Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.
Department of Surgical Sciences, University of Cagliari, Sardinia, Italy.
J Oral Rehabil. 2021 Oct;48(10):1135-1143. doi: 10.1111/joor.13227. Epub 2021 Aug 1.
Pain experienced at teeth during orthodontic treatment varies largely over time, with the reasons for its interindividual variability being largely unknown: age, sex, clinical activations, psychosocial factors and genetic polymorphisms of candidate genes are putative factors that may account to explain this variability. We aimed to investigate the effect of clinical, demographic, psychological and genetic factors on pain levels experienced during fixed orthodontic treatment.
A convenience sample of 183 patients undergoing full-fixed orthodontic treatment were recruited. Participant's pain levels were assessed seven times over a three-day period via a smartphone app. Clinical, demographic and psychological data were collected via questionnaires. This included the Pain Catastrophising Scale (Child version), the Corah Dental Anxiety Scale and the State and Trait Anxiety Inventory. Participants provided a DNA sample either in the form of blood or saliva, which were used for genotyping COMT gene rs6269, rs4680, rs4646310, NR3C1 gene rs2963155 and the HTR2A gene rs9316233.
Bond ups had the greatest influence on perceived levels of pain experienced on teeth during orthodontic treatment, accounting for over 20% of total variance in pain response. High-pain responders had higher scores on pain catastrophising (magnification subscale). Self-reported pain during fixed orthodontic treatment was not influenced by sex, age, time into treatment, anxiety, nor by polymorphisms of COMT, HTR2A or NR3C1 genes.
Pain on teeth resulting from orthodontic fixed appliances is stronger during bonds-up and in patients with high catastrophising scores. Demographics, type of clinical activations and the genetic polymorphisms investigated in this research had little or no impact on perceived pain levels.
正畸治疗过程中牙齿疼痛的个体差异很大，其个体间差异的原因尚不清楚：年龄、性别、临床激活、心理社会因素和候选基因的遗传多态性是可能导致这种差异的因素。我们旨在研究临床、人口统计学、心理和遗传因素对固定正畸治疗过程中疼痛程度的影响。
本研究采用便利抽样法招募了 183 名接受全固定正畸治疗的患者。通过智能手机应用程序，在三天内七次评估参与者的疼痛程度。通过问卷收集临床、人口统计学和心理数据。这包括疼痛灾难化量表（儿童版）、科勒牙科焦虑量表和状态-特质焦虑量表。参与者提供了血液或唾液形式的 DNA 样本，用于 COMT 基因 rs6269、rs4680、rs4646310、NR3C1 基因 rs2963155 和 HTR2A 基因 rs9316233 的基因分型。
结扎对正畸治疗过程中牙齿疼痛的感知水平影响最大，占疼痛反应总方差的 20%以上。高疼痛反应者在疼痛灾难化方面得分较高（放大子量表）。固定正畸治疗期间的自我报告疼痛不受性别、年龄、治疗时间、焦虑以及 COMT、HTR2A 或 NR3C1 基因多态性的影响。
正畸固定矫治器引起的牙齿疼痛在结扎时和疼痛灾难化评分较高的患者中更强。本研究中调查的人口统计学、临床激活类型和遗传多态性对感知疼痛水平的影响很小或没有。
