正畸治疗及去除托槽过程中所经历的疼痛是否取决于托槽的结构或去粘结方法？
Does the pain experienced during orthodontic treatment and bracket removal depend on the architecture of the bracket or debonding method?
作者信息
Gibas-Stanek Marta, Fudalej Piotr
机构信息
Department of Prosthodontics and Orthodontics, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Montelupich St. 4/108, 31-155 Krakow, Poland.
出版信息
Eur J Orthod. 2024 Dec 4;47(1). doi: 10.1093/ejo/cjae073.
BACKGROUND
The fear of pain during the various stages of orthodontic treatment with fixed appliances is a common concern of patients. Therefore, the present research aimed to thoroughly investigate the impact of bracket architecture on pain perception during active treatment, debonding, and adhesive removal.
MATERIALS
One hundred consecutive patients who completed treatment with one of two bracket systems (2-slot brackets with an integral base or conventional twin brackets with foil mesh) were included in this prospective cohort study. Participants were asked to evaluate the level of pain encountered throughout their orthodontic treatment with the fixed appliances and during bracket and adhesive removal, utilizing a 0-10 numerical rating scale. Two different methods of bracket removal (bracket debonding pliers and Lift-Off Debonding Instrument) and adhesive removal (adhesive removal pliers and rotary instrument) were tested.
RESULTS
Our study found moderate and comparable levels of pain during active treatment in both groups (4.4 ± 1.6 in the 2-slot group and 3.9 ± 1.9 in the Twin group). Debonding of brackets with integral base caused more discomfort compared to conventional twin brackets and using bracket removal pliers elicited more pain sensations than when Lift-Off Debonding Instrument were employed. Patients are likely to prefer adhesive removal methods involving rotary instruments despite the sound and vibrations produced by contra-angle handpiece.
LIMITATIONS
The lack of randomization in patient grouping introduces an increased risk of bias.
CONCLUSIONS
The results of the present study suggest that the bracket architecture, particularly the construction of the bracket base, affects the level of discomfort experienced during debonding.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT06324162, Registered 20 March 2024-Retrospectively registered, https://clinicaltrials.gov/study/NCT06324162.
背景
在使用固定矫治器进行正畸治疗的各个阶段，对疼痛的恐惧是患者普遍关心的问题。因此，本研究旨在深入调查托槽结构对主动治疗、托槽拆除和粘结剂去除过程中疼痛感知的影响。
材料
本前瞻性队列研究纳入了连续100例使用两种托槽系统之一（一体式底座的双槽托槽或带箔网的传统双翼托槽）完成治疗的患者。参与者被要求使用0至10的数字评分量表评估在使用固定矫治器进行正畸治疗期间以及托槽和粘结剂去除过程中所经历的疼痛程度。测试了两种不同的托槽拆除方法（托槽拆除钳和 Lift-Off 脱粘器械）和粘结剂去除方法（粘结剂去除钳和旋转器械）。
结果
我们的研究发现两组在主动治疗期间的疼痛程度适中且相当（双槽组为4.4±1.6，双翼组为3.9±1.9）。与传统双翼托槽相比，一体式底座托槽的拆除会引起更多不适，并且使用托槽拆除钳比使用 Lift-Off 脱粘器械引发更多疼痛感。尽管弯机头会产生声音和振动，但患者可能更喜欢使用旋转器械的粘结剂去除方法。
局限性
患者分组缺乏随机化增加了偏倚风险。
结论
本研究结果表明，托槽结构，特别是托槽底座的构造，会影响托槽拆除过程中所经历的不适程度。
试验注册
ClinicalTrials.gov，NCT06324162，2024年3月20日注册——追溯注册，https://clinicaltrials.gov/study/NCT06324162 。
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