Background
The aim of the present three-arm parallel trial was to compare the effectiveness of chewing gum and ibuprofen in the control of orthodontic pain.
Methods
Patients to undergo orthodontic treatment at a private orthodontic clinic were randomly divided into three parallel groups, each of which took either a placebo, ibuprofen or chewing gum. The eligibility criteria included patients in the full permanent dentition with moderate crowding requiring the extraction of two mandibular and two maxillary premolars. The main outcome was the patient’s level of discomfort, which was assessed by a 0–10 numeric rating scale (NRS) at two hours, six hours, at bedtime, 24 hours, two days, three days and seven days after the placement of initial arch wires in four functions including chewing, biting, occluding back teeth, and occluding front teeth. Randomisation was accomplished according to the patient’s clinic entrance number and by using a table of random numbers. The patients in the placebo and ibuprofen groups were blinded to the type of medication used. The differences in the groups were analysed using repeated measures ANOVA.
Results
Sixty-six patients between 12 and 30 years were randomised in a 1:1:1 ratio. The pain questionnaire response rate was 100% in the three groups, but six patients were excluded and consequently 60 patients were analysed (N = 20 in each group). There was no significant difference between the chewing gum and ibuprofen groups during any oral function at any time point (p > 0.05). However, repeated measures ANOVA showed that patients in the placebo group experienced significantly higher pain scores compared with patients in the ibuprofen and chewing gum groups at two hours, six hours, at bedtime, at 24 hours and two days after initial arch wire placement (p < 0.05). No patient harm was observed in this study.
Conclusions
In contrast to the common orthodontic belief that gum chewing may lead to bracket breakage, it seems that chewing gum is as beneficial as medication for pain relief and can be a recommended alternative during orthodontic treatment.
Multiple impacted permanent teeth is a rare finding and often associated with systemic diseases or some rare syndromes. This article reports two Iranian cases with multiple impacted teeth without systemic disease or syndromes. The first patient, a 17-year-old male, had 18 unerupted teeth and 9 unerupted supernumerary teeth. The second patient, a 16-year-old female, had 14 unerupted teeth. In these cases, an interdisciplinary approach between orthodontist, oral surgeon and prosthodontist is required to achieve optimum facial aesthetics and functional occlusion.
Introduction
The metals nickel (Ni) and chromium (Cr) can cause immunological sensitivity and adverse biological and cytotoxic effects.
Aim
To evaluate hair levels of these metals in patients undergoing fixed orthodontic treatment compared with controls.
Material and methods
Five databases – PubMed, Web of Science, Scopus, Cochrane Library, and ScienceDirect – were searched up to January 2018 for evaluation of the hair levels of nickel and/or chromium in patients undergoing fixed orthodontic treatment. To assess the study quality, the Newcastle-Ottawa Scale was used (NOS), and to compare hair Ni and Cr levels in the cases compared with the controls, a random-effects meta-analysis was performed by Review Manager 5.3 using standard mean differences (SMDs) and 95% confidence intervals (CIs).
Results
Out of 38 studies in the databases searched, 6 studies were included in the meta-analysis. The pooled SMD of hair Ni levels between the cases and controls was 0.95 μg/g (95% CI: –0.09, 1.99;
p
= 0.07), which showed that the Ni level was similar in the cases compared with the controls, and that for hair Cr levels was 0.88 μg/g (95% CI: –0.45, 2.21;
p
= 0.20), so the Cr level was similar in the cases compared with the controls.
Conclusions
The slightly elevated hair levels of Ni and Cr in patients undergoing fixed orthodontic treatment suggest that changing the components of fixed orthodontic appliances can be considered as an acceptable solution in the future.
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