Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire

Abstract

Two nickel-titanium arch-wire types commonly used for initial tooth alignment were compared with regard to the pain/discomfort patients experience during the initial phase of tooth movement. The two arch wires used were a superelastic nickel-titanium alloy, 0.014 inch Sentalloy, Light (GAC International Inc. Central Islip, NY, USA) and a 0.014 inch Nitinol (Unitek, Monrovia, CA, USA), a conventional nickel-titanium aligning archwire. One hundred and twenty-eight consecutive patients attending an orthodontic university clinic and 2 private practices for routine placement of a fixed appliance were randomly assigned one of these 2 initial arch wires. Assessments of pain/discomfort were made daily by means of a 100 mm visual analog scale (VAS) over the first 7-day period after bonding. On the first day, recordings were made every hour for the first 11 hours. The results showed that the level of discomfort increased continuously every hour after the insertion of either a Sentalloy or a Nitinol as first arch wires, with a peak in the first night, remaining high on the second day and decreasing thereafter to baseline level after 7 days. During the first 10 hours it was apparent that the pain/discomfort experienced after placement of a Sentalloy was less than that found with the Nitinol archwire, although a significant difference could be found at 4 hours only. No significant gender-specific differences were found in either archwire group. A significant difference between the upper and lower dental arches was observed during the first 11 hours after placement of either a Sentalloy or a Nitinol arch wire, with the lower arch having the higher pain experience.

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

“…25,26 When compared to other pain/discomfort assessment methods like the verbal rating scales, VAS is more precise and demonstrates better sensitivity between small changes in pain intensity. 27,28 The general time-course of pain intensity concurs with previous studies as the pain level peaked within the first 2 days after archwire insertion, and then gradually declined to near baseline levels 6 to 7 days postoperatively, 4,5,16,17 which indicates that any differences in pain/discomfort are likely to be minimal after 7 days. This observed pain time-course correlates well with the underlying biologic response to orthodontic forces.…”

“…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. Similar to our study, Jones and Chan 16 and Fernandes et al 17 used a visual analog scale to evaluate the pain intensity.…”

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

“…17 However, Fernandes et al 17 found that conventional Nitinol wires induced significantly higher pain levels than superelastic Sentalloy wires at 4 hours. Similar to our study, Jones and Chan 16 and Fernandes et al 17 used a visual analog scale to evaluate the pain intensity. VAS is one of the most commonly used tools in the measurement of the perceived discomfort during orthodontic treatment.…”

“…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.…”

A randomized controlled trial of self-perceived pain, discomfort, and impairment of jaw function in children undergoing orthodontic treatment with fixed or removable appliances

“…1,2 Pain starts about 4 hours after insertion of the appliance, peaks between 12 hours and 3 days after insertion and then decreases for up to 7 days. [2][3][4][5] Almost all patients (95%) report and suffer pain or discomfort 24 hours after insertion of fixed appliances, and fixed appliances may produce higher pain responses than removable appliances. [6][7][8] Pain scores tend to be higher in anterior than in posterior teeth.…”