How does orthodontic pain differ in patients using fixed appliances versus those using clear aligner therapies?
Researchers have found in a new study that the intensity of orthodontic pain in that fixed appliance versus those who use clear aligner therapies is the same in the initial 2 days of treatment. However, after two days those using clear aligners reported a low rate and intensity of pain whereas for those using fixed appliances pain peaked after 2 days touching baseline within a week.
The study results have been published in the American Journal of Orthodontics and Dentofacial Orthopedics.
This prospective study compared pain perception, intensity, and analgesic use among patients treated with fixed appliances (FAs) and clear aligners (CAs) over 6 months. Digital surveys were collected from 87 adult patients treated with CA or FA from 2 orthodontic offices.
The 7-item survey was sent at 3-time points (preappointment, 2-day postappointment, and 7-day postappointment) for each appointment. Wilcoxon, t test, and Fisher exact chi-square tests were performed with significance set at 0.05. Results: The FA group had a higher rate and intensity of pain 2 days after the second, third, and fifth appointments (P <0.030). At 7 days postappointment, the FA group had a higher rate and intensity of pain for the first and fifth appointments. Dull pain was reported the most in both groups, with a proportion of FA patients reporting throbbing (31%) or sharp (20%) pain (P = 0.035) at 2 days postappointment.
The CA group reported the most pain at rest, whereas the FA group reported chewing as the most painful (P = 0.002). The FA group had a higher rate of analgesic consumption after the first appointment (P = 0.037). Both the FA and CA groups experienced similar rates and intensities of pain 2 days after the delivery of appliances at the first appointment. Although CA pain intensity remained minimal, FA pain peaked 2 days postappointment whenever a new orthodontic stimulus was introduced and remained elevated 7 days postappointment when that stimulus was a new archwire material.
Reference:
Chan V, Shroff B, Kravitz ND, Carrico C, Hawkins D, Tran P, Lindauer S. Orthodontic pain with fixed appliances and clear aligners: A 6-month comparison. Am J Orthod Dentofacial Orthop. 2024 Jul 30:S0889-5406(24)00271-3. doi: 10.1016/j.ajodo.2024.07.002. Epub ahead of print. PMID: 39078353.
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