title: Efficacy of different methods to reduce pain during debonding of orthodontic brackets.
abstract: OBJECTIVE
  To determine pain during debonding and the effects of different pain control methods, gender, and personal traits on the pain experience.
  
  
  METHODS
  Patients who had fixed orthodontic treatment with metal brackets, but no surgical treatment or craniofacial deformity, were included. Sixty-three patients (32 female, aged 17.2 ± 2.9 years; 31 male aged, 17.2 ± 2.5 years) were allocated to three groups (n = 21) according to the pain control method: finger pressure, elastomeric wafer, or stress relief. Pain experience for each tooth was scored on a visual analogue scale (VAS), and general responses of participants to pain were evaluated by Pain Catastrophizing Scale (PCS). Multiple linear regression analysis, the Mann Whitney U-test, and Spearman's rank correlation coefficient analysis were used to analyze the data.
  
  
  RESULTS
  When the VAS scores were adjusted, finger pressure caused a 47% reduction overall, 56% in lower elastomer wafer total, 59% in lower right arch, 62% in lower left, and 62% in lower anterior compared with the elastomeric wafer. In the elastomer wafer group, upper and lower anterior scores were higher than posterior scores, respectively. Females had higher VAS (lower left and anterior) and total PCS scores than males. Regardless of the pain control method, total PCS scores were correlated with total (r = .254), upper total (r = .290), right (r = .258), left (r = .244), and posterior (r = .278) VAS scores.
  
  
  CONCLUSIONS
  The stress relief method showed no difference when compared with the other groups. Finger pressure was more effective than the elastomeric wafer in the lower jaw. Higher pain levels were recorded for the anterior regions with the elastomeric wafer. Females and pain catastrophizers gave higher VAS scores.
authors.forename: Nehir Canigur
authors.initials: NC
authors.lastname: Bavbek
authors.forename: Burcu Balos
authors.initials: BB
authors.lastname: Tuncer
authors.forename: Tuba
authors.initials: T
authors.lastname: Tortop
authors.forename: Bülent
authors.initials: B
authors.lastname: Celik
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D016910:Orthodontic Brackets / Q000009:adverse effects*; D010146:Pain; D059408:Pain Management; D010147:Pain Measurement; D055815:Young Adult
keywords: Debonding; Fixed appliances; Pain; Pain catastrophizing scale