Aligning Effectiveness, Secretion of Interleukin 1β and Pain Control During Fixed Orthodontic Treatment with Self-Ligating Appliances and Supplemental Vibrational Appliances. A Randomized Controlled Clinical Trial

Abstract

Aims: The aims of the present study were to investigate rate of mandibular incisors alignment, levels of IL-1β and pain and discomfort during orthodontic alignment with the following: 1) conventional-ligating appliance (CLA); 2) self-ligating appliance (SLA); 3) self-ligating appliance combined to vibrational appliance (SLA-VA). Methods: This was a three-armed parallel group randomized clinical trial with allocation ratio 1:1:1. The main inclusion criteria were: full permanent dentition, age below 25 years, no missing teeth, first skeletal and molar class, non-extraction treatment, Little's Irregularity Index (LII) from 3mm to 6mm. The main outcomes were rate of mandibular incisors alignment, concentration of IL-1β and pain and discomfort. Measurements on models were performed at appliance placement (t0) and at monthly intervals for the first 3 months (T1, T2, T3), whereas IL-1β levels were measured at weekly intervals for the first 3 weeks (t1, t2, t3). Differences between groups for normally-distributed variables were initially estimated through Analyses of Variance (ANOVAs) tests, followed by Post-Hoc Scheffe analysis for pair wise comparisons. Results: Thirty-three patients were recruited and randomized with no lost to follow-up. During the first two months, faster alignment was observed for SLA (P=0.0491) and SLA-VA (P=0.0134) compared to CLA. At each time-point of measurement no differences were observed between SLA and SLA-VA. At t1 and t2 were found higher values of IL-1β for SLA-VA compared to SLA (P=0.0209, P=0.0352) and CLA (P=0.0018, P=0.0029), whereas at t3 the difference persisted only versus CLA (P=0.0304). No relevant differences in terms of pain and discomfort were observed between groups at any time point. Conclusions: Self-ligating appliances seem to perform better than conventional-ligating appliances in terms of timing of teeth leveling and alignment. Vibrational devices seem to enhance secretion of IL-1β but do not increase effectiveness of leveling and alignment with regard to treatment acceleration or pain reduction.

Bruxism Influence on Volume and Interleukin-1β Concentration of Gingival Crevicular Fluid: A Preliminary Study

“…The increase in IL-1 levels occurred both by direct and indirect applications of mechanical force to the teeth. A similar study concerning the determination of IL-1β concentrations in GCF from the fissure of lower incisal teeth in patients during orthodontic treatments with self-ligating braces was conducted by Kalemaj et al [38].…”

Impact of Vibration on the Levels of Biomarkers: A Systematic Review

“…In vitro studies [27][28][29][30][31] and different in vivo studies [32][33][34][35][36][37] ) conducted in the past using various biomarkers and vibration devices have reported mixed results.…”

“…Therefore, the study has an overall high risk of bias. Kalemaj et al 34 conducted a 3-armed parallel group RCT with the allocation ratio of 1:1:1. A sample of 33 patients was randomly categorized into 3 groups (conventional ligating appliance group, self-ligating appliance group, and selfligating appliance with accledent group).…”

“…They advocated that it is because of effects of various biomarkers being present in bone and GCF. Leethanakul et al, 32 Ahmed et al, 33 Kalemaj et al, 34 and Chouinard 37 evaluated the effect of interleukins, TNF-alpha biomarkers on tooth movements. In a study by Ahmed 35 effect of vibrating devices was analyzed on osteocalcin.…”

Effectiveness of Computer-Assisted Anesthetic Delivery System (Sta�) in Dental Implant Surgery: A Prospective Study

“…Recent studies have reported how dental anxiety is an understudied problem and have underlined the importance of implementing strategies to overcome such a common problem for both children and adult patients (2)(3)(4). Attempts to control dental pain and discomfort include a wide variety of psychological therapies and mechanical strategies, depending mainly on the type of dental treatment and structure of dental anxiety (5,6). Among the fear provoking objects, the sight and sensation of anesthetic needle remains one of the most relevant (7,8).…”