Perception of pain due to various orthodontic procedures

Objective: To investigate five orthodontic procedures, namely separator placement, banding, initial arch wire ligation (0.016 NiTi), T-loop activation, and use of intermaxillary elastics with respect to intensity of peak pain, time of peak pain, need of medication for pain relief, and effect on routine life due to pain. Method and Materials: One hundred patients (52 males, 48 females) selected for comprehensive orthodontic therapy were included in the study. They were divided into five study groups, namely the separator group, banding group, initial NiTi group, T-loop activation group, and intermaxillary elastics group. Each patient was given a previously prepared questionnaire regarding the following: time of peak pain, intensity of peak pain, need for analgesic consumption, and effect on routine life. Results: Consumption of medication for pain relief was found to be highest in the separator and the initial NiTi groups. Routine life was affected most in the intermaxillary elastics and the initial NiTi groups, but it was not statistically significant. Statistically significant differences were found between the T-loop activation and the banding groups and also between the banding and the intermaxillary elastic groups with respect to perception of intensity of peak pain. In the separator group, the time of peak pain was experienced at the 24th hour and in the rest of the groups it was at the 6th hour with most patients, although the values were not statistically significant. Conclusion: Peak pain intensity varies from one procedure to another. It was significantly more due to T-loop activation and wear of intermaxillary elastics than banding. Keywords: orthodontics, pain, T-loop, visual analog scale