Abstract
The aim of this study was to compare pain and its relationship with the oral quality of life of patients with different types of orthodontic appliances: conventional and conventional low-friction brackets, lingual brackets, and aligners. A prospective clinical study was carried out with a sample size of 120 patients (54 men, 66 women) divided into 4 groups of 30 patients each. The modified McGill questionnaire was used to measure pain at 4, 8, and 24 h and 2, 3, 4, 5, 6, and 7 days after the start of treatment, and the Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure the oral-health-related quality of life (OHRQoL) in the first month of treatment. The maximum peak of pain was obtained between 24 and 48 h of treatment. It was found that patients in the lingual orthodontic group described lower levels of pain at all times analyzed, and their scores in the total OHIP-14 indicated less impact on their oral quality of life (1.3 ± 1.2, p < 0.01) compared with the other groups analyzed. There was little difference with the aligners group (Invisalign) (1.7 ± 1.9, p < 0.01). The technique used influences the pain and quality of life of patients at the start of orthodontic treatment.
Highlights
Regarding orthodontic treatment, around 90% of patients state that pain and discomfort are the main drawbacks [1]
At 24 h and 7 days after treatment, we found statistically significant differences (p < 0.05), with the low-friction bracket group presenting the highest level of pain (5.6 ± 2.0 and 0.8 ± 1.6, respectively) and the lingual bracket group presenting the least pain (4 ± 1.9 and 0.04 ± 0.2)
We found higher scores in the low-friction group, with a greater negative impact compared with the lingual bracket group at the levels of psychological discomfort (LF: 1.3 ± 0.8, LO: 0.03 ± 0.2, p < 0.01), psychological disability (LF: 0.8 ± 0.9, LO: 0.0 ± 0.0, p < 0.01), and social disability (LF: 0.3 ± 0.5, LO: 0.0 ± 0.0, p < 0.05), as well as for the total impact scores (LF: 4.5 ± 2.8, LO: 1.3 ± 1.2, p < 0.01)
Summary
Around 90% of patients state that pain and discomfort are the main drawbacks [1]. Patients report two types of pain: immediate pain related to periodontal compression and delayed pain related to the inflammatory response [1]. This increase, or pain peak, at the start of treatment occurs mainly 24 h after the placement of elastics and/or fixed multibracket appliances [7,8]. It decreases until reaching minimum values after 7 days [8,9,10]. The pain is of moderate intensity during active chewing of hard and fibrous foods and of mild intensity during chewing of soft foods and brushing [4,5]
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