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Master's Dissertation
DOI
https://doi.org/10.11606/D.23.2023.tde-21062023-091851
Document
Author
Full name
Tereza Cristina Holtz Schuch
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Paiva, João Batista de (President)
Lima, Darwim Vaz de
Rino Neto, José
Ursi, Weber Jose da Silva
Title in Portuguese
Avaliação da sintomatologia dolorosa em pacientes tratados com braquetes autoligados passivos durante a troca de arcos
Keywords in Portuguese
Arcos iniciais
Autoligado
Dor ortodôntica
Escala analógica visual
Abstract in Portuguese
Os procedimentos clínicos ortodônticos evoluíram de uma forma significativa em relação a dor, entretanto ainda se observam relatos de sintomatologia dolorosa por estes pacientes durante o tratamento ortodôntico com aparelho fixo. Uma das características da dor é a ampla variabilidade nas respostas dos pacientes, independente da extensão da patologia clínica. Isso se deve a uma gama de fatores cognitivos, emocionais, culturais e comportamentais que estão intimamente relacionados não apenas a percepção da dor, mas também a sua manutenção e subsequente incapacidade funcional. O objetivo desse estudo foi avaliar a intensidade e duração da sintomatologia dolorosa do paciente durante a sequência de troca de arcos, na fase de nivelamento do tratamento ortodôntico, bem como as variáveis de ansiedade e desalinhamento dental. Método: Foi realizado um estudo prospectivo, paralelo de 3 braços, composta de 43 pacientes, jovens e adultos de 14 a 25 anos, de gênero masculino (53,5%) e feminino (46,5%) tratados com aparelho fixo auto ligado passivo (Damon® Q Ormco Corporation, Glendora) divididos em 3 grupos, classificados em relação ao tempo de troca dos arcos: 4 semanas, 8 semanas e 12 semanas. e com 4 arcos utilizados (Arcos Cooper Ni-Ti (0,014''; 0,018; 0,014'' x 0,025''; 0,018'' x 0,025''). Ormco Corporation, Glendora -California). As comparações da Escala Analógica Visual (EAV) entre os arcos de acordo com os tempos e grupos foram realizadas com a utilização de modelos mistos com efeito aleatório de indivíduo (McCulloch et al, 2008). Os cálculos apresentados foram realizados com auxílio do software R 3.6.0 Para os testes estatísticos, foi adotado um nível de significância de 5% e foram apresentadas em médias e desvios padrão da EAV para cada tempo de acordo com o fio e grupo. Para estabelecer relação entre a dor e a ansiedade foram apresentadas as médias e desvios padrão da escala de dor média e máxima e a comparação dos grupos de acordo com o teste t. Considerando um nível de significância de 5%. Resultados: O pico de dor foi observado em até 24 horas da inserção dos arcos ortodônticos utilizados, sendo que nos arcos 0,018, 0,014x 0,025, 0,018 x 0,025 CuNiTi, o pico de dor foi revelado após 8 horas, o arco que expressou maior nível de dor independentemente do grupo foi o 0,14 seguido dos fios em ordem decrescente 0,014x 0,025, 0,018 e 0,018 x 0,025 CuNiTi. A ansiedade e o grau de desalinhamento dental mostraram associação estatisticamente significativa com a dor.
Title in English
Assessment of painful symptoms in patients treated with passive self-ligation brackets during archwire change
Keywords in English
Initial archwires
Orthodontic pain
Self-ligation
Visual analog scale
Abstract in English
Clinical orthodontic procedures have evolved significantly in regard to pain; however, patients still report painful symptoms during orthodontic treatment with fixed appliances. One of the hallmarks of pain is the wide variability in patient responses, regardless of the extent of clinical pathology. This is due to a range of cognitive, emotional, cultural and behavioral factors that are closely related not only to pain perception, but also to its maintenance and subsequent functional disability. The aim of this study is to evaluate the intensity and duration of the patient's painful symptoms during the arch change sequence, in the leveling phase of orthodontic treatment, as well as the dental misalignment and the anxiety variables. Method: A prospective, parallel 3-arm study was carried out, comprising 43 patients, young people and adults aged 14 to 25 years, male (53.5%) and female (46.5%) treated with a self-ligating fixed appliance. (Damon® Q Ormco Corporation, Glendora) divided into 3 groups, classified according to the time of arch change: 4 weeks, 8 weeks and 12 weeks. and with 4 archwires used (Cooper Ni-Ti Arches (0.014''; 0.018''; 0.014'' x 0.025''; 0.018'' x 0.025''). Ormco Corporation, Glendora - California). Comparisons of the Visual Analog Scale (VAS) between the archwires according to the instants and periods were performed applying mixed models with individual random effects (McCulloch et al, 2008). The calculations presented were performed by means of the R 3.6.0 software. For the statistical tests, a significance level of 5% was adopted and they were presented as means and standard deviations of the VAS for each time according to the archwire and group. To establish a relationship between pain and anxiety, the means and standard deviations of the mean and maximum pain scale were presented, and the groups were compared according to the t test. Considering a significance level of 5%. Results: Peak pain was observed within 24 hours of insertion of the orthodontic wires used, and in wires 0.018, 0.014x 0.025, 0.018 x 0.025 CuNiTi, the peak of pain was occurred after 8 hours, the wire that expressed the highest level of pain regardless of the group was 0.14 followed in descending order by 0.014x 0.025, 0.018 and 0.018 x 0.025 CuNiTi. The greatest pain experience was detected after the placement of the first arch, anxiety and the degree of dental misalignment showed a statistically significant association with pain.
 
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Publishing Date
2023-06-26
 
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