Nihon University School of Dentistry, Department of Orthodontics, Chiyoda-ku, Tokyo, Japan.
Nihon University School of Dentistry, Division of Clinical Research, Dental Research Center, Chiyodaku, Tokyo, Japann.
J Appl Oral Sci. 2021 Jul 23;29:e20200879. doi: 10.1590/1678-7757-2020-0879. eCollection 2021.
Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for ceramic brackets, compared with metal and plastic brackets, to determine which removal method resulted in less pain and discomfort.
81 subjects (mean age, 25.1 years; 25 males and 56 females) were enrolled, from whom 1,235 brackets (407 ceramic, 432 plastic, and 396 metal) were removed. Measured teeth were distinguished at six segments. Pain was measured with a visual analogue scale (VAS) during the removal of each bracket. An additional grip was placed on the grips of debonding pliers with right-angled beaks; a mini loading cell sensor pinched by the grips was used to measure removal force during debonding. VAS and force values were statistically analyzed. The Kruskal-Wallis test followed by the Mann-Whitney U test with Bonferroni correction were performed for multiple comparisons; multiple regression analysis was also performed.
Forces in the upper and lower anterior segments were significantly smaller (p<0.05) than those in the other segments. Pain tended to be greater in the upper and lower anterior segments than in the posterior segments. In all segments, the removal force was greater for metal brackets than for plastic or ceramic brackets. Ceramic brackets caused significantly greater pain than plastic brackets for the upper and lower anterior segments. Debonding force was involved in the brackets, following adjustments for pain, upper left segment, age, and sex.
Pain and discomfort are likely to occur during bracket debonding.
托槽去除过程中会产生疼痛，因此需要更舒适的治疗方法。本研究比较了陶瓷托槽、金属托槽和塑料托槽去除所需的力与疼痛的关系，以确定哪种去除方法产生的疼痛和不适更少。
共纳入 81 名受试者（平均年龄 25.1 岁；男性 25 名，女性 56 名），共去除 1235 个托槽（陶瓷托槽 407 个，塑料托槽 432 个，金属托槽 396 个）。将待处理的牙齿分为六个区段。在去除每个托槽时，使用视觉模拟评分（VAS）测量疼痛程度。在直喙型去釉镊的手柄上再放置一个握力器；使用夹在手柄上的微型测力传感器测量去釉过程中的去除力。对 VAS 和力值进行统计学分析。采用 Kruskal-Wallis 检验，随后进行多重比较的 Mann-Whitney U 检验和 Bonferroni 校正；还进行了多元回归分析。
在上颌和下颌前牙段，力值明显小于其他段（p<0.05）。上颌和下颌前牙段的疼痛程度大于后牙段。在所有段，金属托槽的去除力均大于塑料托槽和陶瓷托槽。在上颌和下颌前牙段，陶瓷托槽引起的疼痛明显大于塑料托槽。在调整疼痛、上颌左侧段、年龄和性别后，去除力与托槽相关。
托槽去除过程中可能会出现疼痛和不适。
