Department of Orthodontics, University of North Paraná (UNOPAR), Londrina, Brazil.
Department of Prosthodontics, Bauru School of Dentistry, Bauru Orofacial Pain Group, University of São Paulo, São Paulo, Brazil.
Orthod Craniofac Res. 2021 May;24(2):268-276. doi: 10.1111/ocr.12431. Epub 2020 Oct 26.
This randomized clinical trial aimed to compare the pain intensity in patients treated with orthodontic aligners and conventional fixed appliances.
This study was a randomized clinical trial. The sample comprised 39 patients randomly allocated into 2 groups: OA (orthodontic aligners, n = 20) and FA (Fixed Appliance, n = 19).
The pain intensity was measured by the visual analogue scale (VAS) in the following periods: T0 (baseline), T1 (seven days after appliance placement) and seven days after each return on the first (T2), third (T3) and sixth (T4) months. The following variables were also investigated in the baseline: conditioned pain modulation, anxiety levels, hypervigilance and catastrophizing. The VAS measurements between groups were compared by the Mann-Whitney test. Comparisons between periods within each group were performed by the Friedman test. Data regarding catastrophizing and hypervigilance were compared by the t test. All tests were applied at a significance level of 5%, with 95% confidence interval.
Both groups presented similar levels of anxiety, hypervigilance, catastrophizing and conditioned pain modulation. Both groups did not differ concerning the pain intensity in all periods. The intragroup evaluation revealed statistical differences between days in the FA group at all moments evaluated, for the OA group, similar findings between days were found for the T1 evaluation; however, at the 6-month period (T4), the pain levels varied over these days without statistical difference. Higher levels of pain were observed in the first seven days after appliance placement.
The pain intensity, usually mild, was not influenced by the appliance design, although different patterns of reported pain seem to occur between groups.
本随机临床试验旨在比较使用正畸直丝弓矫治器和传统固定矫治器治疗的患者的疼痛强度。
本研究为随机临床试验。样本由 39 名随机分为两组的患者组成:OA(正畸直丝弓矫治器,n=20)和 FA(固定矫治器,n=19)。
疼痛强度通过视觉模拟评分(VAS)在以下时期测量:T0(基线)、T1(矫治器放置后七天)以及第一个(T2)、第三个(T3)和第六个(T4)月每次复诊后七天。在基线时还调查了以下变量:条件性疼痛调制、焦虑水平、过度警惕和灾难化。通过 Mann-Whitney 检验比较组间 VAS 测量值。通过 Friedman 检验对每组内各时期进行比较。通过 t 检验比较灾难化和过度警惕的数据。所有检验的置信区间均为 95%,显著水平为 5%。
两组的焦虑、过度警惕、灾难化和条件性疼痛调制水平相似。两组在所有时期的疼痛强度均无差异。组内评估显示 FA 组在所有评估时刻的天数之间存在统计学差异,OA 组在 T1 评估时发现相似的天数之间存在差异;然而,在 6 个月(T4)期间,疼痛水平在这些天内变化,但无统计学差异。在放置矫治器后的头七天观察到更高的疼痛水平。
疼痛强度通常较轻,不受矫治器设计的影响,尽管两组之间似乎出现了不同的疼痛报告模式。