Evaluation of pain intensity with prostaglandin E2 biomarker and visual analog scale during initiation of orthodontic treatment: A prospective study

Objectives

The aim of this study was to assess subjectively and objectively, at which timepoint the patient undergoing fixed orthodontic treatment will have maximum pain during the initiation of orthodontic treatment.

Materials and Method

A total of 22 patients (21 ± 2.7 years, [15 female and 7 male]) requiring extraction of maxillary first premolar participated in the study. Following bonding, an initial archwire of 0.016" NiTi was placed with a distal force of 100 g applied to the canines. The concentration of prostaglandin E2 (PGE2) in the gingival crevicular fluid was assessed at four time points: 1 hour before (T0); 24 hours (T1); 48 hours (T2); 72 hours (T3) after initial archwire placement. The pain intensity was recorded with visual analog scale.

Results

The concentration of PGE2 increased from T0 to T1. The highest concentration was observed at T2 following which there was a mild decline at T3. Statistically significant difference in the PGE2 concentration was observed between T0 to T1 and T1 to T2. The visual analogue scale (VAS) scores increased from T0 to T1. The highest score was observed at T2 followed by a decline at T3. A statistically significant difference in the VAS score was noted between T0 to T1 and T2 to T3. On correlating PGE2 and VAS score, a weak negative correlation was noted between T0 to T1 and no correlation was noted between T1 to T2 and T2 to T3.

Conclusion

The patients experience maximum pain between 24 hours (T1) and 48 hours (T2) following initial archwire placement. The highest concentration of PGE2 and VAS score was observed at 48 hours (T2).