Comparison of pain levels in patients treated with 3 different orthodontic appliances - a randomized trial

Rajasri Diddige, Gunjan Negi, Kanamarlapudi Venkata Sai Kiran, Prasad Chitra, Rajasri Diddige, Gunjan Negi, Kanamarlapudi Venkata Sai Kiran, Prasad Chitra

Abstract

Background and aims: To compare pain levels experienced during initial alignment with three different orthodontic appliance types and to correlate pain with male and female differences, if any.

Methods: A prospective, randomized 3-arm parallel trial allocated 36 adult orthodontic patients into three appliance groups: MBT 0.022" slot (Mini Twin, Ormco, Glendora, USA), self ligating 0.022" slot Damon 3MX (Ormco, Glendora, USA) and clear aligners (Smile align, Mumbai, India). The level of discomfort was assessed through a questionnaire based on the visual analogue scale at four hours, twenty four hours, third and seventh day after appliance placement.

Results: Patients treated with clear aligners reported less pain than patients treated with conventional and self ligating fixed appliances. Patients treated with MBT conventional appliances showed greater pain levels than Damon appliances. A significantly higher visual analogue scale score was observed at 24 hours and the least visual analogue scale scores on the seventh day post appliance placement.

Conclusion: During the first week of orthodontic treatment, patients treated with clear aligners reported lower pain than those treated with conventional and self-ligating appliances.

Keywords: orthodontic appliances; pain perception; visual analogue scale (VAS).

Figures

Figure 1
Figure 1
Questionnaire.
Figure 2
Figure 2
CONSORT Diagram of demographic representation.
Figure 3
Figure 3
Pain levels in all 3 tested groups.
Figure 4
Figure 4
Pain levels in the 3 groups 4 hours post appliance placement.
Figure 5
Figure 5
Pain levels in 3 groups 24 hours post appliance placement.
Figure 6
Figure 6
Pain levels in 3 groups 3 days post appliance placement
Figure 7
Figure 7
Pain levels in the 3 groups 7 days post appliance placement.
Figure 8
Figure 8
Pain comparisons among the 3 groups at tested time intervals.

References

    1. Treede RD. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Pain Rep. 2018;3:e643.
    1. Reitan K. Selecting forces in orthodontics. Trans Eur Orthod Soc. 1956;32:108–125.
    1. Frustman L, Bernick S. Clinical considerations of the periodontium. Am J Orthod. 1972;61:138–155.
    1. Bertl MH, Onodera K, Čelar AG. A prospective randomized split-mouth study on pain experience during chairside archwire manipulation in self-ligating and conventional brackets. Angle Orthod. 2013;83:292–297.
    1. Rahman S, Spencer RJ, Littlewood SJ, O’Dywer L, Barber SK, Russell JS. A multicenter randomized controlled trial to compare a self-ligating bracket with a conventional bracket in a UK population: Part 2: Pain perception. Angle Orthod. 2016;86:149–156.
    1. Fleming PS, Dibiase AT, Sarri G, Lee RT. Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system. A randomized controlled clinical trial. Angle Orthod. 2009;79:46–50.
    1. Scott P, Sherriff M, Dibiase AT, Cobourne MT. Perception of discomfort during initial orthodontic tooth alignment using a self-ligating or conventional bracket system: a randomized clinical trial. Eur J Orthod. 2008;30:227–232.
    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;102:373–381.
    1. Jones ML. An investigation into the initial discomfort caused by placement of an archwire. Eur J Orthod. 1984;6:48–54.
    1. Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1989;96:47–53.
    1. Bergius M, Kiliaridis S, Berggren U. Pain in orthodontics. A review and discussion of the literature. J Orofac Orthop. 2000;61:125–137.
    1. Fernandes LM, Ogaard B, Skoglund L. Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire. A randomized clinical trial. J Orofac Orthop. 1998;59:331–339.
    1. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8:1153–1157.
    1. Stewart FN, Kerr WJ, Taylor PJ. Appliance wear: the patient’s point of view. Eur J Orthod. 1997;19:377–382.
    1. Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment--effects on compliance and prediction of patients’ adaptation by personality variables. Eur J Orthod. 2000;22:307–315.
    1. Pringle AM, Petrie A, Cunningham SJ, McKnight M. Prospective randomized clinical trial to compare pain levels associated with 2 orthodontic fixed bracket systems. Am J Orthod Dentofacial Orthop. 2009;136:160–167.
    1. Miles PG, Weyant RJ, Rustveld L. A clinical trial of Damon 2 vs conventional twin brackets during initial alignment. Angle Orthod. 2006;76:480–485.
    1. Tecco S, D’Attilio M, Tetè S, Festa F. Prevalence and type of pain during conventional and self-ligating orthodontic treatment. Eur J Orthod. 2009;31:380–384.
    1. Miller KB, McGorray SP, Womack R, Quintero JC, Perelmuter M, Gibson J, et al. A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. Am J Orthod Dentofacial Orthop. 2007;131:302.e1–e9.
    1. White DW, Julein KC, Jacob H, Campbell PM, Buschang PH. Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial. Angle Orthod. 2017;87:801–808.
    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;100:349–356.
    1. Sandhu S, Leckie G. Diurnal Variation in orthodontic pain: Clinical implications and pharmacological management. Semin Orthod. 2018;24:217–224.
    1. Scheurer PA, Firestone AR, Bürgin WB. Perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod. 1996;18:349–357.
    1. Burstone CJ. Biomechanics of tooth movement. In: Krause BS, editor. Vistas in orthodontics. Philadelphia: Lea and Febiger; 1964. pp. 197–213.
    1. Batham P, Batham A, Kalia U, Nagar A, Jain S. Pathways of pain to pleasure in orthodontics: A review. Indian J Orthod Dentofacial Res. 2017;3:124–128.
    1. Shalish M, Cooper-Kazaz R, Ivgi I, Canetti L, Tsur B, Bachar E, et al. Adult patients’ adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and Invisalign™. Eur J Orthod. 2012;34:724–730.
    1. Krishnan V. Orthodontic pain: from causes to management--a review. Eur J Orthod. 2007;29:170–179.
    1. Carter LA, Geldenhuys M, Moynihan PJ, Slater DR, Exley CE, Rolland SL. The impact of orthodontic appliances on eating - young people’s views and experiences. J Orthod. 2015;42:114–122.
    1. Nicolay OF, Davidovitch Z, Shanfeld JL, Alley K. Substance P immunoreactivity in periodontal tissues during orthodontic tooth movement. Bone Miner. 1990;11:19–29.
    1. Fujiyama K, Honjo T, Suzuki M, Matsuoka S, Deguchi T. Analysis of pain level in cases treated with Invisalign aligner: comparison with fixed edgewise appliance therapy. Prog Orthod. 2014;15:64.
    1. Oliver RG, Knapman YM. Attitudes to orthodontic treatment. Br J Orthod. 1985;12:179–188.
    1. Navarro PR, Assis GB, Souza LL, Macluf FE, Azenha CR, Tessitore A. Changes in oral functions in presence of fixed orthodontic appliances with features intraoral. Rev CEFAC. Cefac. 2013;15:1281–1290.
    1. Khattab TZ, Farah H, Al-Sabbagh R, Hajeer MY, Haj-Hamed Y. Speech performance and oral impairments with lingual and labial orthodontic appliances in the first stage of fixed treatment: A randomized controlled trial. Angle Orthod. 2013;83:519–526.
    1. Nijs J, Mairesse O, Neu D, Leysen L, Danneels L, Cagnie B, et al. Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice. Phys Ther. 2018;98:325–335.
    1. Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth. 2013;111:52–58.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅