title: Patient pain experience after placement of initial aligning archwire using active and passive self-ligating bracket systems: a randomized clinical trial.
abstract: OBJECTIVE
  To test whether there is any difference in pain perception during the week following placement of initial aligning archwire in active and passive self-ligating bracket systems.
  
  
  METHODS
  Seventy patients (mean age ± SD, 16.1 ± 2.3 years; 35 males and 35 females) were enrolled in this prospective randomized clinical trial. After appliance placement and engagement of a 0.016-inch round martensitic nickel-titanium (Ni-Ti) alloy archwire, pain levels were recorded after 4 hours; at bed time on the day of the appointment; after 24 hours; and after 2, 3, 4, 5, 6, and 7 days using a nine-page visual analog system (VAS) questionnaire. The use of pain medication self-administered by the patient was also recorded. Independent sample t tests were used to analyze normally distributed data obtained from VAS measurements.
  
  
  RESULTS
  Sixty (85.71%) patients completed the trial. The type of self-ligating bracket had a significant influence on the pain experienced at 4 hours (P = .03), bed time (P = .05), 24 hours (P = .04), and 2 days (P = .05) after placement of initial aligning archwire.
  
  
  CONCLUSIONS
  The type of self-ligating bracket system had a significant difference on subjective pain experience after placement of the initial aligning archwire. Patients treated with active self-ligating appliances experience significantly higher pain levels until the second day compared with patients treated with passive self-ligating appliances.
authors.affiliation: Department of Dental Sciences, Jabalpur Hospital and Research Center, Napier Town, Jabalpur, India. sarvaj.kohli@gmail.com
authors.forename: Sarvraj Singh
authors.initials: SS
authors.lastname: Kohli
authors.forename: Virinder Singh
authors.initials: VS
authors.lastname: Kohli
mesh_terms: D006801:Humans; D016382:Orthodontic Appliance Design; D016910:Orthodontic Brackets; D009969:Orthodontic Wires; D010146:Pain; D011446:Prospective Studies