Abstract
The aim of this study was to evaluate the perception of periodontal pain in patients treated with either fixed multibrackets or removable alignment systems with a monthly follow-up over a period of twelve months. Materials and Methods: This longitudinal clinical study comprised a sample of 140 patients (72 women; 68 men) divided into two groups of 70 patients each: the bracket group (BG) with conventional fixed brackets using the MBT technique with a 0.022″ slot and the Invisalign group (IG) with aligners (Invisalign). The visual analog scale (VAS) was used to quantify patient-reported pain. Pain analysis was conducted monthly at 4 (T1), 8 (T2), and 24 h (T3) post-follow-up as well as at 2 (T4), 3 (T5), 4 (T6), 5 (T7), 6 (T8), and 7 days (T9) post-follow-up during the first twelve months after starting orthodontic treatment. Results: Statistically significant differences (p < 0.05) were observed between both study groups in the mean pain scores on the visual analog scale (VAS) during the twelve-month follow-up period, except for during the eighth month of treatment. In the first month, the group with conventional brackets reported higher pain scores. From the second month onwards, we observed that patients with aligners described a higher level of pain compared to the group of patients with conventional brackets. In both experimental groups, though at different evaluation periods, we found that the peak of maximum pain occurred between 24 and 48 h (T3–T4) after monthly follow-up appointments; from this point, the pain decreased until reaching minimum values from the fifth day onwards (T7). Conclusions: In the first month of treatment, the patients with conventional fixed multibrackets reported the highest levels of pain compared to those with removable aligners. From the second month on, this trend changed. The patients with removable aligners reported the highest levels of pain. Therefore, the orthodontic system used influenced the perception of pain in patients.
Highlights
The painful and uncomfortable experiences described by orthodontic patients are common side effects related to dental therapy involving either fixed multibrackets braces or plastic aligners
From the second month onwards, we observed that patients with aligners described a higher level of pain compared to the group of patients with conventional brackets
Though at different evaluation periods, we found that the peak of maximum pain occurred between 24 and 48 h (T3–T4) after monthly follow-up appointments; from this point, the pain decreased until reaching minimum values from the fifth day onwards (T7)
Summary
The painful and uncomfortable experiences described by orthodontic patients are common side effects related to dental therapy involving either fixed multibrackets braces or plastic aligners. The maximum peak of pain described by patients was observed within the first 24 h after starting treatment and gradually decreased from the second day and onward [1]. Pain is a subjective experience that is influenced by a patient’s age, sex, or emotional factors. It has a negative effect on patient oral hygiene and compliance that may be indicated during orthodontic treatment. Specialists have underestimated the level of pain perceived by patients during treatment [2]. Published studies on pain during orthodontic treatment have concluded that the majority of patients, between 91% and 95%, have described significant discomfort and pain during orthodontic treatment, regardless of the techniques used [3,4]
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