Orthodontic Appliance Complication Clinical Trial
Official title:
Evaluation of Pain, Discomfort and Acceptance During the Orthodontic Treatment of Class III Malocclusion Using Bone-anchored Intermaxillary Traction Versus the Removable Mandibular Retractor: A Randomized Controlled Trial
The aim of this study is to evaluate the levels of pain, discomfort and acceptance between two treatment modalities of Class III correction of growing patients in the late mixed dentition period.
The acceptance of orthodontic appliance is measured by the amount of discomfort occurring
during orthodontic treatment. Different feelings can be encountered during the course of
orthodontic treatment such as pressure, tension and pain. Pain is defined as an unpleasant
feeling and a bad subjective experience combined with internal or external reason and it is
considered as the most annoying factor during orthodontic treatment with fixed appliance. In
a study by Oliver and Knappman, patients stated that the worse thing related to the
orthodontic treatment was pain and 70% of the subjects suffered from pain during orthodontic
treatment regardless the appliance' type. The fear from the pain is considered as the most
important factor that not encourage patient to ask orthodontic treatment.Many studies
demonstrated that there were no differences in the amount of the pain resulted from the
orthodontic treatment between males and females [2, 5]. In a study of the reasons which make
patient stopped the orthodontic treatment, Haynes found that the pain was the first reason,
whereas the second one was the effect of the orthodontic appliance on the patient's daily
social life.
When reviewing the medical literature, few studies have been found to identify the patient
acceptance degree to the orthodontic appliance used for treating Class III cases in general
and Class III functional appliances in particular.Removable appliances were evaluated by a
series of publications by Sergl et al in Germany.Additionally, when rigorous study designs
are considered utilizing randomized controlled trials (RCTs), there are only few RCTs in the
dental literature that evaluated patients' responses towards orthodontic treatment. Idris et
al., evaluated Class II growing patients undergoing functional orthopedic corrections,
whereas Khattab et al., compared labial brackets versus lingual brackets in terms of speech
and functional impairments. Recently, Saleh et al., evaluated the levels of acceptance
towards the removable mandibular retractor (RMR) when treating young children with Class III
malocclusion in the late primary dentition and early mixed dentition (i.e. between 5 and 9
years) and found high levels of acceptance recommending the need for further analysis of
patients' responses to this appliance in older age groups.
Bone-anchored intermaxillary elastics have been proposed as a method of correcting Class III
deformities. Although this method was compared to the removable mandibular retractor in terms
of skeletal and dentoalveolar changes, but the published paper did not report any information
about the associated levels of pain and discomfort as well the general acceptability to this
treatment modality.
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