, following appliance-placement (T1) and first-adjustment (T2) for 1-week (immediately-after, 4, 24, 72-hours and at 1-week). Mean maximum-pain for the total sample was 72.96 mm [SD 21.59; 95%CI 68.19–77.74 mm] with no significant differences among groups (P = 0.282). Subjects taking analgesics reported slightly higher maximum-pain although this was not significant (P = 0.170). The effect of intervention was independent of analgesia (P = 0.883). At T1 and T2, a statistically and clinically significant increase in mean pain was seen at 4 and 24-hours, declining at 72-hours and becoming insignificant at 1-week. For mean alignment-rate, pain-intensity and use of analgesics, no significant differences existed between groups (P > 0.003). The only significant predictor for mean pain was time. Use of an AcceleDent vibrational device had no significant effect on orthodontic pain or analgesia consumption during initial alignment with fixed appliances.
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Affiliation(s)
- Neil R Woodhouse
- King's College London Dental Institute, Department of Orthodontics, London SE19RT, UK.,Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - Andrew T DiBiase
- East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Department of Orthodontics, Ashford TN240LZ, UK
| | - Spyridon N Papageorgiou
- University of Bonn, Department of Orthodontics and Department of Oral Technology, Bonn DE-53111, Germany
| | - Nicola Johnson
- Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - Carmel Slipper
- Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - James Grant
- Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - Maryam Alsaleh
- King's College London Dental Institute, Department of Orthodontics, London SE19RT, UK
| | - Martyn T Cobourne
- King's College London Dental Institute, Department of Orthodontics, London SE19RT, UK
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