Evaluation of painful, inflammation and somatosensory alteration in patients during orthodontic treatment: a controlled study

Abstract

Orthodontic tooth movement is induced by mechanical stimuli and facilitated by remodeling of periodontal ligament and alveolar bone. A pre condition for the remodeling activities is the occurrence of inflammatory process. Pain is one of the most important cardinal signs of inflammation and it is present during orthodontic tooth movement. Several studies showed that Quantitative Sensory Testing (QST) might be useful to identify presence of inflammatory process adjacent to the nerves. The purpose of present study is to evaluate possible sensory alteration using QST and pro-inflammatory cytokines from the gingival crevicular fluid (GCF) in patients during orthodontic treatment in order to correlate those factors with pain during tooth movement. 30 patients will be selected from the orthodontic department. Patients will initiate the orthodontic treatment in the superior arch and only after 1 month the inferior arch will be initiated. The study will consist of 8 visits. All the subjects will be tested with 6 different QST modalities in two facial regions (infraorbital nerve and mental nerve territories) and also in an extra-trigeminal region (dominant arm). The QST are: Current Pain Threshold (CPT), Heat Detection Threshold (HDT), Cold Detection Threshold (CDT), Mechanical Detection Threshold (MDT), Mechanical Suprathreshold (MST) and Conditioned Pain Modulation (CPM). Pain intensity will be measured with a visual analog scale (VAS) and daily pain diary during all the study. The initial GCF will collect in the first sessions from the four first molars and the experimental GCF from the posterior teeth of the patient's dominant side at 24 hours after elastic separator placement and 24 and 720 hours after NiTi 0.14 wire placement in both arches. The pro-inflammatory cytokines will be analyzed using a multiplex Luminex analyzes. Statistical analyzes will be performed using paried t-test, ANOVA and RANOVA. Significant level will set as 5% (p<0,05). (AU)