Sampaio Fernanda A, Sampaio Claudine R A, Cunha Carolina O, Costa Yuri M, Alencar Phillipe N B, Bonjardim Leonardo R, Garib Daniela, Garlet Gustavo P, Eliav Eli, Conti Paulo C R
Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil.
Department of Prosthodontics, University Center Christus, Fortaleza, Brazil.
J Oral Rehabil. 2019 Mar;46(3):257-267. doi: 10.1111/joor.12742. Epub 2018 Nov 28.
Although inflammation can alter cytokines release and nerve function, it is not yet fully established if orthodontic-induced inflammation can cause significant extraoral trigeminal somatosensory alterations and release of inflammatory chemical mediators.
The primary aim of this study was to investigate the impact of orthodontic separator and short-term fixed orthodontic appliance on the extraoral trigeminal somatosensory function and concentrations of cytokines in the gingival crevicular fluid (GCF).
Twenty-two female patients were evaluated as follow: baseline, 24 hour-after elastomeric separator (-aES), 24 hour- and 1 month-after bonding brackets (-aBB) at both arches. The outcome variables were as follows: self-reported pain (Visual Analog Scale), QSTs (current perception threshold-CPT, cold detection threshold-CDT, warm detection threshold-WDT, mechanical detection threshold-MDT, mechanical suprathreshold-MST and wind-up ratio-WUR. All QSTs were performed at infra-orbital and mental nerve entry zone at patient`s dominant side. In addition, GCF samples in order to assess cytokines profile (IL-1β,IL-8,IL-6 and TNF-α) were collected. ANOVA and Tukey's post hoc analyses were performed (a = 5%).
Patients reported higher pain intensity 24 hour-aBB compared to baseline and 24 hour-aES (P < 0.050). Patients were less sensitive to pin-prick pain (MST) at 24 hour-aBB and 1 month-aBB compared to baseline (P < 0.006). Significant increases in IL-6 levels were observed 24 hour-aBB (P < 0.001). Multiple comparison analysis showed significant increase in IL-1β levels (P < 0.001) and TNF-α (P < 0.001) 1 month-aBB compared to baseline.
Elastomeric separators only induced mild pain and were not able to significantly increase proinflammatory cytokines level in the GCF. In addition, orthodontic fixed appliance may induce only minor somatosensory changes at extraoral trigeminal locations.
尽管炎症可改变细胞因子释放及神经功能，但正畸诱导的炎症是否会导致明显的口外三叉神经体感改变及炎症化学介质释放尚未完全明确。
本研究的主要目的是调查正畸分离器和短期固定正畸矫治器对口外三叉神经体感功能及龈沟液（GCF）中细胞因子浓度的影响。
对22名女性患者进行如下评估：基线、戴弹性分离器后24小时（-aES）、双侧牙弓粘结托槽后24小时及1个月（-aBB）。观察指标如下：自我报告疼痛（视觉模拟量表）、定量感觉测试（电流感觉阈值-CPT、冷觉检测阈值-CDT、温觉检测阈值-WDT、机械感觉阈值-MDT、机械超阈值-MST和累积比率-WUR。所有定量感觉测试均在患者优势侧的眶下神经和颏神经入区进行）。此外，采集GCF样本以评估细胞因子谱（IL-1β、IL-8、IL-6和TNF-α）。进行方差分析和Tukey事后分析（α=5%）。
与基线和戴弹性分离器后24小时相比，患者在粘结托槽后24小时报告的疼痛强度更高（P<0.050）。与基线相比，患者在粘结托槽后24小时及1个月时对针刺疼痛（MST）的敏感性较低（P<0.006）。在粘结托槽后24小时观察到IL-6水平显著升高（P<0.001）。多重比较分析显示，与基线相比，粘结托槽后1个月IL-1β水平（P<0.001）和TNF-α水平（P<0.001）显著升高。
弹性分离器仅引起轻度疼痛，且无法显著提高GCF中促炎细胞因子水平。此外，正畸固定矫治器可能仅在口外三叉神经部位引起轻微的体感变化。
