Initial Archwire Research Articles

Effectiveness of Transcutaneous Electric Nerve Stimulation for Controlling Pain after the Archwire Placement

Introduction: The aim of the study was to evaluate the effectiveness of transcutaneous electric nerve stimulation (TENS) for controlling pain after the archwire placement and then comparison between the placebo, extra-oral, and intra-oral group depending upon the electrode placement. Materials and Methods: The study consists of a sample size of 90 patients who were further divided into three groups. Each group had 30 samples each, and the groups were divided into placebo group, extra-oral TENS group, and intra-oral TENS group. TENS application was done after the bonding and ligation of initial archwire. The patients were asked to record the level of pain on a VAS form at 4 hours, 8 hours, 12 hours, 24 hours, and 48 hours interval. Result: On comparison of VAS of all the three groups at 8 hours intervals significant result (P = 0.037) has occurred. Individual intra-group comparison has also shown some significant result. Conclusion: TENS being a non-pharmacological, non-invasive method for controlling pain is found to be effective. Both the extra-oral and intra-oral applications are effective.

Low-level laser therapy and laser acupuncture therapy for pain relief after initial archwire placement : Arandomized clinical trial.

Pain is among the most unpleasant experience during fixed orthodontic therapy. This study compared the effectiveness of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in pain reduction after initial archwire placement. This randomized, parallel-group, single-blind clinical trial included 60female patients who required four premolar extractions to relieve crowding. The subjects were randomly designated into four groups of 15. After placement of the initial orthodontic archwire, patients in group1 took ibuprofen (400 mg), whereas those in group2 received LLLT (808 nm, 200 mW, 2 J/cm2) on both buccal and lingual sides of the teeth. In group3 (LAT), the laser (808 nm, 200 mW, 24 J/cm2) was applied bilaterally to acupuncture points (SI18, ST6, LI4, SJ2, and SJ5). Subjects in group4 received placebo laser treatment. Patients were requested to record the intensity of spontaneous pain, pain while biting with anterior teeth, and pain while biting with posterior teeth at different times using avisual analogue scale (VAS). The intensity of spontaneous and biting pain increased up to the first or second days following initial archwire placement and diminished to anegligible value by the seventh day. No significant difference was found between the study groups concerning spontaneous and biting pain at any timepoint of investigation (P > 0.05). With the protocols used in the study, low-level laser therapy and laser acupuncture therapy were as effective as ibuprofen and placebo laser treatment for pain reduction in orthodontic patients. IRCT, IRCT20200622047886N1. Registered 2020-06-29; https://www.irct.ir/trial/49121.

Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study.

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation. This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance. The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding. The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Comparison of Pain Levels on Patients Undergoing Fixed Orthodontic Treatment with 2 Different Self-Ligating Bracket Systems.

Comparison of pain levels of patients treated with 2 different passive self-ligating bracket systems right after initial archwire placement. A total of 34 patients with mild crowding were allocated randomly to 2 groups to be treated using 2 different self-ligating brackets. 0.014 inch copper nitinol and 0.014 inch superelastic nitinol archwires were selected as the initial archwire for Damon Q and SmartClip SL3 systems respectively. Seven page questionnaires that consisted of 3 visual analogue scales were handled to patients to mark their pain levels while chewing, biting with anterior teeth, and biting with posterior teeth at 2nd hour, 6th hour, 2nd day, 3rd day, and 7th day time intervals. Pain scores were measured manually using a ruler and noted. The SmartClip group reported less pain at the 2nd and the 6th hours while chewing. Pain levels were the highest at the 6th h and the 2nd day for the Damon Q and SmartClip SL3 groups respectively. The SmartClip group reported more pain for the first two days, and after the 2nd day, pain scores were very similar to the Damon group. No statistically significant differences were reported between the groups. The highest pain sensation was reported for the 2nd day and decreased toward the 7th day. The SmartClip SL3 group reported lower pain scores in the first two days, but the levels were equaled on the 2nd day and after.

Investigation of Forces and Moments during Orthodontic Tooth Intrusion Using Robot Orthodontic Measurement and Simulation System (ROSS).

The Robot Orthodontic Measurement and Simulation System (ROSS) is a novel biomechanical, dynamic, self-regulating setup for the simulation of tooth movement. The intrusion of the front teeth with forces greater than 0.5 N poses a risk for orthodontic-induced inflammatory root resorption (OIIRR). The aim was to investigate forces and moments during simulated tooth intrusion using ROSS. Five specimens of sixteen unmodified NiTi archwires and seven NiTi archwires with intrusion steps from different manufacturers (Forestadent, Ormco, Dentsply Sirona) with a 0.012″/0.014″/0.016″ wire dimension were tested. Overall, a higher wire dimension correlated with greater intrusive forces Fz (0.012″: 0.561-0.690 N; 0.014″: 0.996-1.321 N; 0.016″: 1.44-2.254 N) and protruding moments Mx (0.012″: -2.65 to -3.922 Nmm; 0.014″: -4.753 to -7.384 Nmm; 0.016″: -5.556 to -11.466 Nmm) during the simulated intrusion of a 1.6 mm-extruded upper incisor. However, the 'intrusion efficiency' parameter was greater for smaller wire dimensions. Modification with intrusion steps led to an overcompensation of the intrusion distance; however, it led to a severe increase in Fz and Mx, e.g., the Sentalloy 0.016″ medium (Dentsply Sirona) exerted 2.891 N and -19.437 Nmm. To reduce the risk for OIIRR, 0.014″ NiTi archwires can be applied for initial aligning (without vertical challenges), and intrusion steps for the vertical levelling of extruded teeth should be bent in the initial archwire, i.e., 0.012″ NiTi.

Evaluation of pain intensity with prostaglandin E2 biomarker and visual analog scale during initiation of orthodontic treatment: A prospective study

The aim of this study was to assess subjectively and objectively, at which timepoint the patient undergoing fixed orthodontic treatment will have maximum pain during the initiation of orthodontic treatment. A total of 22 patients (21 ± 2.7 years, [15 female and 7 male]) requiring extraction of maxillary first premolar participated in the study. Following bonding, an initial archwire of 0.016" NiTi was placed with a distal force of 100 g applied to the canines. The concentration of prostaglandin E2 (PGE2) in the gingival crevicular fluid was assessed at four time points: 1 hour before (T0); 24 hours (T1); 48 hours (T2); 72 hours (T3) after initial archwire placement. The pain intensity was recorded with visual analog scale. The concentration of PGE2 increased from T0 to T1. The highest concentration was observed at T2 following which there was a mild decline at T3. Statistically significant difference in the PGE2 concentration was observed between T0 to T1 and T1 to T2. The visual analogue scale (VAS) scores increased from T0 to T1. The highest score was observed at T2 followed by a decline at T3. A statistically significant difference in the VAS score was noted between T0 to T1 and T2 to T3. On correlating PGE2 and VAS score, a weak negative correlation was noted between T0 to T1 and no correlation was noted between T1 to T2 and T2 to T3. The patients experience maximum pain between 24 hours (T1) and 48 hours (T2) following initial archwire placement. The highest concentration of PGE2 and VAS score was observed at 48 hours (T2).

Effectiveness of tubular coaxial nickel-titanium and copper nickel-titanium orthodontic aligning archwires: A randomized clinical trial

This study aimed to compare tubular coaxial-NiTi and copper-NiTi orthodontic aligning archwires in terms of teeth alignment, patients' pain perception, and root resorption. Orthodontic patients aged 12 years or older, having Little's irregularity index (LII) of 5-9mm were randomly allocated to either the copper-NiTi group or tubular coaxial-NiTi group with a 1:1 allocation ratio. The archwire sequence was 0.014-inch followed by 0.018-inch for the copper-NiTi group and 0.016-inch followed by 0.018-inch for the tubular coaxial-NiTi group. Each archwire was left in place for eight weeks before progressing to the next size. Good quality impression for the lower arch before treatment (T0) and thereafter every 4 weeks up to 16 weeks was taken to measure LII. Evaluation of pain perception was performed using a visual analog scale (VAS) during the first week following each archwire insertion. Assessment of root resorption was undertaken at T0 and after 16 weeks by taking periapical radiographs for mandibular central incisors using the long cone paralleling technique. A total of 33 patients were randomized and selected for participation. Of those, 31 patients with a mean age of 15.45±2.22 who completed the trial were included in the analyses (15 patients in the copper-NiTi group and 16 patients in the tubular coaxial-NiTi group). In both groups, the irregularity index significantly decreased after 16 weeks of treatment with an overall reduction of 5.22mm for the copper-NiTi group and 6.03mm for the tubular coaxial-NiTi group. However, the difference between the two groups was not statistically significant. Likewise, pain perception and root resorption were not significantly different between the two study groups. Both copper-NiTi and tubular coaxial-NiTi archwires were equally effective in terms of teeth alignment, patients' pain perception, and root resorption. Consideration could be given to the cost and clinician preference when selecting an initial archwire. the trial was registered in ClinicalTrials.gov on 26/05/2022 with a registration ID: NCT05391542, https://clinicaltrials.gov/ct2/show/NCT05391542.

Comparison between chewing gum and ibuprofen for orthodontic pain control after initial archwire placement: A randomized controlled trial

Comparison between chewing gum and ibuprofen for orthodontic pain control after initial archwire placement: A randomized controlled trial

Comparison of the Effects of Nano Micelles Curcumin and Ibuprofen on Pain Reduction After Initial Arch Wire Placement: A Double-Blind Randomized Clinical Trial Study

Aim: To compare the effect of nano micelles curcumin and ibuprofen on pain reduction after primary arch wire placement in orthodontic patients. Materials and Methods: In this double-blind randomized clinical trial study, 60 female patients between the ages of 14 and 30 years who had moderate tooth crowding and were candidates for fixed orthodontic treatment were examined. The subjects were divided into four groups ( n = 15) of nano micelles curcumin (SinaCurcumin), ibuprofen, placebo of SinaCurcumin, and placebo of ibuprofen. Each patient received a questionnaire and a rectangular, flexible cube of silicone to record the severity of their pain under each of the three situations (biting posterior teeth together, fitting anterior teeth together, and without fitting the teeth together) at the designated time points (2 h, 6 h, bedtime, the second, third, and seventh days after archwire placement). The obtained outcomes were statistically verified and analyzed by the employment of SPSS Statistics Version 22. Results: despite the lack of any significant differences among the four groups in terms of pain severity upon biting by the anterior teeth 2 h after the intervention, there was a considerable difference in the cases of 6 h, bedtime, and the second, third, and seventh days subsequent of the placement of archwire. Our data indicated a lower rate of pain severity for SinaCurcumin group than the placebo of SinaCurcumin and ibuprofen groups at 6 h after the archwire placement. However, the pain severity of SinaCurcumin group at bedtime was significantly lower than ibuprofen group, which also resulted in a notably lower rate than the other groups at the second, third, and seventh days after the placement of archwire. Conclusion: These findings support the effectiveness of curcumin in reducing the pain severity of orthodontic patients. Nevertheless, it is a necessity to conduct further confirmation trials on this latter.

THE EFFECT OF INITIAL ARCHWIRES SELECTION ON ORTHODONTIC TREATMENT EFFICIENCY AND OUTCOME

Initial orthodontic archwires perform the desired tooth movements in the phase of alignment andleveling during the fixed orthodontic treatment by applying force to the teeth. The force should be lightand continuous which will result in maximum tooth movement, with minimal root resorption and pain.This literature review aims to explore the current knowledge about initial orthodontic archwires.A literature search was conducted on the following electronic databases: PubMed, Cochrane Library, and Google Scholar, as well as grey literature sources, were reviewed. The search resulted in the selection of relevant peer-reviewed articles, clinical trials as well as academic sources such as textbooks, that provide a comprehensive overview of the topic. The review highlights the importance of selecting the appropriate archwire material, wire size, and shape for optimal and predictable orthodontic treatment outcomes. It also emphasizes the impact of these variables on force generation in order treatment optimization. Lastly, discuss the advantages and disadvantages of archwire customization, a current global trend that should provide better treatment outcomes in a shorter period of time and improved patient comfort. Overall, careful selection of initial archwire is important in achieving successful treatment outcomes customized per patient needs and treatment goals.Key words: orthodontic wires, alloys, elastic modulus, orthodontic force

Effect of low-level laser therapy on the time needed for leveling and alignment of mandibular anterior crowding.

To assess the effect of low-level laser therapy (LLLT) on overall leveling and alignment time of mandibular anterior crowding and associated pain after initial archwire placement. Thirty-two females (18-25 years) with mandibular anterior crowding were randomly allocated into laser and control groups. Eligibility criteria included Angle Class I molar relationship and Little's irregularity index (LII) from 4 to 10 mm. Randomization was accomplished with a computer-generated random list. A 0.014-inch copper-nickel-titanium (Cu-NiTi) wire was inserted immediately after bonding of 0.022-inch Roth brackets followed by 0.016-inch Cu-NiTi, 0.016 × 0.022-inch NiTi then 0.017 × 0.025-inch stainless steel wire after completion of alignment. In-Ga-As laser was applied to the mandibular anterior segment in the laser group on days 3, 7, and 14, then at 1 month followed by every 2 weeks until completion of leveling and alignment. Visual analogue scale questionnaires were completed by each patient over 7 days from initial archwire placement. Digital models were used to monitor changes in the irregularity index. Blinding was applicable for outcome assessors only. The mean time for leveling and alignment was significantly lower in the laser compared to the control group (68.2 ± 28.7 and 109.5 ± 34.7 days, respectively). The laser group displayed a significantly higher mean alignment improvement percentage as well as lower pain scores compared to the control group. Within the constraints of the current study, LLLT has a potential for acceleration of anterior segment alignment as well as reduction of the pain associated with placement of initial archwires.

Efecto del ibuprofeno y el ultrasonido pulsado de baja intensidad en la reducción del dolor después de la colocación inicial del arco de ortodoncia: un ensayo clínico aleatorizado doble ciego

Objetivo: Este estudio tuvo como objetivo comparar el efecto del ibuprofeno y el ultrasonido pulsado de baja intensidad (LIPUS) en la reducción del dolor después de la colocación del arco inicial en pacientes de ortodoncia. Material y Métodos: Este estudio de ensayo clínico doble ciego se llevó a cabo en 60 candidatas a tratamiento de ortodoncia fija referidas al Departamento de Ortodoncia de la Facultad de Odontología de la Universidad de Ciencias Médicas de Mashhad, Mashhad, Irán, durante 2015-2016. Los sujetos se dividieron en cuatro grupos: ibuprofeno, LIPUS, placebo y LIPUS simulado. Se entregó un cuestionario y un bloque de silicona cúbica rectangular y flexible a cada paciente para registrar la intensidad del dolor según la escala analógica visual en puntos de tiempo específicos (es decir, 2 h, 6 h, hora de acostarse, 2do, 3er y 7mo día después de la colocación del arco) al morder el bloque de silicona con los dientes anteriores y posteriores, y sin morder en absoluto. Se utilizó el análisis de varianza de medidas repetidas para comparar la intensidad del dolor en diferentes momentos. Resultados: La comparación de la intensidad del dolor en varios puntos de tiempo mostró que las puntuaciones medias de dolor más altas y más bajas se informaron a la hora de acostarse y siete días después de la intervención (p<0,001). En cada una de las tres condiciones (es decir, al morder el bloque de silicona con los dientes anteriores y posteriores, y sin morder) en seis momentos (2 h, 6 h, antes de acostarse 2do, 3er y 7mo día después de la colocación del arco), no se observó diferencia significativa en la severidad del dolor (p>0.05). Conclusion: En conclusión, LIPUS (con una frecuencia de 1 MHz y una intensidad de 100 mW) y el ibuprofeno no tienen efectos significativos en la reducción de la severidad del dolor en diferentes puntos de tiempo y diversas condiciones en pacientes de ortodoncia.

Orthodontic pain control following arch wire placement; a comparison between pre-emptive tenoxicam and chewing gum: a randomized clinical trial.

BackgroundPain during fixed orthodontic treatment can have a detrimental effect on patient treatment compliance. To overcome this, there is a definite need to establish the best pain-relieving methods suitable for orthodontic patients in terms of efficacy and use. The objective of this study was to compare the effect of chewing gum and pre-emptive tenoxicam on pain after initial archwire placement and to evaluate the pain perceptions of orthodontic patients in the two groups while performing various functions at specific time intervals.MethodsForty-two patients were selected and randomly divided into two groups: group A (chewing gum) and group B (pre-emptive tenoxicam). Pain perception was documented by patients immediately; at 4 h; at bedtime on the day of archwire placement; the next morning; at 24 h; and at bedtime on the 2nd, 3rd, and 7th day after the initial archwire placement. Pain scores were noted during fitting of the posterior teeth, biting, and chewing using a visual analog scale. The data obtained were subjected to statistical analysis.ResultsGroup A showed a significant increase in pain until the next morning while fitting the posterior teeth, biting, and chewing [36.2, 52.0, 33.4, respectively]], followed by a gradual decrease by the 7th day. Group B showed a significant increase in pain at bedtime on biting, with a peak value of 47.5. Pain on chewing, fitting posterior teeth, peaked the morning of the next day (100.0, 45.0). The Freidman test showed a statistically significant difference with a p-value of < 0.01. Higher pain scores were observed while chewing and biting compared with that while fitting the posterior teeth in both groups. The overall comparison of pain control between the two groups was not statistically significant [P > 0.05] between the two groups.ConclusionsChewing gum was not inferior to pre-emptive tenoxicam. Thus, chewing gum is a non-pharmacological alternative to analgesics for orthodontic pain control that eliminates the chance of adverse reactions and can be used in the absence of adult observation.

Chewing gum as a non-pharmacological alternative for orthodontic pain relief: A randomized clinical trial using an intention-to-treat analysis.

ObjectiveTo compare the effectiveness of ibuprofen, acetaminophen, and chewing gum for orthodontic pain relief and to assess if chewing gum can be a non-pharmacological alternative for orthodontic pain relief.MethodsThe study enrolled 106 patients of both sexes, aged ≥ 12 years, with body weight > 50 kg, and mild-to-moderate dental crowding in the upper arch. After randomization and allocation concealment, the intervention groups were either administered with ibuprofen (400 mg) or acetaminophen (500 mg) or chewed sugar-free chewing gum immediately after initial archwire placement and every 6 hours for 1 week if the pain persisted. The control group did not receive any pain relief. The pain was assessed on a 100-mm visual analog scale at rest and while biting down at T1 (2 hours), T2 (24 hours), T3 (2 days), T4 (3 days), T5 (7 days), and T6 (21 days). Statistical analyses were performed using the Kruskal–Wallis and post-hoc Mann–Whitney U tests (α = 0.05).ResultsThe chewing gum group experienced more pain relief than the ibuprofen group at while biting down at T3 (p = 0.04) and at rest at T4 (p < 0.001). The chewing gum group reported more pain relief than the acetaminophen and control groups while biting down at T3 (p = 0.03 and p = 0.0006, respectively) and T4 (both p < 0.001).ConclusionsChewing gum can be a non-pharmacological alternative for orthodontic pain relief at 2 and 3 days after initial archwire placement.

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.

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.

Choice of Initial Alignment Archwires in Moderate to Severe Crowding in Patients Treated with Damon and MBT Systems: A Retrospective Study

Initial arch wires are the firsts arch wires to be inserted into the fixed appliance at the beginning of orthodontictreatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With anumber of different types of orthodontic arch wires available for initial tooth alignment, it is importantto understand which wire is most efficient. The purpose of this study was to evaluate the choice of initialalignment archwires in treating patients with moderate to severe crowding with the MBT and Damonappliances. Sample included 50 patients aged 18 years and above,selected from the pretreatment recordsof the patients reported to the Department of Orthodontics,Saveetha Dental College,Chennai.Results ofthe study was obtained by evaluating the initial archwires used in case of MBT and Damon appliances.This study revealed that 85.7% out of the 35 MBT cases used 0.014 NiTi as the initial archwire and all ofthe Damon cases started with 0.013 CuNiTi.The collected data were entered into an Excel sheet(MicrosoftExcel 2007) and statistical analysis done. The association between gender and initial alignment archwiresin moderate to severe crowding cases was found using Chi-square association test in IBM SPSS software,which showed a statistically not significant difference (p -value &gt;0.05) , hence there is no gender differencein the choice of initial alignment archwires in moderate to severe crowding patients.

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’.

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.

Preortodonciai kortikocízió és szimultán csont augmentáció a bukkális alveoláris dehiszcencia prevenciójában : Esetismertetés

Buccal orthodontic tooth movement (OTM) of the anterior teeth out of the osseous envelope of the alveolar process incase of front teeth crowding may be associated with a higher tendency for developing gingival recessions. The aim ofthis case report is to present the effectiveness of a minimally invasive preorthodontic corticotomy combined with a buccalbone augmentation according to the rules of periodontally accelerated osteogenic orthodontics (PAOO). The maingoal of our therapy is to increase or maintain the buccal bone thickness, which could prevent the development of gingivalrecessions. Corticotomy possibly have an additional benefit throughout regional acceleratory phenomenon, reducingthe duration of OTM in the early treatment phases. A generally and periodontally healthy individual at the age of17 presenting crowding and thin bone morphotype in the mandibular y front area, who requiresting OTM with incisorproclination, was treated. Surgery was performed under local anesthesia. Three vertical incisions were performed onthe midline and on both sides between lateral incisors and canines, with preservation of the papilla integrity. Incisionswere connected by tunneling knifes in 2 layers, subperiosteally in the whole length and supraperiosteally apically fromthe mucogingival junction. Corticocisions were utilized by ultrasonic instrument penetrating through the cortical bone.“Sticky bone” plates, a combinations of platelet rich fibrin (PRF) and xenograft, were used subperiosteally for bone, andPRF membranes supraperiosteally for soft tissue augmentation. Initiation of OTM started 1 week postoperatively, andactivation of the multibond appliance was performed activated in 2 weeks. The extent of tooth movement measuredon the central incisor was compared followed-up on cephalometric radiographs made taken at the different treatmenttime appointments, while buccal bone thickness on the 6 front teeth was evaluated in CBCT before and after OTM. Thealignment phase ended up at the 20th week due to an initial arch wire sequence using light forces. The buccal bony wallthicknesses showed similar values compared to the initial ones, and there was no radiologically proven substantial verticalbone loss. The presented comprehensive treatment approach promised a good option in the prevention of the periodontalside effects during orthodontic treatment.