Archwire Placement Research Articles

Music for Pain Control Following Orthodontic Initial Archwire Placement

Background: Pain control is very important aspect of orthodontic practice. Aim: To compare the efficacy of music therapy for pain control following initial archwire placement in orthodontics. Methods: This randomized control trial was conducted at orthodontics department. The study consisted of 50 orthodontic subjects from 1.1.2019 to 1.30.2020. Purposive sampling technique was used. 25 were in control group while other 25 were randomly allocated to music group. The pain was recorded using VAS scale at multiple points of time following archwire placement. T-test was used for the statistical analysis. Results: The study found that there was insignificant difference in mean pain scores between the two groups with less pain scores in music group. Conclusion: Music can play an effective role in pain control following orthodontic initial bonding. Keywords: Music; Orthodontics.

Comparative Evaluation of Different Numerical Pain Scales Used for Pain Estimation during Debonding of Orthodontic Brackets.

Introduction Patients experience various levels of discomfort during orthodontic treatment, i.e., after placement of separators, orthodontic implant placement, and archwire placement and during debonding. Various pain control methods have been developed to relive pain during debonding, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Aim To analyse various pain scales commonly used to determine the effect of different pain control methods during debonding of orthodontic brackets. Study Design. A comparative cross-sectional study performed on a sample of 60 patients (n = 60) including 14 males and 46 females who were ready for debonding and who were divided into three groups, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Materials and Methods A 100 mm Visual Analog Scale (VAS) was used to record the pain intensity for each tooth. Another scale known as Pain Catastrophizing Scale (PCS) was used to evaluate the patient's general attitude towards pain perception. The armamentarium and operator were kept same for all the patients. Statistical analysis used was the Kruskal–Wallis test, used for intergroup and intragroup comparison of pain scores. Results Lowest total pain score was recorded in the FP group (P=0.043) on intergroup comparison, while on intragroup comparison, higher pain scores were recorded in lower anterior region (P=0.02) in all three groups. There was no significant difference between the pain scores reported by the male and female subjects. Conclusion FP is an effective method of pain control. And teeth in the anterior region of lower and upper arches are more sensitive to pain. In terms of cognitive-affective constructs, although the VAS has been widely used in previous studies, the PCS has been detailed to show the most reliable association with physical discomfort and emotional distress.

Photobiomodulation with 940 nm laser diode: effect on the interleukin 6 expression after orthodontic initial archwire activation

To evaluate the effect of photobiomodulation (PBM) during the initial stage of orthodontic treatment, measuring levels of IL-6 in gingival crevicular fluid (GCF), and comparing to a control group of teeth. Forty-four first premolars were orthodontically treated with passive self-ligation Damon Q (Ormco, Orange, CA, USA) brackets and 0.014 CuNiTi archwires. Sides were randomly assigned to a non-irradiated control group and experimental group (n = 22) treated with 940 nm, 0.1 W, and 2 J for 20s/surface. Gingival crevicular fluid was obtained before treatment and 24 h after; a third sample was obtained immediately after a second laser irradiation. IL-6 concentration was measured by enzymatic immunoassay. The basal concentration of IL-6 in the control group (3.194 ± 0.71 pg/μl) was higher than in the experimental group (2.923 ± 0.48 pg/μl) and was reduced 24 h after the initial archwire placement. In the experimental group of teeth, 24 h after and after the first laser application, the levels were lower. However, the values obtained following the second laser application, evaluating immediate effect, presented a mild increment. The difference between control and experimental groups after 24 h was significant. PBM with 940 nm, 0.1 W, 4 J, 21.05 J/cm2, and 40 s per tooth is not able to produce statistically significant changes in the concentration of IL-6 in GCF, immediately or after 24 h of its application, during initial orthodontic treatment with light forces.

Comparison of two different initial archwires for tooth alignment during fixed orthodontic treatment-A randomized clinical trial.

OBJECTIVES:The aim of the study was to clinically evaluate and compare 0.016-inch superelastic nickel–titanium (NiTi) and 0.016-inch heat-activated nickel–titanium (NiTi) archwires in terms of alignment efficiency, root resorption, and pain intensity.METHOD:A total of 20 patients requiring fixed orthodontic treatment, having Little's irregularity index of 5–8, and requiring first premolar extractions were recruited. They were randomly allocated to receive two different archwires (0.016-inch superelastic NiTi or 0.016-inch thermoelastic NiTi). Good-quality impressions were taken of the lower arch before archwire placement (T0) and at every month after that till the alignment was complete. The rate of tooth alignment was measured on casts by determining Little's irregularity index. The pain experienced by the patient was assessed 24 hours and 1 week after the placement of the archwire on a visual analogue scale. Cone beam computed tomographic radiographs of lower anterior teeth were taken before and after alignment to assess root resorption. Data obtained were subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%.RESULTS:The repeated measures ANOVA indicated that there was no significant difference in the aligning efficiency of superelastic and heat-activated NiTi wires. (p = 0.45). The Mann Whitney U test showed that superelastic NiTi wires had statistically significant higher VAS scores than heat-activated NiTi at 24 hours and 1-week interval (p < 0.05). Student's t-test indicated greater root resorption with superelastic NiTi but the difference was not statistically significant.CONCLUSION:Both the wires showed similar aligning efficiency and resulting root resorption. Superelastic NiTi was observed to produce more pain compared to heat-activated NiTi in the aligning phase.

Pulpal blood flow changes and pain scores related to using Superelastic 0.018-inch Nickel Titanium as the first orthodontic alignment archwire: a prospective clinical trial.

Background Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce.Objectives to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment.Methodology Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment.Results For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment – groups.Conclusions Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.

Low-level laser therapy effectiveness in reducing initial orthodontic archwire placement pain in premolars extraction cases: a single-blind, placebo-controlled, randomized clinical trial

BackgroundThe objective of this randomized clinical trial was to evaluate Low-Level Laser Therapy (LLLT) effectiveness in spontaneous and chewing pain reduction following initial orthodontic archwire placement.Methods26 patients (mean age 20.07 ± 3.13 years) with maxillary Little’s Irregularity Index (LII) of 7 mm or more that indicates first maxillary premolars extraction and no medications intake were eligible for this trial. Patients were randomly assigned with 1:1 ratio using simple randomization technique to receive either LLL or placebo treatment. Blinding was applicable for patients only. In the laser group, patients received a single LLL dose (wavelength 830 nm, energy 2 J/point) in four points (2 buccal, 2 palatal) for each maxillary anterior tooth root. Patients in the placebo group had the same laser application procedure without emitting the laser beam. Patients were asked to score spontaneous and chewing pain intensity by filling out a questionnaire with a 100-mm Visual Analogue Scale (VAS) after 1, 6, 24, 48, and 72 h of treatment application. Independent t-test was used to compare the mean pain scores between the laser and placebo groups for both spontaneous and chewing pain at each studied time point.ResultsNo dropout occurred so the results of the 26 patients were statistically analyzed. Despite some clinical differences observed between the two groups, no statistical significance was found for each studied time point (p > 0.05) for both spontaneous and chewing pain except after 72 h for chewing pain with a VAS score of (18.84 ± 13.44) mm for the laser group compared to (38.15 ± 27.06) mm for the placebo group.ConclusionsLLLT, with the suggested parameters, is not effective in pain reduction following initial orthodontic archwire placement.Trial registrationName of the registry:Clinicaltrials.govTrial registration number:NCT02568436.Date of registration: 26 September 2015 ‘Retrospectively registered’.

Pain and Oral Health Related Quality of Life among Patients Undergoing Fixed Orthodontic Treatment: A Descriptive Cross-sectional Study.

Fixed orthodontic procedures such as separator placement, archwire placement and activations, application of orthopaedic forces, and debonding of brackets produce pain in patients. This study was conducted to assess pain and oral health-related quality of life among patients undergoing orthodontic treatment. This descriptive cross-sectional study was conducted among 152 orthodontic patients of a teritary care center from January 2019 to October 2019 after receiving ethical approval from the Institutional Review Committee (Ref. no. 2311201813). Convenience sampling method was done to select the participants. Oral health-related quality of life using "Oral Health Impact Profile-14" and pain experienced during the first month of fixed orthodontic treatment were assessed. Data analysis for calculation of frequency and proportion was done in Statistical Package of Social Sciences. Mean pain score of the study participants was 5.05±2.07 and their mean oral health impact was 12.71±7.27. Most of the study participants 86 (56.58%), had experienced moderate pain due to orthodontic treatment. Out of the reported impacts, 134 (88.2%) had painful aching in mouth and 127 (83.6%) had difficulty during eating. Least impact was seen in alteration of taste 35 (23%). The pain intensity experienced by patients was variable. Most participants had moderate pain but few patients perceived no pain at all. The participants had at least one or other oral health impacts due to fixed orthodontic treatment. Orthodontists should counsel the patients regarding possible discomfort so that there is no discontinuation of treatment due to pain.

Application of computational fluid dynamics models for the evaluation of salivary flow patterns and related bacterial accumulation around orthodontic brackets.

To simulate and compare salivary flow patterns over a tooth surface bonded with different orthodontic appliances using computational fluid dynamics (CFD) and investigate the impact of bracket design on salivary flow in relation to peri-bracket bacterial accumulation. The models were constructed using computed tomography (CT) data of 81 patients scheduled for fixed orthodontic treatment: 27 patients (10 males, 17 females) for the metal Victory MBT™ bracket; 27 patients (seven males, 20 females) for the ceramic Clarity MBT™ bracket; 27 patients (15 males, 12 females) for the Mini Uni-Twin (MUT) bracket. The salivary flow patterns were simulated by CFD and compared between the groups and the model predictions were validated using a bacteriological experiment. The MUT bracket was associated with the greatest number of low salivary velocity areas, as it is designed with a connector between double tie wings and a right contact angle between tooth surface and bracket base. After archwire placement, the centred slot in the bracket and the bilateral sites around the bracket had higher bacterial retention and needed special oral hygiene measures. The obtuse contact angle of the ceramic bracket formed a pocket structure in the tie-wing area, retarding salivary flow and contributing to bacteria retention. With the evaluation of CFD models, we demonstrate that salivary flow patterns over a tooth surface with a bracket vary with bracket designs and further promote bacterial retention in specific locations, suggesting the need for additional oral hygiene measures for specific bracket types.

Comparative Assessment between Ibuprofen, Chewing Gum, and Bite Wafers in Pain Control Following First Arch Wire Placement in Orthodontic Patients

This study aimed to investigate the effectiveness of using bite wafers and chewing gum in relieving pain after the activation of the first archwire among Saudi orthodontic patients and evaluating them in comparison with ibuprofen use. Furthermore, the study investigated the effect of chewing gum and plastic wafers on the frequency of orthodontic appliance breakage. A total of 105 female patients aged 15-35 years, undergoing maxillary and mandibular fixed appliance treatment were classified randomly into three groups of 35 each. In each group, the patients were given one of the following treatments immediately after the placement of the first archwire, every 8 hours for 1 week as needed: ibuprofen (400 mg), or a viscoelastic bite wafer, or chewing gum. A visual analog scale was given to the patients to record their pain perception following initial archwire placement. In addition, the patients were asked to report any incidence of detached brackets while using the above methods. Data were analyzed using analysis of variance (ANOVA). No statistically significant differences were found in pain perception at any time interval among the three groups. The pain experienced at bedtime and 24 hours after wire placement among different groups in the present study was found to be slightly higher with maximum intensity and the pain perception finding at different time intervals within each pain relief method was statistically significant (p = 0.000, p < 0.05). Furthermore, ANOVA results demonstrate no significant differences in bracket detachment between the groups (p = 0.20, p < 0.05). The use of bite wafers and chewing gum was effective and comparable to ibuprofen use for pain relief following the initial activation of fixed orthodontic appliances among Saudi orthodontic patients. In addition, the study found no clinically or statistically significant differences in bracket detachment between the groups. The nondrug modalities of controlling pain such as chewing gum and/or bite wafers can be used as an alternative to ibuprofen use following the first activation of fixed orthodontic appliances.

Comparison of chewing gum and ibuprofen in alleviating orthodontic pain: a single centre, randomised clinical trial

Abstract Background The aim of the present three-arm parallel trial was to compare the effectiveness of chewing gum and ibuprofen in the control of orthodontic pain. Methods Patients to undergo orthodontic treatment at a private orthodontic clinic were randomly divided into three parallel groups, each of which took either a placebo, ibuprofen or chewing gum. The eligibility criteria included patients in the full permanent dentition with moderate crowding requiring the extraction of two mandibular and two maxillary premolars. The main outcome was the patient’s level of discomfort, which was assessed by a 0–10 numeric rating scale (NRS) at two hours, six hours, at bedtime, 24 hours, two days, three days and seven days after the placement of initial arch wires in four functions including chewing, biting, occluding back teeth, and occluding front teeth. Randomisation was accomplished according to the patient’s clinic entrance number and by using a table of random numbers. The patients in the placebo and ibuprofen groups were blinded to the type of medication used. The differences in the groups were analysed using repeated measures ANOVA. Results Sixty-six patients between 12 and 30 years were randomised in a 1:1:1 ratio. The pain questionnaire response rate was 100% in the three groups, but six patients were excluded and consequently 60 patients were analysed (N = 20 in each group). There was no significant difference between the chewing gum and ibuprofen groups during any oral function at any time point (p &gt; 0.05). However, repeated measures ANOVA showed that patients in the placebo group experienced significantly higher pain scores compared with patients in the ibuprofen and chewing gum groups at two hours, six hours, at bedtime, at 24 hours and two days after initial arch wire placement (p &lt; 0.05). No patient harm was observed in this study. Conclusions In contrast to the common orthodontic belief that gum chewing may lead to bracket breakage, it seems that chewing gum is as beneficial as medication for pain relief and can be a recommended alternative during orthodontic treatment.

Low-level laser-aided orthodontic treatment of periodontally compromised patients: a randomised controlled trial

Low-level laser irradiation (LLLI) shows effects in orthodontic pain relief and periodontal inflammation control. The aim of this article is to investigate the analgesic and inflammation-modulatory effects of low-level laser irradiation among orthodontic patients with compromised periodontium. A randomised controlled trial with split-mouth design was conducted in 27 adults with treated and controlled chronic periodontitis over 6 months. One side of the dental arch underwent repeated treatment under a 940-nm diode laser (EZlase; Biolase Technology Inc.) with a beam size of 2.8 cm2 for 60 seconds at 8.6 J/cm2, whilst the other side received pseudo-laser treatment. Laser irradiation was applied repeatedly for 8 times during the first 6 weeks after bracket bonding and monthly thereafter until the end of orthodontic treatment. Subjective pain (assessed by visual analogue scale in pain diary and by chairside archwire activation), periodontal status (assessed by periodontal clinical parameters), cytokines in gingival crevicular fluid (interleukin 1β, prostaglandin E2, substance P) and periodontopathic bacteria (Porphyromonas gingivalis and Treponema denticola) in supragingival plaque were assessed. The intensity of pain was lower on the laser-irradiated side at multiple follow-up visits (P < 0.05). The pain subsided 1 day earlier on the laser side, with a lower peak value during the first week after initial archwire placement (P < 0.05). The laser side exhibited a smaller reduction in bite force during the first month (mean difference = 3.17, 95% CI: 2.36–3.98, P < 0.05 at 1-week interval; mean difference = 3.09, 95% CI: 1.87–4.32, P < 0.05 at 1-month interval). A smaller increase was observed in the plaque index scores on the laser side at 1-month (mean difference = 0.19, 95% CI: 0.13–0.24, P < 0.05) and in the gingival index scores at the 3-month follow-up visit (mean difference = 0.18, 95% CI: 0.14–0.21, P < 0.05). Laser irradiation inhibited the elevation of interleukin-1β, prostaglandin E2 and substance P levels during the first month (P < 0.05). However, no intergroup difference was detected in the bacteria levels. Low-level laser irradiation exhibits benefits in pain relief and inflammation control during the early stage of adjunctive orthodontic treatment in periodontally compromised individuals.

A comparative assessment of clinical efficiency between premium heat-activated copper nickel-titanium and superelastic nickel-titanium archwires during initial orthodontic alignment in adolescents: a randomized clinical trial

BackgroundTo compare the clinical efficiency of premium heat-activated copper nickel-titanium (Tanzo Cu-NiTi) and NT3 superelastic NiTi during initial orthodontic alignment.Subject and methodsA total of 50 patients were randomly allocated to 1 of 2 different archwire types (group 1, Tanzo Cu-NiTi; group 2, NT3 superelastic NiTi). Eligibility criteria included Class I or Class II malocclusion, moderate maxillary anterior crowding, and healthy periodontal condition. Impressions of the upper arches were taken before archwire placement (T0) and at every 4 weeks (T1, T2, T3, and T4). For T1 and T2 stages, 0.014-in., and for T3 and T4 stages, 0.018-in. archwires were used. The primary outcome was the alignment efficiency assessed using Little’s irregularity index. The secondary outcomes were arch width and incisor inclination changes. Data were analyzed using independent samples t test, repeated measures ANOVA, and Mann-Whitney U test. Marginal models were established for the estimation of coefficients.ResultsThe anterior irregularity index reduction was mostly observed between T0 and T2 periods, which were respectively − 7.40 ± 0.50 mm (p < 0.001; 95% CI, − 8.94, − 5.85) and − 6.80 ± 0.55 mm (p < 0.001; 95% CI, − 8.49, − 5.12) for groups 1 and 2 (p < 0.001). With both wires, Little’s irregularity index decreased over time, and the difference between the groups was not significant (p = 0.581; estimated effect size, 0.011). No statistically significant difference was found between the groups in terms of intercanine and intermolar width and incisor inclination changes.ConclusionThere were no significant between-group differences in alignment efficiency, arch width, and incisor inclination change. There was an increased alignment with 0.014-in. compared with 0.018-in. diameter archwire.

Comparison of Patient-reported Pain After Initial Archwire Placement

Comparison of Patient-reported Pain After Initial Archwire Placement

Assessment of Pain, Anxiety, and Cortisol Levels During the Initial Aligning Phase of Fixed Orthodontic Treatment.

We assessed pain and anxiety using psychological testing instruments (State-Trait Anxiety Inventory for Children, visual analog scale) and a physiological testing instrument (salivary cortisol hormone level) after the insertion of orthodontic appliances and during the initial alignment phase of orthodontic treatment. The study group involved two groups matched according to age and gender. Group 1 used 0.016-, 0.016×0.016-, and 0.16×0.22-inch and Group 2 used 0.014-, 0.016-, and 0.016×0.016-inch superelastic nickel-titanium archwires in the initial alignment phase of treatment. Pain and anxiety instruments were applied, and saliva samples were collected from the patients before and after molar band insertions, and bracket and initial archwire placement, and 7 days after the initial bonding and archwire replacements. Cortisol levels and state anxiety scores revealed statistically significant differences within groups (p<0.01, p<0.05). No significant differences were found between Group 1 and Group 2 in cortisol hormone levels, anxiety scores, or pain measurements (p>0.05). Although not statistically significant, the most severe pain was measured in the posterior teeth after band insertion and in the anterior teeth after the first archwire insertion (p>0.05). Orthodontic appliances and the initial alignment phase of orthodontic treatment affect patients' anxiety and cortisol hormone levels. Both archwires were equally effective with regard to perceived pain, anxiety, and stress hormone levels.

Effectiveness of different psychological interventions in reducing fixed orthodontic pain: A systematic review and meta-analysis

Abstract Background/Objective Pain induced by tooth movement is a common experience for orthodontic patients. The effectiveness of psychological intervention, as a new approach to control pain, has not been fully explored. Hence, this systematic review and meta-analysis is intended to evaluate the analgesic effect of psychological intervention within the week after fixed orthodontic initial arch wire placement. Methods A computerised literature search was conducted in the Medline (1966-2019), Embase (1984-2019), Cochrane Library (Issue 1 of 2019), CBMdisk (1978-2019) and CNKI (1994-2019) databases to identify randomised clinical trials (RCTs), which used psychological interventions to relieve pain during fixed orthodontic treatment. Specific inclusion and exclusion criteria were applied to identify relevant articles. The data were extracted independently by two reviewers and a quality assessment was carried out by using the Cochrane Collaboration ‘risk of bias’ tool. Meta-analyses were conducted with fixed or random effects models as appropriate. Statistical heterogeneity was also examined. The RevMan 5.3 software was used for data analysis. Results A total of 472 articles were identified, from which nine RCTs were finally included. A meta-analysis revealed that after initial arch wire placement, cognitive behaviour therapy (CBT) and music therapy could significantly reduce pain within three days compared with a control group. In addition, there were no differences in pain reduction between CBT and music therapy within one week. Furthermore, a structured phone and text follow-up could significantly reduce and control pain and had the same effectiveness in pain reduction. Conclusions In the short term after initial arch wire placement, all psychological interventions could significantly reduce the intensity of pain without adverse effects. In the current study, there was no significant difference in pain relief between the different psychological interventions. In the future, more high-quality research with consistency in research design is needed for further evaluation.

Evaluation of stress biomarkers and electrolytes in saliva of patients undergoing fixed orthodontic treatment.

The aim of this study was to test the hypothesis that treatment with orthodontic appliances evokes significant functional limitations and emotional stress, which can be detected by salivary biomarkers. Twenty subjects (10 men and 10 women) who underwent orthodontic treatment were included in this prospective study. Saliva was sampled for detection of alpha-amylase activity and cortisol levels at three different times: before bracket placement (T0), 24 hours after archwire placement (T1), and 30 days after archwire placement (T2). The saliva electrolytes concentrations of calcium, phosphorus, magnesium, sodium and potassium were also evaluated. Moreover, the possible functional limitations of the appliances were evaluated by a masticatory performance test and pain experience registration. All variables were compared with those in a control group with normal occlusion. The orthodontic patients exhibited a significant increase in emotional stress as detected by the alpha-amylase activity at T1, the period in which patients reported the higher values of pain and exhibited the lower masticatory performance indices. The basal salivary cortisol was not affect by the treatment and the main change detected in electrolyte concentration was a sodium reduction, when these patients were compared to controls. The present data indicate that orthodontic patients are under emotional stress only during the period of higher pain experience, which could also disrupt the masticatory performance. However, these alterations were not correlated with a single measurement of stress-related biomarkers in saliva, suggesting that these solitary endocrine measurements are not adequate to predict the temporary pain and masticatory limitation experimented by patients undergoing orthodontic treatment.

Pulsed electromagnetic field seems to decrease pain levels in females from 24 through 72 hours after initial archwire placement

Jung JG, Park JH, Kim SC, et al. Effectiveness of pulsed electromagnetic field for pain caused by placement of initial orthodontic wire in female orthodontic patients: a preliminary single-blind randomized clinical trial. Am J Orthod Dentofacial Orthop. 2017;152(5):582-591. .

Pain and chewing sensitivity during fixed orthodontic treatment in extraction and non-extraction patients.

The aim of this study was to evaluate the differences in pain perception and chewing sensitivity between extraction and non-extraction patients. Thirty orthodontic patients (11 males, 19 females) were included in this study who were classified as extraction (n=15; 6 males, 9 females) and non-extraction patients (n=15; 7 males, 8 females). The mean age of patients were 15.10±1.83 years in non-extraction group and 15.44±0.75 years in extraction group. The patients were asked to complete the Visual Analogue Scale (VAS) questionnaire and they were asked to mark the presence or absence of sensitivity during 7 days after the first arch wire placement. Pain intensity comparison between groups was performed using the Mann-Whitney U test. The Friedman test was used to analyze within-group differences over time. There were no significant differences in pain scores between the groups. Pain levels significantly decreased between day 1 and day 3 in both the groups. No differences were found in the chewing sensitivity between the non-extraction and extraction groups. No difference in the pain perception was observed between the extraction and non-extraction patients during the 7 days after arch wire placement.

Validating the factor structure and testing measurement invariance of modified Short-Form McGill Pain Questionnaire (Ortho-SF-MPQ) for orthodontic pain assessment.

To validate the factor structure of recently modified Short-Form McGill Pain Questionnaire (Ortho-SF-MPQ) to assess orthodontic pain; and to test its Measurement Invariance (MI) across gender. 180 orthodontic patients were enrolled in this study. 0.016 inch Super-elastic NiTi arch wire was used in 0.022″ × 0.028″ slot pre-adjusted edgewise appliance. After initial arch wire placement, pain was assessed at T1 (24 hours), T2 (day 3), and T3 (day 7) by using the Ortho-SF-MPQ which consists of seven sensory (pressure, sore, aching, tight, throbbing, pulling, miserable) and four affective (uncomfortable, strange, frustrating, annoying) descriptors. Confirmatory factor analysis (CFA) models were fitted for analysis. Multiple-groups CFA (MG-CFA) approach was used for MI testing. Data from 172 patients (85 male, 87 female) with mean age 14.2 years (SD 1.4) was analysed. CFA model fit indices value at T1 (RMSEA 0.048; CFI 0.995; TLI 0.995), T2 (RMSEA 0.051; CFI 0.998; TLI 0.997), and T3 (RMSEA 0.040; CFI 0.998; TLI 0.998) confirmed the validity of two-factor structure of Ortho-SF-MPQ in assessing orthodontic pain. MG-CFA model based non-significant scaled chi-square difference test (Satorra-Bentler method) for weak invariance (T1: χ2 = 6.566, df = 9, p = 0.682; T2: χ2 = 14.637, df = 9, p = 0.101; T3 (χ2 = 14.248, df = 9, p = 0.114) and strong invariance (T1: χ2 = 25.874, df = 20, p = 0.170; T2: χ2 = 25.052, df = 20, p = 0.199; T3: χ2 = 18.889, df = 20, p = 0.529) confirmed MI across male and female groups. Two-factor structure (sensory and affective) of Ortho-SF-MPQ is structurally valid and invariant to measure pain in male and female orthodontic patents after initial arch wire placement.

Decrowding of lower anterior segment with and without photobiomodulation: a single center, randomized clinical trial.

The aim of this study was to evaluate the effect of low-level light therapy using light-emitting diodes (LEDs) on the speed of tooth movements that were required for the leveling and aligning of the lower anterior segment during non-extraction orthodontic treatment. The sample was comprised of patients (n = 40) with lower anterior crowding who were treated with self-ligating orthodontic brackets and a standardized wire sequence. A test group of patients (n = 20) who were treated with extraoral infrared light therapy for 20min daily with at least 80% compliance was compared to a control group (n = 20). The date of the first arch wire placement was recorded as T1, and the date of the completion of the lower anterior segment decrowding was recorded as T2. A final impression was also taken at T2. The time between T1 and T2 was significantly reduced by 22% in the test group compared to the control group (68.3 vs. 87.8days, respectively, p < 0.043). The use of photobiomodulation for 20min daily at a wavelength of 850nm might reduce the time required to resolve lower anterior crowding. This trial and its protocol were not registered on a publicly accessible registry.