Oral mucosal lesions during orthodontic treatment

Abstract

Orthodontic treatment carries a higher risk of mucosal lesions and implies greater awareness of better oral hygiene as shown by the results of this study. Oral hygiene instructions and early treatment of oral lesions are important considerations in better patient's motivation, treatment planning, and successful outcome.

Prostanoid-dependent spontaneous pain and PAR2-dependent mechanical allodynia following oral mucosal trauma

“…Unfortunately, many dental patients suffer from severe pain in the mechanical lesion caused by the intraoral appliance. 1–4 The pain mechanism underlying traumatic mucositis-induced pain elucidated in this study (Figure 6) suggests that some effective pain treatments will solve pain-related poor quality of life and low cooperation in therapy in dental patients. 7,8 According to the pain relief observed in the WiM model on day 1 following swab applications of various drugs, topical treatments of drug-containing ointment and mouthwash may be effective approaches for patients with mechanically induced ulcerative mucositis.…”

“…However, the transient mechanical injuries rapidly healed by the following day, which is inconsistent with clinical pain complaints. 1,8 Hence, we selected to install a thick wire in the oral cavity for one day to generate a traumatic ulcer. An orthodontic 10-mm-length wire (E00097, TRU-CHROME, 0.018 × 0.025 inch [0.457 ×0.635 mm]; Rocky Mountain Orthodontics, Denver, CO) was manually bent into the shape shown in Figure 1(a) and soldered to a ligature wire (506-02, preformed ligature wire, 0.25 mm in diameter; TOMY International Inc., Tokyo, Japan) at the first 50°-bended angle using a spot welder (Type 660; Rocky Mountain Orthodontics).…”

“…The incidence of mucositis has been reported to be 92% in denture patients and 63%–95% in general orthodontic patients. 1–4 Implantation of miniscrews in alveolar bone for orthodontic loading has been described to frequently cause traumatic lesions in the area in contact with the miniscrew. 5 Additionally, a clinical review has described abscess formation in orthodontic wire-induced trauma.…”

“…6 Even after removing the injurious parts of the appliance, the previously induced pain is maintained for a few days until healing, particularly during meals and conversations. 1,7,8 Some clinical studies have reported that mucosal trauma-associated pain leads to poor quality of life and decreased cooperation in therapy. 7,8 However, no studies have investigated the pathological properties and pain mechanisms responsible for mechanical trauma to the oral mucosa.…”

Effectiveness of a novel topical powder on the treatment of traumatic oral ulcers in orthodontic patients: A randomized controlled trial

“…The damaged epithelium is replaced by a yellow fibrinopurulent membrane surrounded by erythema 2 ; exposure of nerve endings can provoke a painful sensation. 3 The incidence of oral traumatic ulcers ranges between 60% and 81%. [4][5][6][7] Approximately 47% of adults report oral ulcerations as the most annoying aspect of orthodontic treatment 4 ; 29% of adolescents report ulcers as the second most annoying aspect of treatment.…”