الملخص
Evaluating levels of pain associated with any treatment is a crucial aspect in assessing the effectiveness of any treatment.The aim of the current study was to evaluate the levels of pain associated with total maxillary arch distalization (TMAD) using a one-jaw and two-jaw mechanics, compared to traditional treatment involving extraction of upper premolars and en-mass retraction of anterior teeth in camouflage orthodontic treatment for Class II Division 1 malocclusion patients.
Forty-five patients (20 males, 25 females) with Class II Division 1 malocclusion according to the Angle classification were included in the current study. They were randomly assigned to three groups: the first group was treated with TMAD using mini-screw implants between the second premolars and first maxillary molars; the second group was treated with TMAD using inter-maxillary elastics between the maxillary canines and mini-screws between the first and second mandibular molars; and the third group received traditional treatment involving extraction of premolars and mass retraction of anterior teeth with mini-screws between the second premolar and first maxillary molar and en-mass retraction of the anterior teeth. Spontaneous and on biting pain levels were evaluated immediately after force delivery, as well as after 6, 24, 48 hours, one week, and two weeks, using the 11-point Numeric Rating Scale (NRS). The mean values of spontaneous pain and pain during chewing in the 2-Jaw TMAD group (3.7 and 6, respectively) were significantly higher than the mean values of spontaneous pain in the 1-Jaw TMAD group (1.7 and 3, respectively), which were also significantly higher than the mean values calculated for the traditional extraction group (1 and 2). The peak pain occurred in the two TMAD groups at 24-48 hours, while it peaked at 6 hours in the control group (P<0.001). Treatment with TMAD using two-jaw mechanics resulted in moderate levels of pain, which were higher than those associated with one-jaw mechanic TMAD, while traditional treatment was associated with very low levels of pain.
References
BAEK, E. S., HWANG, S., KIM, K.-H. & CHUNG, C. J. 2017. Total intrusion and distalization of the maxillary arch to improve smile esthetics. The korean journal of orthodontics, 47, 59-73.
BECHTOLD, T. E., KIM, J.-W., CHOI, T.-H., PARK, Y.-C. & LEE, K.-J. 2013. Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews. The Angle Orthodontist, 83, 266-273.
CAPRIOGLIO, A., CAFAGNA, A., FONTANA, M. & COZZANI, M. 2015. Comparative evaluation of molar distalization therapy using pendulum and distal screw appliances. The korean journal of orthodontics, 45, 171-179.
CARDAROPOLI, D., GAVEGLIO, L. & ABOU-ARRAJ, R. V. Orthodontic movement and periodontal bone defects: Rationale, timing, and clinical implications. Seminars in Orthodontics, 2014. Elsevier, 177-187.
CHEN, G., TENG, F. & XU, T.-M. 2016. Distalization of the maxillary and mandibular dentitions with miniscrew anchorage in a patient with moderate Class I bimaxillary dentoalveolar protrusion. American Journal of Orthodontics and Dentofacial Orthopedics, 149, 401-410.
CHOI, Y. J., LEE, J.-S., CHA, J.-Y. & PARK, Y.-C. 2011. Total distalization of the maxillary arch in a patient with skeletal Class II malocclusion. American journal of orthodontics and dentofacial orthopedics, 139, 823-833.
COPE, J. B. Temporary anchorage devices in orthodontics: a paradigm shift. Seminars in orthodontics, 2005. Elsevier, 3-9.
CROSSMAN, I. & REED, R. 1978. Long term results of premolar extractions in orthodontic treatment. British journal of orthodontics, 5, 61-66.
DORUK, C., ÇANKAYA, Ö. S. & GÜVENÇ, İ. S. 2015. Non-Extraction Treatment of Skeletal Class II Adult Patient with Total Maxillary Arch Distalization. Turkish J Orthod, 28, 122-8.
FONTANA, M., COZZANI, M. & CAPRIOGLIO, A. 2012. Non-compliance maxillary molar distalizing appliances: an overview of the last decade. Progress in orthodontics, 13, 173-184.
FRITZ, U., DIEDRICH, P. & WIECHMANN, D. 2002. Lingual Technique–Patients' Characteristics, Motivation and Accpetance Interpretation of a Retrospective Survey. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie, 63, 227-233.
GARIB, D. G., BRESSANE, L. B., JANSON, G. & GRIBEL, B. F. 2016. Stability of extraction space closure. American Journal of Orthodontics and Dentofacial Orthopedics, 149, 24-30.
GIANNOPOULOU, C., DUDIC, A. & KILIARIDIS, S. 2006. Pain discomfort and crevicular fluid changes induced by orthodontic elastic separators in children. The Journal of Pain, 7, 367-376.
GREENSPAN, R. A. 1970. Reference charts for controlled extraoral force application to maxillary molars. American journal of orthodontics, 58, 486-491.
HAAS, A. J. Headgear therapy: the most efficient way to distalize molars. Seminars in Orthodontics, 2000. Elsevier, 79-90.
HALIMI, A., BENYAHIA, H., DOUKKALI, A., AZEROUAL, M.-F. & ZAOUI, F. 2012. A systematic review of force decay in orthodontic elastomeric power chains. International orthodontics, 10, 223-240.
JAMBI, S., THIRUVENKATACHARI, B., D O'BRIEN, K. & WALSH, T. 2013. Orthodontic treatment for distalising upper first molars in children and adolescents. Cochrane Database of Systematic Reviews.
JO, S. Y., BAYOME, M., PARK, J., LIM, H. J., KOOK, Y.-A. & HAN, S. H. 2018. Comparison of treatment effects between four premolar extraction and total arch distalization using the modified C-palatal plate. The korean journal of orthodontics, 48, 224-235.
KIM, S. Y. 2013. Efficacy versus effectiveness. Korean journal of family medicine, 34, 227-227.
KINZINGER, G. S., EREN, M. & DIEDRICH, P. R. 2008. Treatment effects of intraoral appliances with conventional anchorage designs for non-compliance maxillary molar distalization. A literature review. The European Journal of Orthodontics, 30, 558-571.
KINZINGER, G. S., GÜLDEN, N., YILDIZHAN, F. & DIEDRICH, P. R. 2009. Efficiency of a skeletonized distal jet appliance supported by miniscrew anchorage for noncompliance maxillary molar distalization. American journal of orthodontics and dentofacial orthopedics, 136, 578-586.
KOOK, Y.-A., LEE, D., KIM, S. & CHUNG, K. 2013. Design improvements in the modified C-palatal plate for molar distalization. Journal of clinical orthodontics: JCO, 47, 241-8; quiz 267-8.
LEE, S. K., ABBAS, N. H., BAYOME, M., BAIK, U.-B., KOOK, Y.-A., HONG, M. & PARK, J. H. 2018. A comparison of treatment effects of total arch distalization using modified C-palatal plate vs buccal miniscrews. The Angle Orthodontist, 88, 45-51.
LUPPANAPORNLARP, S., KAJII, T. S., SURARIT, R. & IIDA, J. 2010. Interleukin-1β levels, pain intensity, and tooth movement using two different magnitudes of continuous orthodontic force. The European Journal of Orthodontics, 32, 596-601.
MAH, S.-J., KIM, J.-E., AHN, E. J., NAM, J.-H., KIM, J.-Y. & KANG, Y.-G. 2016. Analysis of midpalatal miniscrew-assisted maxillary molar distalization patterns with simultaneous use of fixed appliances: A preliminary study. The korean journal of orthodontics, 46, 55-61.
MANNI, A., LUPINI, D. & COZZANI, M. 2018. Combining skeletal anchorage and intermaxillary elastics in Class II treatment. Journal of clinical orthodontics: JCO, 52, 227-234.
MATTHEWS, J., ALTMAN, D. G., CAMPBELL, M. & ROYSTON, P. 1990. Analysis of serial measurements in medical research. British medical journal, 300, 230-235.
MHEISSEN, S., KHAN, H., ALMUZIAN, M., ALZOUBI, E. E. & PANDIS, N. 2022. Do longitudinal orthodontic trials use appropriate statistical analyses? A meta-epidemiological study. European journal of orthodontics, 44, 352-357.
MOHAMED, N. A. M., KADDAH, A. M., SOLIMAN, S. A. Z. & ELSAYED, E. M. E. 2023. Evaluation Of Pain Perception During Micro-Osteoperforation Assisted Maxillary En-Masse Retraction: A Randomized Controlled Trial. Journal of Pharmaceutical Negative Results, 51-59.
NAIM, M., HASAN, M., NAHAR, L., NASRIN, T., NAZNIN, S. & GHOSH, R. 2016. Causes of Orthodontic Pain & its treatment: an overview. Update Dental College Journal, 6, 43-51.
OWAYDA, A. M., HAJEER, M. Y., MURAD, R. M. & AL-SABBAGH, R. 2022. The efficacy of low-level laser therapy versus paracetamol–caffeine in controlling orthodontic separation pain and changes in the oral-health-related quality of life in Class I malocclusions: A 3-arm, randomized, placebo-controlled clinical trial. Journal of the World Federation of Orthodontists.
PANDA, S., VERMA, V., SACHAN, A. & SINGH, K. 2015. Perception of pain due to various orthodontic procedures. Quintessence International, 46.
PETERSON, L. J. & HUPP, T. 2003. Contemporary oral and maxillofacial surgery 4th. New York: Mosby, 195-235.
PIAO, Y., KIM, S.-J., YU, H.-S., CHA, J.-Y. & BAIK, H.-S. 2016. Five-year investigation of a large orthodontic patient population at a dental hospital in South Korea. The korean journal of orthodontics, 46, 137-145.
QAMRUDDIN, I., ALAM, M. K., FIDA, M. & KHAN, A. G. 2016. Effect of a single dose of low-level laser therapy on spontaneous and chewing pain caused by elastomeric separators. Am J Orthod Dentofacial Orthop, 149, 62-6.
SA'AED, N. L., PARK, C. O., BAYOME, M., PARK, J. H., KIM, Y. & KOOK, Y.-A. 2015. Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents. The Angle Orthodontist, 85, 657-664.
SUGAWARA, J., KANZAKI, R., TAKAHASHI, I., NAGASAKA, H. & NANDA, R. 2006. Distal movement of maxillary molars in nongrowing patients with the skeletal anchorage system. American journal of orthodontics and dentofacial orthopedics, 129, 723-733.
TUNCER, Z., OZSOY, F. S. & POLAT-OZSOY, O. 2011. Self-reported pain associated with the use of intermaxillary elastics compared to pain experienced after initial archwire placement. The Angle Orthodontist, 81, 807-811.
YANG, L., LV, C., YAN, F. & FENG, J. 2020. Force degradation of orthodontic latex elastics analyzed in vivo and in vitro. American Journal of Orthodontics and Dentofacial Orthopedics, 157, 313-319.