Evaluation of pain perception during orthodontic debonding of metallic brackets with four different techniques

Delal Dara Kilinç, Gulsilay Sayar, Delal Dara Kilinç, Gulsilay Sayar

Abstract

Objective: The aim of this study was to evaluate patients' pain levels during four different debonding procedures. The null hypothesis was that the pain perception of the patients undergoing four different debonding applications was not statistically significant different.

Material and methods: One hundred and twenty orthodontic patients who underwent orthodontic debonding were included in this study. The patients were randomly divided into 4 groups according to technique used in the patients. Debonding groups were as follows: Group 1) Conventional debonding group, Group 2) Medication group (acetaminophen was given 1 hour before debonding), Group 3) Soft bite wax group, and Group 4) Soft acrylic bite wafer group. The patients' levels of anxiety and fear of pain were evaluated before debonding, and Numerical Rating Scale (NRS) was applied to evaluate their pain perception during debonding. Mann-Whitney U and Kruskal-Wallis tests were used to evaluate non-normally distributed data. Categorical data analysis were carried by chi-square and McNemar tests. The significance level was set at p<0.05.

Results: Anxiety scores of the patients were not statistically significant between both genders and debonding groups. In the quadrants in which the patients were perceived, the highest pain level was in the left side of the mandible. The teeth in which the highest pain level was perceived were the lower left and upper right lateral incisors. Although there was no statistically significant difference among the pain scores of the patients in each group, quadrant scores of female patients showed significant differences, being the lowest scores in the soft bite wax group.

Conclusions: Majority of the patients had no fear of pain before debonding. Pain levels of the patients in the conventional debonding group were not significantly different from those of the other groups, except quadrant scores of females in the soft bite wax group. The null hypothesis was accepted.

Figures

Figure 1. Intraoral photograph of conventional debonding
Figure 1. Intraoral photograph of conventional debonding
Figure 2. Intraoral photograph of debonding with…
Figure 2. Intraoral photograph of debonding with soft bite wax
Figure 3. Intraoral photograph of debonding with…
Figure 3. Intraoral photograph of debonding with soft acrylic bite wafer

References

    1. Bergius M, Broberg AG, Hakeberg M, Berggren U. Prediction of prolonged pain experiences during orthodontic treatment. Am J Orthod Dentofacial Orthop. 2008;133(3):339.e1–339.e8.
    1. Bergius M, Berggren U, Kiliaridis S. Experience of pain during an orthodontic procedure. Eur J Oral Sci. 2002;110(2):92–98.
    1. Brown DF, Moerenhout RG. The pain experience and psychological adjustment to orthodontic treatment of preadolescents, adolescents, and adults. Am J Orthod Dentofacial Orthop. 1991;100(4):349–356.
    1. Krishnan V. Orthodontic pain: from causes to management - a review. Eur J Orthod. 2007;29(2):170–179.
    1. Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1989;96(1):47–53.
    1. Oliver RG, Knapman YM. Attitudes to orthodontic treatment. Br J Orthod. 1985;12(4):179–188.
    1. Berkley KJ. Sex differences in pain. Behav Brain Sci. 1997;20(3):371–380.
    1. Unruh AM. Gender variations in clinical pain experience. Pain. 1996;65(2):123–167.
    1. Erdinç AM, Dinçer B. Perception of pain during orthodontic treatment with fixed appliances. Eur J Orthod. 2004;26(1):79–85.
    1. Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment: a randomized controlled clinical trial of two initial aligning arch wires. Am J Orthod Dentofacial Orthop. 1992;102(4):373–381.
    1. Lee-Knight CT, Wylie SG, Major PW, Glover KE, Grace M. Mechanical and electrothermal debonding: effect on ceramic veneers and dental pulp. Am J Orthod Dentofacial Orthop. 1997;112(3):263–270.
    1. Williams OL, Bishara SE. Patient discomfort levels at the time of debonding: a pilot study. Am J Orthod Dentofacial Orthop. 1992;101(4):313–317.
    1. Todd KH, Funk KG, Funk JP, Bonacci R. Clinical significance of reported changes in pain severity. Ann Emerg Med. 1996;27(4):485–489.
    1. Pringle AM, Petrie A, Cunningham SJ, McKnight M. Prospectice randomized clinical trial to compare pain levels associated with 2 orthodontic fixed bracket systems. Am J Orthod Dentofacial Orthop. 2009;136(2):160–167.
    1. Normando TS, Calçada FS, Ursi WJ, Normando D. Patients’ report of discomfort and pain during debonding of orthodontic brackets: a comparative study of two methods. World J Orthod. 2010;11(4):e29–e34.
    1. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, et al. Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011;41(6):1073–1093.
    1. Fleming PS, Dibiase AT, Sarri G, Lee RT. Pain experience during initial alignment with self-ligating and a conventional fixed orthodontic appliance system. A randomized controlled clinical trial. Angle Orthod. 2009;79(1):46–50.
    1. Sheridan JJ, Brawley G, Hastings J. Electrothermal debracketing. Part II. An in vivo study. Am J Orthod. 1986;89(2):141–145.
    1. Tsuruoka T, Namura Y, Shimizu N. Development of an easy-debonding orthodontic adhesive using thermal heating. Dent Mat J. 2007;26(1):78–83.
    1. Jensen MP, Karoly P. Self-report scales and procedures for assessing pain in adults. In: Turk DC, Melzack R, editors. Handbook of pain assessment. New York: Guilford Press; 2011. pp. 19–44.
    1. Pithon MM, Santos Fonseca Figueiredo D, Oliveira DD, Coqueiro RS. What is the best method for debonding metallic brackets from the patient's perspective? Prog Orthod. 2015;16(1):17–17.
    1. Polat O, Karaman AI. Pain control during fixed appliance therapy. Angle Orthod. 2005;75(2):214–219.
    1. Tuncer Z, Ozsoy FS, Polat-Ozsoy O. Self-reported pain associated with the use of intermaxillary elastics compared to pain experienced after initial archwire placement. Angle Orthod. 2011;81(5):807–811.
    1. Burstone CJ, Every TW, Pryputniewicz RJ. Holographic measurement of incisor extrusion. Am J Orthod. 1982;82(1):1–9.
    1. Bavbek NC, Tuncer BB, Tortop T, Celik B. Efficacy of different methods to reduce pain during debonding of orthodontic brackets. Angle Orthod. 2016;86(6):917–924.
    1. Mangnall LA, Dietrich T, Scholey JM. A randomized controlled trial to assess the pain associated with the debond of orthodontic fixed appliances. J Orthod. 2013;40(3):188–196.
    1. Koyama T, McHaffie JG, Laurienti PJ, Coghill RC. The subjective experience of pain: where expectations become reality. Proc Natl Acad Sci U S A. 2005;102(36):12950–12955.
    1. Pilling LF. Psychosomatic aspects of facial pain. In: Alling CC, editor. Facial pain. Philadelphia; Lea & Febinger: 1977.

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