The European Journal of Orthodontics Advance Access published online on May 22, 2009
The European Journal of Orthodontics, doi:10.1093/ejo/cjp003
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Prevalence and type of pain during conventional and self-ligating orthodontic treatment
Department of Oral Science, University G.D’Annunzio, Pescara Italy
Address for correspondenceSimona Tecco, Via Le Mainarde 26, 65121 Pescara, Italy, E-mail: simtecc{at}tin.it
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Abstract |
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This study investigated the prevalence and type of pain experienced during orthodontic treatment in 30 subjects (12 males, 18 females, aged 12–18 years) with crowding. Fifteen patients were treated with conventional brackets (Victory Series) and 15 with self-ligating brackets (Damon SL II). The first archwire for all patients was a 0.014 inch nickel–titanium (NiTi) archwire with a force of approximately 100 g. Conventional brackets were ligated with elastomeric modules. A visual analogue scale (VAS) was used daily to assess the intensity of pain; the use of pain medication was also reported in a specially designed daybook for a total period of 3 months. Pearson’s chi-square was used to investigate the difference between groups in the frequency of pain experience, its nature, and the use of analgesia. Non-parametric statistics (Mann–Whitney U-test) were computed to compare pain intensity between the groups. To investigate reported pain assessments, Friedman’s two-way analysis of variance was used and the differences were estimated using Wilcoxon’s signed-rank test.
The results showed that pain was reported for a period of 9 days after archwire insertion. Patients treated with self-ligating brackets reported the highest pain intensity on the day following placement of the first archwire (VAS mean = 42.6), while those treated with conventional brackets experienced the greatest pain intensity at placement of the first archwire (VAS mean = 52) and after the second orthodontic appointment (VAS mean = 59.6). Analgesics were used by 16.5 per cent of patients treated with self-ligating brackets and by 10 per cent of those treated with conventional brackets, most often during the first 2 days after archwire placement. Patients treated with conventional brackets reported significantly more ‘constant’ pain than those treated with self-ligating brackets who complained of ‘chewing/biting’ pain.
Pain appears to be common during orthodontic treatment but perhaps less intense when self-ligating brackets are used, although no difference was observed in the use of analgesics between those treated with self-ligating or conventional brackets. There were no reports of pain after 7–9 days in either group.