The effect of twice and four activations per day of periodontal distractor on pain intensity and pulp vitality of maxillary canine

Abstract

Objectives No study has compared pain intensity and pulp vitality of both activation protocols of periodontal distractor (twice and four activations per day) for rapid canine retraction. Since the periodontal distractor may cause some degree of suffering for the patients and may affect pulp vitality, it is important for orthodontists to handle this situation in the best possible way by choosing the most effective and the least painful method of treatment. Therefore the aim of the present study was to evaluate the effect of twice and four activations/day of periodontal distractor on pain intensity and pulp vitality of maxillary canine. Methods The study was carried out on 32 canine of 16 female patients (16–22 years of age) requiring extraction of bilateral maxillary first premolars and maximum anchorage. They were divided into two groups. (Group I): Canine retraction was done by periodontal distractor with twice activations per day. (Group II): Canine retraction was done by periodontal distractor with four activations per day. Periodontal distractor was cemented after bilateral maxillary premolar extraction and inter septal bone corticotomy was done. Pain intensity was evaluated at different times by Visual Analogue scale (1st 48 hour after intervention, during each activation of the distractor, and on the Interval between activation).Pulp vitality was measured by electric pulp tester. Results Comparison of pain intensity between different intervals was performed by using Friedman`s test (non-parametric data) which revealed significant difference in both groups, as 1st 48 hours was significantly the highest (8.8 ± 0.77), (9.2 ± 0.77) followed by During each activation (5.4 ± 0.94), (6.9 ± 1.25), while Interval between activation (1 ± 1.03), (2.7 ± 1.38) regarding group I and II respectively. Comparison between both groups was performed by using Mann Whitney`s test (non-parametric), which revealed that there was significant difference during each activation and intervals between activations as group II was significantly higher than group I (P = 0.0001).None of the teeth reacted negatively to the electrical vitality test that was performed one month after the completion of the distraction procedure. There was no clinical sign of discoloration or pulpal pain in any tooth. Conclusion In this study, Pain intensity was y significantly higher in group II (four activations/ day) than group I (twice activations/ day). The pulp of the retracted canine teeth examined in this study for both groups was vital on both groups.