Factors Associated with Pain Intensity in Patients Undergoing Orthodontic Treatment Based on Mini-Implants

Abstract

Introduction: Pain is currently reported as the most common side effect associated with orthodontic treatment. The aim of this study was to evaluate the factors associated with the intensity of pain perception during orthodontic procedures consisting in anesthesia, orthodontic mini-implant placement and removal, as well as during the postoperative period following these procedures. Material and Methods: The study included 50 young adults with a permanent dentition in need of orthodontic treatment. The pain assessment was based on visual analogue scale (VAS), using self-report questions from approved questionnaires. Pain severity was analyzed in relation to: anesthesia, implant placement, implant removal, implant movement, elastic traction and gingiva/bone pain around the implant. The study lot was divided into Group 1 – patients experiencing a pain degree of 1 or 2, and Group 2 – patients experiencing a pain degree of 3 or 4 during implant placement. Results: The maximum pain intensity (PI) was recorded during implant placement, which has been associated with a PI of 2.4 ± 0.8 (95% CI: 2.17–2.63), followed by implant removal (PI = 2.36 ± 0.66, 95% CI: 2.17–2.54), gingiva/bone pain around the implant (PI = 2.32 ± 2.58, 95% CI: 2.15–2.48), and elastic traction (PI = 2.26 ± 0.63, 95% CI: 2.08–2.44). Male gender was present in a significantly higher extent in the group of patients presenting a high intensity pain during implant placement (86.3% in Group 2 vs. 3.5% in Group 1, p <0.0001). The age group most sensitive to pain was 18 to 21 years. Conclusions: In our study, pain perception was significantly higher in males and in the 18–21 years age group. The most painful procedure during surgery was the initial moment of implant placement, followed by the moment of implant removal, gingival/bone pain around the implant, and the elastic tractions placed on the implant during anchorage.