A randomized clinical trial investigating pain associated with superelastic nickel–titanium and multistranded stainless steel archwires during the initial leveling and aligning phase of orthodontic treatment

Abstract

Objective:To investigate and compare the effects of superelastic nickel–titanium and multistranded stainless steel archwires on pain during the initial phase of orthodontic treatment.Design:A double-blind two-arm parallel design stratified randomized clinical trial.Setting:A single centre in India between December 2010 and June 2012. A total of 96 participants (48 male and 48 females; 14.1±2.1 years old) were randomized (stratified on age, sex and initial crowding) to superelastic nickel–titanium or multistranded stainless steel archwire groups using a computer-generated allocation sequence.Methods:We compared 0.016-inch superelastic nickel–titanium and 0.0175-inch multistranded stainless steel wires in 0.022-inch slot (Roth prescription) preadjusted edgewise appliances. The follow-up period was 14 days. Outcome was assessed with a visual analogue scale at baseline and 32 pre-specified follow-up points. Data was analyzed using mixed-effects model analysis.Results:One participant was lost to follow up and 10 were excluded from the analysis due to bond failure or incomplete questionnaire answers. Ultimately, 85 participants (42 males and 43 females; 14.1±2.0 years old) were analysed for the final results. No statistically significant difference was found for overall pain [F value = 2.65, degrees of freedom (df) = 92.6; P = 0.1071]. However, compared to multistranded stainless steel wires, pain in subjects with superelastic nickel–titanium archwires was significantly greater at 12 h (t = 2.34; P = 0.0193), as well as at day 1 in the morning (t = 2.21, P = 0.0273), afternoon (t = 2.11, P = 0.0346) and at bedtime (t = 2.03, P = 0.042).Conclusion:For overall pain, there was no statistically significant difference between the two wires. However, subjects with superelastic nickel–titanium archwires had a significantly higher pain at peak level.

Orthodontic pain trajectories in adolescents: Between-subject and within-subject variability in pain perception

“…1,2,5,6 However, this claim made by authors of previous studies has an inherent flaw, as rightly pointed out by the authors of a recent study. 7 Since none of the previous studies reported the actual time of force application and the subsequent time of pain assessment, therefore, it is difficult to ascertain the actual time of peak intensity level. After controlling for this factor of variation i.e.…”

“…Evidence shows that most orthodontic patients report that pain commences during the first couple of hours of orthodontic force application, reaches peak intensity level after one day, and then eventually declines to normal levels after 7 days. [4][5][6][7] Bergius et al 5,6 report that the experience of pain varied substantially among subjects after elastic separators placement, suggesting BS variation in orthodontic pain perception. The authors further report that patient gender had a significant influence on orthodontic pain perception.…”

Pain experience during initial alignment with three types of nickel-titanium archwires: A prospective clinical trial

“…16 A similar finding was reported in another study; however, superelastic wires had a significantly higher pain at peak level. 18 When comparing conventional Nitinol wires to superelastic Sentalloy wires over 1 week following archwire placement, a significant difference in the overall pain response could not be found. 17 However, Fernandes et al 17 found that conventional Nitinol wires induced significantly higher pain levels than superelastic Sentalloy wires at 4 hours.…”

“…Few studies evaluated the pain intensity experienced by patients during the initial alignment stage of treatment with different archwires. [16][17][18] Bearing these studies in mind, there are no definite conclusions as to which archwire is associated with the least pain. 19 Therefore, the aim of this study was to evaluate the pain experience during the initial aligning phase of orthodontic treatment with three types of NiTi wires: superelastic NiTi, thermoelastic NiTi, and Nitinol aligning archwires.…”

Causes of Orthodontic Pain & its treatment: an overview

“…Among various age groups, children report pain lesser as compared to adults. In the same age group, females report greater pain experiences as compared to the males 7,8 . It is dependent upon various factors including sex, age, pain threshold, magnitude of force, and emotional status.The forces which are applied on teeth trigger an inflammatory response which involve factors which form the basis of tooth movement i.e.…”