J Oral Facial Pain Headache. 2016 Summer;30(3):228-33. doi: 10.11607/ofph.1646.
To evaluate the transient effects of orthodontic treatment on the mechanical detection threshold (MDT) and mechanical pain threshold (MPT) of the buccal attached gingiva and the pressure pain threshold (PPT) of the buccal attached gingiva and of the teeth in two directions (perpendicular and parallel).
A total of 20 patients (15 females and 5 males) aged 18 to 30 years participated in the study. Perceived pain on a 0- to 10-cm visual analog scale (VAS) and MDT, MPT, and PPT scores were evaluated at two time points at the masseter muscle, gingiva, teeth, and hand (control) prior to orthodontic treatment (T₀) and 24 hours after the first archwire placement (T₁). Mean values and SEMs were calculated for all continuous variables. The differences between T₀ and T₁ of MDT, MPT, and PPT were analyzed by means of a paired Student t test.
The pain intensity as assessed on the VAS was 4.2 ± 1.8 cm. No significant changes in MDT or MPT were found at the hand and buccal attached gingiva (P > .06). The PPTs at the buccal attached gingiva of teeth 21, 23, 24, and 34, at teeth 21, 23, 24, and 34 (perpendicular) and at teeth 21 and 23 (parallel) were lower (ie, more sensitive) at T₁ compared with T₀ (P < .04).
This study indicates for the first time that pain following insertion of an archwire causes sensitization to blunt-pressure stimuli both in the attached gingiva and in the periodontal ligament. Quantitative assessment of mechanical sensitivity may provide more insights into procedural pain and allow for better monitoring and evaluation of the effects of orthodontic treatment in the future.
评估正畸治疗对颊侧附着龈的机械检测阈值（MDT）和机械痛阈值（MPT）以及颊侧附着龈和牙齿两个方向（垂直和水平）的压痛阈值（PPT）的瞬态影响。
本研究共纳入 20 名年龄在 18 至 30 岁之间的患者（15 名女性，5 名男性）。在正畸治疗前（T₀）和第一次弓丝放置后 24 小时（T₁），使用 0 至 10cm 视觉模拟量表（VAS）和 MDT、MPT 和 PPT 评分评估患者的颊肌、牙龈、牙齿和手部（对照）的疼痛感知，并计算所有连续变量的平均值和 SEM。采用配对学生 t 检验分析 MDT、MPT 和 PPT 在 T₀ 和 T₁ 之间的差异。
VAS 评估的疼痛强度为 4.2±1.8cm。手部和颊侧附着龈的 MDT 或 MPT 无明显变化（P＞.06）。与 T₀ 相比，T₁ 时 21、23、24 和 34 号牙的颊侧附着龈以及 21、23、24 和 34 号牙（垂直）和 21 和 23 号牙（平行）的 PPT 较低（即更敏感）（P＜.04）。
本研究首次表明，弓丝插入后引起的疼痛会导致附着龈和牙周膜对钝压刺激敏感。机械敏感性的定量评估可能会更深入地了解程序疼痛，并允许更好地监测和评估未来正畸治疗的效果。
