Effects of single-dose, low-level laser therapy on pain associated with the initial stage of fixed orthodontic treatment: A randomized clinical trial / 대한치과교정학회지

OBJECTIVE: The aim of this study was to assess the analgesic effect of a single application of low-level laser therapy (LLLT) on spontaneous pain and pain on chewing after placement of initial archwires. METHODS: Forty-two patients (26 women, 16 men) were randomly recruited for this split-mouth randomized clinical trial. Each patient received super-elastic nickel-titanium (NiTi) initial archwires (0.012, 0.014, 0.016, and 0.018-inch [in]) in the maxilla for leveling and alignment for an interval of 4 weeks between archwires. One side of the mouth was randomly designated as experimental, while the other side served as placebo. After insertion of each archwire, the experimental side was irradiated with a diode laser for 3 seconds each on 5 points facially and palatally per tooth, from the central incisor to first molar. On the placebo side, the laser device was held the same way but without laser application. A numerical rating scale was used to assess the intensity of spontaneous and masticatory pain for the following 7 days. The Mann-Whitney U test was used to compare pain scores between sides. RESULTS: Patients in the LLLT group exhibited significantly lower mean scores for spontaneous pain after insertion of the initial two archwires (0.012-in and 0.014-in NiTi; p < 0.05), while there was no significant difference for 0.016-in and 0.018-in wires between the LLLT and placebo groups. LLLT significantly reduced chewing pain scores (p < 0.05) for all archwires. CONCLUSIONS: A single dose of LLLT considerably lessened postoperative pain accompanying the placement of super-elastic NiTi wires for initial alignment and leveling.

Effect of chewing gum on pain in fixed orthodontic treatment

Objective: To assess the intensity of orthodontic pain with and without the use of chewing gum during fixed orthodontic treatment in two groups of patients presenting at the Orthodontic Department of Liaquat College of Medicine and Dentistry, Karachi

Methods: The study was conducted at the Orthodontic Department of Liaquat College of Medicine and Dentistry, Karachi, Pakistan. The sample population of this study was thirty adult patients who were planned to initiate fixed orthodontic appliance treatment. In this study, a parallel group clinical trial was conducted with two analogous groups, one was asked to chew gum following orthodontic bracket placement and second was asked not to chew gum. Up until the working wire was placed, the patients filled a questionnaire of Impact of Fixed Appliances after 24hrs and 1week. In order to analyze the intensity of pain, a visual analogue scale [VAS] was used

Results: At the initial 24hrs, among both chewing gum and non chewing gum groups, the difference in median Total Impact Score was 2, which means there was considerable difference [p=0.034; Mann-Whitney U test]

Whereas, the median difference of VAS among the two groups at 24 hours was also 2, also depicting there was considerable difference [p=0.03; Mann-Whitney U test]. However, after 1 week, there was no significant difference in both groups

Conclusion: Both the pain and impact of fixed orthodontic appliance was reduced by using chewing gum

Assessment of gender dimorphism on sagittal cephalometry in Pakistani population

Objective: To determine and compare the cephalometric values among Pakistani males and females using commonly used sagittal skeletal measurements [ANB, Wits appraisal, Beta-angle] and newly developed cephalometric analyses [Yen-angle and W-angle]

Study Design: Observational, cross-sectional study

Place and Duration of Study: Orthodontic Department of Baqai Medical University, Karachi, Pakistan, from August to October 2013

Methodology: A total of 209 pre-treatment lateral cephalometric radiographs of orthodontic patients were selected from departmental records, comprised of 92 males and 117 females. Radiographs were traced for measurements of ANB, Wits appraisal, Beta-angle, W-angle and Yen-angle. Patients were categorized into skeletal classes I, II, and III on the basis of performed measurements, incisor classification, and profile recorded from their records. Descriptive analysis was used to obtain median interquartile range in both the genders and Mann-Whitney U-test was used to observe gender dimorphism

Results: Skeletal class II was the most prevalent type of malocclusion. There were no difference in the obtained measurements between males and females except the Wits appraisal and Beta-angle in class II patients, which showed significant difference in values [p < 0.05]

Conclusion: Pakistani population has no significant different difference in the craniofacial morphology of males and females, with the exception of Wits-appraisal and Beta-angle in class II cases

Radiographic evaluation of aetiology of mandibular third molar impactions

To determine the role of various factors in the etiology of lower third molar impaction by using measurements on conventional panoramic radiograph. Orthopantomograms of 100 patients having full dentition with bilateral mandibular third molars were included in the study ranging between ages of 18-39 years. All the patients were divided into erupted and impacted groups on the basis of status of lower thirdmolar on Orthopantomogram. All Radiographs were traced on overlying acetate paper and analyzed by measuring retromolar eruption space [from Xi-7 and AER-7] mesiodistal width of lower third molar, space width ratio and angulations of lower third molar, In erupted group, retromolar eruption space measured from Xi-7 was 31.79 +/- 3.38 where as in the impacted group, it was 26.93 +/- 4.11. Retromolar space measured from AER-7 was I 6.09 +/- 2.35 mm among erupted group whereas for impacted group, it was 11.06 +/- 3.64 mm. Mesiodistal width of mandibular third molar among erupted group was 13.29 +/- 1.41 mm while among impacted group, it was 13.70 +/- 1.72 mm. Space width ratio among impacted group was 0.83 +/- 0.36 whereas among erupted group, it was 1.22 +/- 0.20. Mean angulations of lower third molars was 7.79° +/- 9.15 among erupted group, where as among impacted group, mean angulations of lower third molars was 34.68° +/- 27.68. Both the groups were statistically different in all the tested variables except mesiodistal width of lower third molar

Relation between centric slide and angle's classification

To compare the difference in sagittal cephalometric analysis in centric occlusion [CO] and in centric relation [CR], among Angle's classes i.e. class I, class II, and class III. Comparative, cross-sectional study. Orthodontic Outpatient Department, Karachi Medical and Dental College, Karachi, from July 2003 to December 2004. Eighty pre-treatment orthodontic patients were divided into 3 groups according to Angle's classification. The first lateral cephalogram was taken in CO. Then leaf gauges were placed in between incisors for deprogramming. The second cephalogram was taken with leaf gauges in place to obtain centric relation. Both the radiographs were traced. Angle ANB was measured for sagittal analysis. ANB angle compares the position of mandible with the maxilla relating it with the cranial base. Angles from both cephalograms were compared with each other. Significant difference [p<0.0001] was found in values of ANB in CO [2.93° +/- 3.7] and CR [4.88° +/- 3.4] cephalograms. Significant CO-CR discrepancy was found [p<0.05] in Angle's class III patients [3.05° +/- 0.55] in comparison to Angle's class I [1.96° +/- 0.94] and class II [1.65° +/- 0.65]. CO-CR discrepancy can occur regardless of Angle's classification. Special emphasis should be given to Angle's class III patients for the centric slide