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ORTHODONTİC PAIN

Year 2014, Volume: 41 Issue: 2 - Volume: 41 Issue: 2, 121 - 127, 01.05.2014

Abstract

The most common orthodontic treatment is pain and it is closely related to both clinicians and patients. Orthodontic patients experience varying degrees of pain and discomfort during the treatment. Patients may experience pain after orthodontic applications such as separation, arch wire implementation, the implementation of removable appliances, activation of fixed/removable appliances and debonding. Pressure, ischemia, inflammation and edema occurs in the region of the force applied. Tension and pressure areas of the periodontal ligament causes pain. Orthodontic pain can be classified according to the force applied and time. The most common method of assessing pain in which patients score their pain experience is NRS. Nonsteroidal anti-inflammatory drugs NSAID is the most preferred method for pain control during the orthodontic treatment. Anesthetic gel, bite wafers, transcutaneous electrical nerve stimulation, the use of low level laser and vibration alert methods have also been proposed for pain control during orthodontic treatment. The purpose of this paper is to examine the pain/discomfort experienced during orthodontic treatment, it’s causes and treatment methods.

References

  • 1. Kluemper GT, Hiser DG, Rayens MK, Jay MJ. Efficacy of a wax containing benzocaine in the relief of oral mucosal pain caused by orthodontic appliances. Am J Orthod Dentofacial Orthop 2002 Oct; 122(4): 359-65.
  • 2. Oliver RG, Knapman YM. Attitudes to orthodontic treatment. Br j Orthod 1985 Oct; 12(4): 179-88
  • 3. Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1989 Jul; 96(1): 47-53.
  • 4. Brown DF, Moerenhout RG. The pain experience and psychological adjustment to orthodontic treatment of preadolescents, adolescents, and adults. Am J Orthod Dentofac Orthop 1991 Oct; 100(4): 349-56.
  • 5. Scheurer PA, Firestone AR, Bürgin WB. Perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod 1996 Aug; 18(4): 349-57.
  • 6. Firestone AR, Scheurer PA, Bürgin WB. Patients' anticipation of pain and pain-related side effects, and their perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod 1999 Aug; 21(4): 387-96.
  • 7. Bergius M, Kiliaridis S, Berggren U. Pain in orthodontics. A review and discussion of the literature. J Orofac Orthop 2000; 61(2): 125-37.
  • 8. Koritsánszky N, Madléna M. Pain and discomfort in orthodontic treatments. Literature review. Fogorv Sz 2011 Dec; 104(4): 117-2.
  • 9. Sergl HG, Klages U, Zentner A. Pain and discomfort during orthodontic treatment: causative factors and effects on compliance. Am J Orthod Dentofac Orthop 1998 Dec; 114(6): 684- 91.
  • 10. Kvam E, Bondevik O, Gjerdet NR. Traumatic ulcers and pain in adults during orthodontic treatment. Community Dent Oral Epidemiol 1989 Jun; 17(3): 154-7.
  • 11. Lew KK. Attitudes and perceptions of adults towards orthodontic treatment in an Asian community. Community Dent Oral Epidemiol 1993 Feb; 21(1): 31-5.
  • 12. Soltis JE, Nakfoor PR, Bowman DC. Changes in ability of patients to differentiate intensity of forces applied to maxillary central incisors during orthodontic treatment. J Dent Res 1971 May-Jun; 50(3): 590-6.
  • 13. Furstman L, Bernick S. Clinical considerations of the periodontium. Am J Orthod 1972 Feb; 61(2): 138-55.
  • 14. Burstone CJ. The biomechanics of tooth movement. In: Kraus BS, Riedel RA. Vistas in orthodontics. Philadelphia: Lea&Febiger, 1962; p.197-213.
  • 15. Stewart FN, Kerr WJ, Taylor PJ. Appliance wear: the patient's point of view. Eur J Orthod 1997 Aug; 19(4): 377-82.
  • 16. Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment--effects on compliance and prediction of patients' adaptation by personality variables. Eur J Orthod 2000 Jun; 22(3): 307-15.
  • 17. Ngan P, Wilson S, Shanfeld J, Amini H. The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1994 Jul; 106(1): 88- 95.
  • 18. Bondemark L, Fredriksson K, Ilros S. Separation effect and perception of pain and discomfort from two types of orthodontic separators. World J Orhod 2004 Summer; 5(2): 172-6.
  • 19. Michelotti A, Farella M, Martina R. Sensory and motor changes of the human jaw muscles during induced orthodontic pain. Eur J Orthod 1999 Aug; 21(4): 397-404.
  • 20. Jones ML. An investigation into the initial discomfort caused by placement of an archwire. Eur J Orthod 1984 Feb; 6(1): 48-54.
  • 21. Erdinç AM, Dinçer B. Perception of pain during orthodontic treatment with fixed appliances. Eur J Orthod 2004 Feb; 26(1): 79-85.
  • 22. Polat O, Karaman AI, Durmus E. Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain. Angle Orthod 2005 Sep; 75(5): 791-6.
  • 23. Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment: a randomized controlled clinical trial of two initial aligning arch wires. Am J Orthod Dentofac Orthop 1992 Oct; 102(4): 373-81.
  • 24. Jones ML, Chan C. Pain in the early stages of orthodontic treatment. J Clin Orthod 1992 May; 26(5): 311-3.
  • 25. Jones ML, Richmond S. Initial tooth movement: force application and pain--a relationship? Am J Orthod 1985 Aug; 88(2): 111- 6.
  • 26. Fernandes LM, Ogaard B, Skoglund L. Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire. A randomized clinical trial. J Orofac Orthop 1998; 59(6): 331-9.
  • 27. Smith RJ, Burstone CJ. Mechanics of tooth movement. Am J Orthod 1984 Apr; 85(4): 294-307.
  • 28. Goldreich H, Gazit E, Lieberman MA, Rugh JD. The effect of pain from orthodontic arch wire adjustment on masseter muscle electromyographic activity. Am J Orthod Dentofac Orthop 1994 Oct; 106(4): 365-70.
  • 29. Mao JJ. Mechanobiology of craniofacial sutures. Journal of Dental Research 2002; 81: 810-816.
  • 30. Mao JJ, Wang X, Kopher RA. Biomechanics of craniofacial sutures: orthopedic implications. Angle Orthod 2003 Apr; 73(2): 128- 35.
  • 31. Needleman HL, Hoang CD, Allred E, Hertzberg J, Berde C. Reports of pain by children undergoing rapid palatal expansion. Pediatr Dent 2000 May-Jun; 22(3): 221-6.
  • 32. Egolf RJ, BeGole EA, Upshaw HS. Factors associated with orthodontic patient compliance with intraoral elastic and headgear wear. Am J Orthod Dentofac Orthop 1990 Apr; 97(4): 336-348.
  • 33. Cureton SL. Headgear and pain. J Clin Orthod 1994 Sep; 28(9): 525-30.
  • 34. Ngan PW, Yiu C, Hagg U, Wei SH, Bowley J. Masticatory muscle pain before, during, and after treatment with orthopedic protraction headgear: a pilot study. Angle Orthod 1997; 67(6): 433-7.
  • 35. Goldman HM, Gianelly AA. Histology of tooth movement. Dent Clin North Am 1972 Jul; 16(3): 439-48.
  • 36. Hixon EH, Atikian H, Callow GE, McDonald HW, Tacy RJ. Optimal force, differential force, and anchorage. Am J Orthod 1969 May; 55(5): 437-57.
  • 37. Williams OL, Bishara SE. Patient discomfort levels at the time of debonding: a pilot study. Am J Orthod Dentofac Orthop 1992 Apr; 101(4): 313-7.
  • 38. Rinchuse DJ. Pain-free debonding with occlusal rim wax. J Clin Orthod 1994 Oct; 28(10): 587-8.
  • 39. Chumbley AB, Tuncay OC. The effect of indomethacin (an aspirin-like drug) on the rate of orthodontic tooth movement. Am J Orthod 1986 Apr; 89(4): 312-4.
  • 40. Kehoe MJ, Cohen SM, Zarrinnia K, Cowan A. The effect of acetaminophen, ibuprofen, and misoprostol on prostaglandin E2 synthesis and the degree and rate of orthodontic tooth movement. Angle Orthod 1996; 66(5): 339- 49.
  • 41. Roche JJ, Cisneros GJ, Acs G. The effect of acetaminophen on tooth movement in rabbits. Angle Orthod 1997; 67(3): 231-6.
  • 42. Steen Law SL, Southard KA, Law AS, Logan HL, Jakobsen JR. An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement. Am J Orthod Dentofac Orthop 2000 Dec; 118(6): 629-35.
  • 43. Sari E, Olmez H, Gürton AU. Comparison of some effects of acetylsalicylic acid and rofecoxib during orthodontic tooth movement. Am J Orthod Dentofac Orthop 2004 Mar; 125(3): 310-5.
  • 44. Bernhardt MK, Southard KA, Batterson KD, Logan HL, Baker KA, Jakobsen JR. The effect of preemptive and/or postoperative ibuprofen therapy for orthodontic pain. Am J Orthod Dentofac Orthop 2001 Jul; 120(1): 20-7.
  • 45. Polat O, Karaman AI. Pain control during fixed orthodontic appliance therapy. Angle Orthod 2005 Mar; 75(2): 214-9.
  • 46. Simmons KE, Brandt M. Control of orthodontic pain. J India Dent Assoc 1992 JulAug; 71(4): 8-10.
  • 47. Paganelli C. Pharmacological support during orthodontic therapy with a topical antiinflammatory. Minerva Stomatol 1993 Jun; 42(6): 271-4.
  • 48. Walker JB, Buring SM. NSAID impairment of orthodontic tooth movement. Ann Pharmacother 2001 Jan; 35(1): 113-5.
  • 49. Kyrkanides S, O'Banion MK, Subtelny JD. Nonsteroidal anti-inflammatory drugs in orthodontic tooth movement: metalloproteinase activity and collagen synthesis by endothelial cells. Am J Orthod Dentofacial Orthop 2000 Aug; 118(2): 203-9.
  • 50. Keim RG. Managing orthodontic pain. J Clin Orthod 2004 Dec; 38(12): 641-2.
  • 51. Proffit WR. Contemporary Orthodontics. 3rd ed. St. Louis: The CV Mosby Co. p.311-12.
  • 52. White LW. Pain and cooperation in orthodontic treatment. J Clin Orthod 1984 Aug; 18(8): 572-5.
  • 53. Marie SS, Powers M, Sheridan JJ. Vibratory stimulation as a method of reducing pain after orthodontic appliance adjustment. J Clin Orthod 2003 Apr; 37(4): 205-8.
  • 54. Roth PM, Thrash WJ. Effect of transcutaneous electrical nerve stimulation for controlling pain associated with orthodontic tooth movement. Am J Orthod Dentofacial Orthop 1986 Aug; 90(2): 132-8.
  • 55. Lim HM, Lew KK, Tay DK. A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop 1995 Dec; 108(6): 614-22.

Ortodontik ağrı

Year 2014, Volume: 41 Issue: 2 - Volume: 41 Issue: 2, 121 - 127, 01.05.2014

Abstract

Ortodontik tedavinin en sık görülen yan etkisi olan ağrı hem klinisyenleri hem de hastaları yakından ilgilendirir. Ortodonti hastaları, tedavi süresince değişen derecelerde ağrı ve rahatsızlık hissi yaşarlar. Seperasyon, ark uygulanması, aktivasyonu ve debonding gibi ortodontik uygulamalar sonrasında hastada bir miktar ağrı görülebilir. Kuvvet uygulanan bölgede basınç, iskemi, Periodontal ligamentte gerilim ve basınç alanları oluşarak ağrıya neden olur. Ortodontik ağrı uygulanan sınıflandırılabilir. Ağrıyı değerlendirmede en yaygın metod NRS adlı hastaların ağrılarını skorladığı sistemdir. Ortodontik tedavi sırasında ağrı kontrolünde steroid olmayan antienflamatuar ilaçlar NSAI en yaygın tercih edilen yöntemdir. Ayrıca anestezik jel, ısırma mumu, transkütanöz elektriksel sinir stimülasyonu, düşük seviyede lazer kullanımı ve titreşimsel uyarı yöntemleri de önerilmiştir. Bu derlemenin amacı ortodontik tedavi sırasında görülen ağrı/rahatsızlık hissini, nedenlerini ve tedavi yöntemlerini incelemektir.

References

  • 1. Kluemper GT, Hiser DG, Rayens MK, Jay MJ. Efficacy of a wax containing benzocaine in the relief of oral mucosal pain caused by orthodontic appliances. Am J Orthod Dentofacial Orthop 2002 Oct; 122(4): 359-65.
  • 2. Oliver RG, Knapman YM. Attitudes to orthodontic treatment. Br j Orthod 1985 Oct; 12(4): 179-88
  • 3. Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1989 Jul; 96(1): 47-53.
  • 4. Brown DF, Moerenhout RG. The pain experience and psychological adjustment to orthodontic treatment of preadolescents, adolescents, and adults. Am J Orthod Dentofac Orthop 1991 Oct; 100(4): 349-56.
  • 5. Scheurer PA, Firestone AR, Bürgin WB. Perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod 1996 Aug; 18(4): 349-57.
  • 6. Firestone AR, Scheurer PA, Bürgin WB. Patients' anticipation of pain and pain-related side effects, and their perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod 1999 Aug; 21(4): 387-96.
  • 7. Bergius M, Kiliaridis S, Berggren U. Pain in orthodontics. A review and discussion of the literature. J Orofac Orthop 2000; 61(2): 125-37.
  • 8. Koritsánszky N, Madléna M. Pain and discomfort in orthodontic treatments. Literature review. Fogorv Sz 2011 Dec; 104(4): 117-2.
  • 9. Sergl HG, Klages U, Zentner A. Pain and discomfort during orthodontic treatment: causative factors and effects on compliance. Am J Orthod Dentofac Orthop 1998 Dec; 114(6): 684- 91.
  • 10. Kvam E, Bondevik O, Gjerdet NR. Traumatic ulcers and pain in adults during orthodontic treatment. Community Dent Oral Epidemiol 1989 Jun; 17(3): 154-7.
  • 11. Lew KK. Attitudes and perceptions of adults towards orthodontic treatment in an Asian community. Community Dent Oral Epidemiol 1993 Feb; 21(1): 31-5.
  • 12. Soltis JE, Nakfoor PR, Bowman DC. Changes in ability of patients to differentiate intensity of forces applied to maxillary central incisors during orthodontic treatment. J Dent Res 1971 May-Jun; 50(3): 590-6.
  • 13. Furstman L, Bernick S. Clinical considerations of the periodontium. Am J Orthod 1972 Feb; 61(2): 138-55.
  • 14. Burstone CJ. The biomechanics of tooth movement. In: Kraus BS, Riedel RA. Vistas in orthodontics. Philadelphia: Lea&Febiger, 1962; p.197-213.
  • 15. Stewart FN, Kerr WJ, Taylor PJ. Appliance wear: the patient's point of view. Eur J Orthod 1997 Aug; 19(4): 377-82.
  • 16. Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment--effects on compliance and prediction of patients' adaptation by personality variables. Eur J Orthod 2000 Jun; 22(3): 307-15.
  • 17. Ngan P, Wilson S, Shanfeld J, Amini H. The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1994 Jul; 106(1): 88- 95.
  • 18. Bondemark L, Fredriksson K, Ilros S. Separation effect and perception of pain and discomfort from two types of orthodontic separators. World J Orhod 2004 Summer; 5(2): 172-6.
  • 19. Michelotti A, Farella M, Martina R. Sensory and motor changes of the human jaw muscles during induced orthodontic pain. Eur J Orthod 1999 Aug; 21(4): 397-404.
  • 20. Jones ML. An investigation into the initial discomfort caused by placement of an archwire. Eur J Orthod 1984 Feb; 6(1): 48-54.
  • 21. Erdinç AM, Dinçer B. Perception of pain during orthodontic treatment with fixed appliances. Eur J Orthod 2004 Feb; 26(1): 79-85.
  • 22. Polat O, Karaman AI, Durmus E. Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain. Angle Orthod 2005 Sep; 75(5): 791-6.
  • 23. Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment: a randomized controlled clinical trial of two initial aligning arch wires. Am J Orthod Dentofac Orthop 1992 Oct; 102(4): 373-81.
  • 24. Jones ML, Chan C. Pain in the early stages of orthodontic treatment. J Clin Orthod 1992 May; 26(5): 311-3.
  • 25. Jones ML, Richmond S. Initial tooth movement: force application and pain--a relationship? Am J Orthod 1985 Aug; 88(2): 111- 6.
  • 26. Fernandes LM, Ogaard B, Skoglund L. Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire. A randomized clinical trial. J Orofac Orthop 1998; 59(6): 331-9.
  • 27. Smith RJ, Burstone CJ. Mechanics of tooth movement. Am J Orthod 1984 Apr; 85(4): 294-307.
  • 28. Goldreich H, Gazit E, Lieberman MA, Rugh JD. The effect of pain from orthodontic arch wire adjustment on masseter muscle electromyographic activity. Am J Orthod Dentofac Orthop 1994 Oct; 106(4): 365-70.
  • 29. Mao JJ. Mechanobiology of craniofacial sutures. Journal of Dental Research 2002; 81: 810-816.
  • 30. Mao JJ, Wang X, Kopher RA. Biomechanics of craniofacial sutures: orthopedic implications. Angle Orthod 2003 Apr; 73(2): 128- 35.
  • 31. Needleman HL, Hoang CD, Allred E, Hertzberg J, Berde C. Reports of pain by children undergoing rapid palatal expansion. Pediatr Dent 2000 May-Jun; 22(3): 221-6.
  • 32. Egolf RJ, BeGole EA, Upshaw HS. Factors associated with orthodontic patient compliance with intraoral elastic and headgear wear. Am J Orthod Dentofac Orthop 1990 Apr; 97(4): 336-348.
  • 33. Cureton SL. Headgear and pain. J Clin Orthod 1994 Sep; 28(9): 525-30.
  • 34. Ngan PW, Yiu C, Hagg U, Wei SH, Bowley J. Masticatory muscle pain before, during, and after treatment with orthopedic protraction headgear: a pilot study. Angle Orthod 1997; 67(6): 433-7.
  • 35. Goldman HM, Gianelly AA. Histology of tooth movement. Dent Clin North Am 1972 Jul; 16(3): 439-48.
  • 36. Hixon EH, Atikian H, Callow GE, McDonald HW, Tacy RJ. Optimal force, differential force, and anchorage. Am J Orthod 1969 May; 55(5): 437-57.
  • 37. Williams OL, Bishara SE. Patient discomfort levels at the time of debonding: a pilot study. Am J Orthod Dentofac Orthop 1992 Apr; 101(4): 313-7.
  • 38. Rinchuse DJ. Pain-free debonding with occlusal rim wax. J Clin Orthod 1994 Oct; 28(10): 587-8.
  • 39. Chumbley AB, Tuncay OC. The effect of indomethacin (an aspirin-like drug) on the rate of orthodontic tooth movement. Am J Orthod 1986 Apr; 89(4): 312-4.
  • 40. Kehoe MJ, Cohen SM, Zarrinnia K, Cowan A. The effect of acetaminophen, ibuprofen, and misoprostol on prostaglandin E2 synthesis and the degree and rate of orthodontic tooth movement. Angle Orthod 1996; 66(5): 339- 49.
  • 41. Roche JJ, Cisneros GJ, Acs G. The effect of acetaminophen on tooth movement in rabbits. Angle Orthod 1997; 67(3): 231-6.
  • 42. Steen Law SL, Southard KA, Law AS, Logan HL, Jakobsen JR. An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement. Am J Orthod Dentofac Orthop 2000 Dec; 118(6): 629-35.
  • 43. Sari E, Olmez H, Gürton AU. Comparison of some effects of acetylsalicylic acid and rofecoxib during orthodontic tooth movement. Am J Orthod Dentofac Orthop 2004 Mar; 125(3): 310-5.
  • 44. Bernhardt MK, Southard KA, Batterson KD, Logan HL, Baker KA, Jakobsen JR. The effect of preemptive and/or postoperative ibuprofen therapy for orthodontic pain. Am J Orthod Dentofac Orthop 2001 Jul; 120(1): 20-7.
  • 45. Polat O, Karaman AI. Pain control during fixed orthodontic appliance therapy. Angle Orthod 2005 Mar; 75(2): 214-9.
  • 46. Simmons KE, Brandt M. Control of orthodontic pain. J India Dent Assoc 1992 JulAug; 71(4): 8-10.
  • 47. Paganelli C. Pharmacological support during orthodontic therapy with a topical antiinflammatory. Minerva Stomatol 1993 Jun; 42(6): 271-4.
  • 48. Walker JB, Buring SM. NSAID impairment of orthodontic tooth movement. Ann Pharmacother 2001 Jan; 35(1): 113-5.
  • 49. Kyrkanides S, O'Banion MK, Subtelny JD. Nonsteroidal anti-inflammatory drugs in orthodontic tooth movement: metalloproteinase activity and collagen synthesis by endothelial cells. Am J Orthod Dentofacial Orthop 2000 Aug; 118(2): 203-9.
  • 50. Keim RG. Managing orthodontic pain. J Clin Orthod 2004 Dec; 38(12): 641-2.
  • 51. Proffit WR. Contemporary Orthodontics. 3rd ed. St. Louis: The CV Mosby Co. p.311-12.
  • 52. White LW. Pain and cooperation in orthodontic treatment. J Clin Orthod 1984 Aug; 18(8): 572-5.
  • 53. Marie SS, Powers M, Sheridan JJ. Vibratory stimulation as a method of reducing pain after orthodontic appliance adjustment. J Clin Orthod 2003 Apr; 37(4): 205-8.
  • 54. Roth PM, Thrash WJ. Effect of transcutaneous electrical nerve stimulation for controlling pain associated with orthodontic tooth movement. Am J Orthod Dentofacial Orthop 1986 Aug; 90(2): 132-8.
  • 55. Lim HM, Lew KK, Tay DK. A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop 1995 Dec; 108(6): 614-22.
There are 55 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Özge Uslu Akçam This is me

Publication Date May 1, 2014
Published in Issue Year 2014 Volume: 41 Issue: 2 - Volume: 41 Issue: 2

Cite

Vancouver Uslu Akçam Ö. Ortodontik ağrı. EADS. 2014;41(2):121-7.