The correlation between pain perception among patients with six different orthodontic archwires and the degree of dental crowding

Abstract

Introduction Forces generated in orthodontic treatment with fixed appliances create tension and compression zones in the periodontal ligament resulting in a painful experience for patients. In the first phase of orthodontic treatment, when leveling of teeth is needed, nickel-titanium (NiTi) archwires can be completely engaged in brackets, even in the cases of extreme crowding, exerting small forces. There is a great individual variation in the pain perception related to the application of orthodontic forces. Objective The aim of this study was to investigate the pain perception among patients with dental crowding after insertion of six different NiTi orthodontic archwires as a part of fixed appliances in the first stage of orthodontic treatment. Methods The study was conducted on a sample of 189 orthodontic patients receiving one of six different either superelastic or heat activated NiTi archwires, in the first phase of orthodontic treatment. Pain perception was evaluated in groups of patients with different degree of crowding. The modified McGill Pain Questionnaire with Visual Analogue Scale was used to evaluate the quality and intensity of pain. Statistical analysis was performed using simple descriptive statistics, and Pearson's chi-square test with statistical significance of p lt 0.05. Results Majority of patients reported pain as discomfort or pressure of moderate intensity caused by chewing or biting, started within 12 hours, carried on for 3-4 days, and decreased over time without self-medication. Conclusion No correlation was found between pain perception among patients with different types of NiTi archwires and the degree of crowding.

Uvod Ortodontske sile kojima se tokom terapije fiksnim aparatima pomeraju zubi dovode do istezanja i kompresije parodontalnih vlakana, te pojave bola kod pacijenata. U prvoj fazi ortodontskog lečenja, kada se zubi nivelišu, žice od legure nikl-titanijuma proizvode relativno malu silu i mogu se potpuno ligirati u slotove bravica, čak i u slučajevima velike teskobe. Postoje veoma velike individualne varijacije u percepciji bola prilikom primene ortodontskih sila. Cilj rada Cilj istraživanja je bio da se ispita percepcija bola kod osoba s teskobom u zubnim nizovima nakon ligiranja šest različitih ortodontskih žica u sklopu prve faze terapije fiksnim aparatima. Metode rada Studija je urađena na uzorku od 189 pacijenata kojima je u okviru ortodontskog lečenja fiksnim aparatima bila ligirana jedna od šest različitih superelastičnih ili termo žica od legure nikl-titanijuma. Percepcija bola je procenjivana kod osoba s različitom izraženošću teskobe. Korišćen je modifikovani Makgilov (McGill) upitnik za bol s Vizuelnom analognom skalom radi opisivanja kvaliteta i intenziteta bola. Statistička obrada podataka je obuhvatila deskriptivnu statističku analizu i primenu h2-testa sa statističkom značajnošću od p lt 0,05. Rezultati Najveći broj ispitanika je opisao bol kao neprijatnost ili pritisak srednjeg intenziteta izazvan žvakanjem ili dodirom, koji je počinjao do 12 sati od ligiranja žice, trajao je tri-četiri dana i smanjivao se bez primene lekova. Zaključak Nije utvrđena statistički značajna razlika u percepciji bola kod osoba s različitom izraženošću teskobe zubnih nizova kojima su bile ligirane superelastične i termo žice od legure nikl-titanijuma.