A Six-Month Comparison of Orthodontic Pain Associated with Fixed Edgewise Appliances and Clear Aligners
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Master of Science in Dentistry
Title: A Six-Month Comparison of Orthodontic Pain Associated with Clear Aligners and Fixed Edgewise Appliances
Objective: To document and compare pain perception, intensity, and analgesic use over a sixmonth period between patients treated with fixed appliances (FA) and clear aligners (CA).
Methods: A prospective, parallel, two-arm, multi-center, longitudinal cohort study was conducted with 87 adults treated with CA (n=59) or FA (n=28). Subjects were selected according to inclusion and exclusion criteria. A seven-item, digital survey was sent at three timepoints (preappointment, 2-days post-appointment, and 7-days post-appointment) at each adjustment over a six-month period. The variables measured included pain experience, pain intensity on the VAS scale, analgesic usage, pain quality, pain frequency, and most painful function (chewing, biting on front teeth, biting on back teeth).
Results: At pre-appointment, the FA group had a higher rate (P=0.0135) and intensity (P=0.007) of pain at the 1st adjustment. At 2-days post-appointment, the FA group had a higher rate of pain for the 2nd, 3rd, 4th, and 5th adjustments and greater pain intensity at the 2nd (P=0.0005), 3rd (P=0.0002), 5th (P=0.0199), and 6th (P=0.0262) adjustments. Of those in the CA group who experienced pain, they experienced dull pain more often than the FA group who experienced throbbing or sharp pain more often (P=0.0346). The CA group was more likely to report pain when biting with front teeth (31%) or at rest (37%) while the FA group was more likely to report pain when chewing (66%) (P=0.0016). The FA group had a higher rate of analgesic consumption after the 1st adjustment (P=0.0367) and no CA subjects reported use at or after the 4th adjustment. At 7-days post-appointment, the FA group had a higher rate and intensity of pain for the 1st, 4th, and 5th adjustments.
Conclusion: Patients treated with FA reported higher rates and intensity of pain and were more likely to report pain when chewing than patients treated with CA. Patients treated with FA reported more frequent use of analgesics than patients treated with CA.
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