The pain and discomfort experienced during orthodntic treatment: A randomized controlled clinical trial of two intial aligning arch wires

Objective: To compare the effectiveness of preoperative administration of ibuprofen and piroxicam on orthodontic pain experienced after separator placement. Materials and Methods: Ninety patients aged between 13 years 9 months and 18 years 2 months who were to undergo fixed appliance orthodontic treatment were enrolled in this double-blind, parallel-arm, prospective study. Patients were evenly and randomly distributed to any of three experimental groups, as follows: (1) administration of placebo, (2) administration of 400 mg ibuprofen, and (3) administration of 20 mg piroxicam; medications were administered 1 hour before separator placement. The pain perceived was recorded by the patients on a linear and graded Visual Analogue Scale at time intervals of 2 hours; 6 hours; nighttime on the day of appointment; 24 hours after the appointment; and 2 days, 3 days, and 7 days after separator placement during each of the four activities (viz, chewing, biting, fitting front teeth, and fitting back teeth). Results:The results revealed that preoperative administration of 20 mg of piroxicam 1 hour prior to separator placement resulted in a significant decrease in pain levels at 2 hours, 6 hours, nighttime, and 24 hours and on the second and third days after separator placement, compared to patients on a placebo or ibuprofen. Conclusions: Premedication with 20 mg of piroxicam results in significantly decreased pain experienced, compared to premedication with 400 mg of ibuprofen or placebo. Usage of 20 mg of piroxicam 1 hour prior to separator placement is recommended. (Angle Orthod. 2011;81:1097-1102

Section: Introductionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Effectiveness of piroxicam and ibuprofen premedication on orthodontic patients' pain experiences

Kohli

2011

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Abdelrahman

Al-Nimri

Maaitah

2015

Objective: To clinically evaluate the pain intensity during the week following initial placement of three different orthodontic aligning archwires. Materials and Methods: A consecutive sample of 75 patients requiring upper and lower fixed orthodontic appliances were alternately allocated into three different archwires (0.014-inch superelastic NiTi, 0.014-inch thermoelastic NiTi or 0.014-inch conventional NiTi). Assessments of pain/discomfort were made on a daily basis over the first 7-day period after bonding by means of visual analog scale and consumption of analgesics. The maximum pain score was recorded. The possible associations between age, gender, degree of crowding, and teeth irregularity and the pain intensity were also examined. Demographic and clinical differences between the three groups were compared with chi-square test or analysis of variance (ANOVA) test. Results: No statistically significant differences were found in the pain intensity when the three aligning NiTi archwires were compared (P 5 .63). No significant differences in pain perception were found in terms of gender, age, lower arch crowding, and incisor irregularity. The intake of analgesics was the least in the superelastic NiTi group. Conclusions: The three forms of NiTi wires were similar in terms of pain intensity during the initial aligning stage of orthodontic fixed appliance therapy. Gender, age, and the degree of crowding have no effect on the perceived discomfort experienced by patients undergoing fixed orthodontic treatment. (Angle Orthod. 2015;85:1021-1026

“…1 Orthodontic pain has been proved to be associated with substance P, calcitonin gene-related peptide, and up-regulation of c-fos in the trigeminal system, and it has been characterized as inflammatory pain, 2 which is innervated mainly by the primary sensory neurons of the trigeminal ganglion (TG). 3 However, orthodontic pain control is a great challenge clinically, largely as a result of the fact that the mechanism regulating tooth movement pain is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Chemokine ligand 2 in the trigeminal ganglion regulates pain induced by experimental tooth movement

Yang

Luo

Wang

et al. 2014

Objective: To test the hypothesis that the chemokine ligand 2/chemokine receptor 2 (CCL2/ CCR2) signaling pathway plays an important role in pain induced by experimental tooth movement. Materials and Methods: Expression of CCL2/CCR2 in the trigeminal ganglion (TG) was determined by Western blotting 0 hours, 4 hours, 1 day, 3 days, 5 days, and 7 days after tooth movement. CCL2 localization and cell size distribution were revealed by immunohistochemistry. The effects of increasing force on CCL2 expression and behavioral changes were investigated. Furthermore, the effects of CCL2/CCR2 antagonists on these changes in pain behaviors were all evaluated. Exogenous CCL2 was injected into periodontal tissues and cultured TG neurons with different concentrations, and then the pain responses or c-fos expression were assessed. Results: Experimental tooth movement led to a statistically significant increase in CCL2/CCR2 expression from day 3 to day 7, especially in small to medium-sized TG neurons. It also triggered an increase in the time spent on directed face-grooming behaviors in a force magnitudedependent and CCL2 dose-dependent manner. Pain induced by experimental tooth movement was effectively blocked by a CCR2 antagonist and by CCL2 neutralizing antibody. Also, exogenous CCL2 led to an increase in c-fos expression in cultured TG neurons, which was blocked by CCL2 neutralizing antibody. Conclusions: The peripheral CCL2/CCR2 axis is modulated by experimental tooth movement and involved in the development of tooth movement pain. (Angle Orthod. 2014;84:730-736.)