A longitudinal evaluation of pulpal pain during orthodontic tooth movement.
OBJECTIVE
To examine the longitudinal changes in pulpal sensitivity to electrical stimulation and the relationship to pulpal sensitivity as measured by electrical stimulation and subjective reports of tooth pain after archwire insertion.


METHODS
Non-randomized, prospective trial, with matched controls.


METHODS
Regional Clinical Dental Research Center at the University of Washington School of Dentistry. Eighteen adult subjects of age 13-37 years. Nine experimental subjects planned for orthodontic treatment. Nine control subjects matched for gender and age who did not have orthodontic treatment.


METHODS
Fixed orthodontic appliances and initial archwire placement in experimental subjects compared with 'no treatment' control subjects.


METHODS
Subjective assessments of orthodontic tooth pain were made using visual analogue scales. Electrically evoked detection and pain thresholds were determined using a computer-controlled tooth stimulator. Data were gathered at five time points: after bracket placement (baseline), 1 h after placement of initial archwires, 1 day after archwire placement, 1 week after archwire placement, and 1 month after archwire placement. Comparable time intervals were used for the 'no treatment' control subjects.


RESULTS
Subjective ratings of treatment-evoked tooth pain in the experimental group were the greatest at the post-archwire day 1 observation and progressively decreased for the remaining observations. Control subjects reported little pain at any of these observation times. The detection and pain threshold changes from baseline showed no statistical differences over time or between groups. While not statistically significant, a trend was noted where reports of greater orthodontic tooth pain were associated with increased sensitivity to electrical stimulation (i.e. lower detection and pain thresholds).


CONCLUSIONS
Orthodontic patients experience significant pain and discomfort 1 day after initial archwire placement (i.e. activation). Future research should investigate whether self-reports of treatment-evoked tooth pain intensity are associated with pulpal sensitivity.
Leavitt
A H
AH
Department of Orthodontics, University of Washington School of Dentistry, Seattle 98195-3446, USA.
King
G J
GJ
Ramsay
D S
DS
Jackson
D L
DL
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003782:Dental Pulp / Q000503:physiopathology*; D003791:Dental Pulp Test; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009967:Orthodontic Appliances / Q000009:adverse effects; D010147:Pain Measurement; D017288:Pain Threshold; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D014087:Tooth Movement Techniques / Q000009:adverse effects*; D014098:Toothache / Q000209:etiology*