Pain and chewing sensitivity during fixed orthodontic treatment in extraction and non-extraction patients

Orthodontic pain is related to oral health-related quality of life in orthodontic patients

INTRODUCTION

Orthodontic pain (OP) is a subjective experience induced by prolonged force on the teeth in fixed orthodontic treatment. OP acts as a predictor of aspects related to oral health-related quality of life (OHRQOL). It is important to understand the extent of the impact of OP on a patient's daily life, especially on stomatognathic function and social impact.

OBJECTIVE

To assess the correlation between OP and OHRQOL in fixed orthodontic treatment patients.

MATERIAL AND METHODS

The comparative pain rating scale is used to assess pain intensity, while the oral health impact profile-14 (OHIP-14) assesses the impact of OP severity on OHRQOL of 57 patients undergoing fixed orthodontic treatment in the early stages of treatment (1-3 months of treatment) at the Dental Hospital, Universitas Airlangga. Gender, age, and malocclusion classifications were also analyzed for their influence. The data were analyzed using Spearman correlation and two-way analysis of variance (ANOVA).

RESULTS

In the initial phase of treatment, most of the patients (53%) experienced mild OP and moderate OP (39%), and OP was reduced over a week. The overall OHRQOL score was 17.4 ± 8, which indicates a negative impact on OHRQOL. There were also positive correlation dimensions of OHRQOL, which include the dimensions of physical limitations, psychological discomfort, and psychological limitations (r > 0.50). There was a significant difference between age groups in OP perception and OHRQOL (P < 0.05).

CONCLUSIONS

There was a positive correlation between OP intensity and OHRQOL experienced by fixed orthodontic patients at the Dental Hospital, Universitas Airlangga.

The Impact of Orthodontic Treatment on Masticatory Performance: A Literature Review

The aim of this narrative review was to evaluate the possible association between orthodontic therapy and improved masticatory function. A search strategy was conducted using the PubMed database for up to January 2020 using the keywords "mastication" and "orthodontics". Only human studies investigating mastication in orthodontics settings were selected. The search strategy resulted in 1,011 articles, out of which 57 were included in the final analysis. Investigations have generally agreed that masticatory and chewing functions improved post-orthodontic and orthognathic treatments. Studies also showed improvement in the quality of life of patients' post-orthodontic treatment. The articles examined reinforced that besides esthetic reasons, orthodontic therapy does improve the masticatory and chewing functions of individuals, ultimately enhancing their health-related quality of life.

Orthodontic pain in maxilla and mandible during the first week of orthodontic treatment

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.

Comparison of the Perception of Pain during Fixed Orthodontic Treatment with Metal and Ceramic Brackets

Introduction:

Pain is experienced by patients during various fixed orthodontic procedures such as placement of separators, insertion of arch wire and its activations, orthopedic appliances such as headgear, and debonding of the appliance. This study was formulated with the background that the level of pain sensation differs between conventional metal and ceramic brackets, arch wire being the same.

Materials and Methods:

The sample comprised 40 patients. The patients were separated into two groups: Group A (metal brackets) and Group B (ceramic brackets). In Group A, the brackets were bonded with 0.022” conventional stainless steel brackets (Unitek Gemini, 3M, Monrovia, California). In Group B, the brackets were bonded with ceramic brackets (Unitek Gemini Clear Brackets, 3M, Monrovia, California). The bonding of the brackets was carried out according to the conventional etching, priming, and curing technique. A 0.016” NiTi (nickel titanium) arch wire was used as the first arch wire. The intensity of pain was documented in a figure containing two 100-mm visual analog scales (VASs).

Results:

The level of pain reduced in intensity in due course. During 1 month, VAS scores increased at the end of day 1 (24 h) for the metal and ceramic group. The pain then decreased for up to 5 days. The average pain intensity reached 4.44 in the ceramic group, whereas it was 2.7 in the metal group for the upper anterior region. It decreased up to 1 in the ceramic and 0.22 in the metal group.

Conclusion:

Patients bonded with ceramic brackets experienced a higher and more severe pain of longer duration than individuals treated with conventional brackets.

Pain Perception and Personality Trait toward Orthodontic Treatment

Aim

The study was done to evaluate the pain perception, attitude, and personality trait of the patient toward orthodontic treatment.

Materials and Methods

In this cross-sectional questionnaire survey, 100 patients were divided into Group 1, 150 (75 males and 75 females) as untreated group and Group 2, 150 as treated group (75 males and 75 females). Evaluation of the patients was done based on pain perception, attitude, and personality trait. Set of questionnaire was used to assess attitude and pain perception on visual analog scale. The data were tabulated, and statistical evaluation was done using statistical software IBM SPSS Statistics for Windows, (Version 21.0. Armonk, NY: IBM Corp.) using t-test and Tukey's test.

Results

The mean pain perception for Group 1 was 4.8 ± 1.30 and 4.17 ± 1.58 in Group 2; the difference was not statistically significant (P = 0.26). The mean value for attitude in Group 1 was 3.57 ± 1.21, and in Group 2, it was 3.39 ± 1.60 (P = 0.09). There was statistically significant difference in pain perception between low (L) level to high level (H) neuroticism (P = 0.009). There was significant difference (P = 0.021) in pain for conscientiousness from very low to very high levels which is directly proportional.

Conclusion

The present study indicated that attitude, personality traits, and pain perception have a definite role in patient cooperation and success of orthodontic treatment.