Background. Orthodontists use mini-implants temporarily as an effective mode of skeletal anchorage devices. The placement of mini-implants can cause pain and discomfort to the patients. Patients often develop swelling, and the pain could interfere with their daily activities. Practitioners tend to prescribe antibiotics and pain medication for management. Objectives. The main objectives of this study are to evaluate the pain perception and discomfort due to mini-implant placement experienced by the patient and evaluate the interventions for pain management commonly practiced among orthodontists. Materials and Methods. The study was designed as a questionnaire-based cross-sectional study. A total of 271 patients were assessed, for whom 625 mini-implants (ranging from 1.2 to 2 mm diameter and length 8-14 mm) were placed. Pain scores were assessed using the VAS and the “Faces” pain rating scale to collect data about discomfort in daily activity and function. Data was collected from 244 patients. A total of 155 orthodontists were questioned regarding the prescription of medications and the interventions for managing pain and adverse effects. Results. Average pain score among female subjects was 16.71 and among men was 13.5. The highest pain scores were recorded for palatal mini-implants with an average score of 36.29 and the least for interradicular mini-implants with an average score of 9.02. Among the subjects, 47.9% of them took analgesics, and the most commonly prescribed analgesics were paracetamol (39%). Swelling at the site is where the mini-implants were placed, and ulceration due to implants were commonly dealt with the excision of the surrounding soft tissue, composite placement, and palliative care with oral analgesic gels. Conclusion. Female subjects had more mini-implants placed, and female subjects had also given more pain scores than their male counterparts. Palatal mini-implants caused the highest pain, followed by mini-implants placed at the infrazygomatic crest and the buccal shelf region. Palatal mini-implants caused maximum discomfort during speech and eating, followed by the mini-implant in the buccal shelf and the infrazygomatic crest region that also caused difficulty in yawning and laughing. Infiltration anesthesia was commonly given for the placement of interradicular implants and extra-alveolar mini-implants. Paracetamol was the most prescribed by the orthodontists, and more than half the doctors did not regularly prescribe antibiotics.
Introduction: Orthodontic treatment with fixed appliances especially during the retraction stage makes it challenging to maintain the oral hygiene. Attachments used, such as elastic chains, loops and springs, result in changes in the oral environment due to the accumulation of plaque and increase in the levels of bacterial count mainly Streptococcus mutans and Lactobacilli species. Aim: To determine the prevalence of oral microbial flora during orthodontic space closure. Materials and Methods: This was a cross-sectional pilot study conducted during the month of December 2019 which consisted of eight patients who were randomly selected among the age group of 18-25 years. Mean and SD of age in Males (4) and Females (4) were 22±2.16 years and 22.25±1.70 years, respectively and had reported to the Department of Orthodontics of a private dental college, Saveetha Dental College. In each patient, after 6-8 months of orthodontic treatment, plaque samples were collected only once around the orthodontic brackets at the cervical aspect of the maxillary lateral incisor, maxillary premolar, mandibular canine, mandibular premolar in 1st, 2nd, 3rd, and 4th quadrant respectively, by the method of cotton swabbing for the evaluation of micro flora. Independent paired t-test and One-way ANOVA with Post-hoc Tukey HSD test were done to estimate the prevalence of microorganisms at different sites. Results: Independent paired t-test showed highly significant differences in the levels of Streptococcus mutans when compared to Lactobacillus (p<0.001) with mean values of 4.8±2.5 and 23.1±9.2 for Streptococcus and Lactobacillus, respectively. One-way ANOVA with Post-hoc Turkey HSD analysis showed significant difference at the region of maxillary lateral incisor compared to other sites whereas Lactobacillishowed no significant differences between the various sites tested (p-value<0.001). Kappa statistics was performed which revealed an inter examiner reliability of 0.91. Conclusion: During orthodontic space closure, bacterial count of Streptococcus mutans showed a statistically significant difference between different sites (maxillary lateral incisor, mandibular canines, maxillary and mandibular premolars) with highest being the maxillary incisor region followed by that of mandibular canines. However, the incidence of Lactobacillusacidophilus did not show any difference between the various sites evaluated.
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