Effect of cotton roll biting on pain perception during orthodontic bracket debonding using Weingart pliers: A randomized controlled trial.

ObjectiveThis study aimed to evaluate the effectiveness of biting on a cotton roll in reducing pain during metal bracket removal using a Weingart plier compared with the conventional method.MethodsThis two-arm, parallel-group, randomized controlled trial included 36 patients (11 males and 25 females) with a mean age of 20.5 ± 3.08 years (range: 16-25 years). The study was conducted among patients who had completed orthodontic treatment with a fixed appliance using MBT prescription 0.022-inch metal brackets featuring a single-mesh base (Pinnacle®, MBT compatible 0.022, OrthoTechnology™, Florida, USA), and they were referred for metal bracket debonding. Brackets were removed using a Weingart plier, and participants were randomly assigned to one of two groups: the open-mouth group and the biting-on-a-cotton-roll group. Pain intensity was assessed for each tooth using a visual analog scale (0-100 mm) immediately after each bracket removal. Pain levels were compared between the two groups, between the upper and lower jaws, and across sexes.ResultsPatients in both groups reported pain levels ranging from mild to mild-moderate, with lower mean pain levels observed in the biting-on-a-cotton-roll group compared with the open-mouth group. Significant differences in mean pain scores were found between the open-mouth group and biting-on-a-cotton-roll group in the upper and lower incisors (13.61 and 13.19,  < 0.001, respectively), upper and lower canines (4.03 and 3.61,  < 0.001, respectively), and upper and lower premolars (12.78 and 11.11,  < 0.001, respectively). No significant differences in pain perception were observed between males and females across all regions ( > 0.05).ConclusionsBiting on a cotton roll significantly reduces pain during metal bracket debonding in the upper and lower incisor regions. The anterior regions of both jaws exhibit increased sensitivity to pain during the debonding procedure, whereas no differences in pain perception were observed between male and female patients.