Assessment of Pain When Removing Metallic Brackets for Orthodontic Patients Using Two Removal Methods
NCT ID: NCT06873503
Last Updated: 2025-03-12
Study Results
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Basic Information
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COMPLETED
NA
36 participants
INTERVENTIONAL
2024-05-19
2025-01-05
Brief Summary
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Open mouth group:
The debonding procedure was conducted using the open-mouth technique. All brackets were removed using a Weingart plier (American Orthodontics, Sheboygan, Wisc) by squeezing them from both sides of the mesial-distal surfaces. Before debonding, the stainless steel finishing archwires (0.017 × 0.025 inches) were removed.
Biting-on a-cotton-roll-group:
All brackets were removed using the same plier. The brackets were debonded using a Weingart plier (American Orthodontics, Sheboygan, Wisc) by squeezing them from both sides of the mesial-distal surfaces. Additionally, cotton rolls were placed between the upper and lower teeth, and patients were instructed to bite on them during the procedure. Before debonding, the stainless steel finishing archwires (0.017 × 0.025 inches) were removed. Patients in the second group were instructed to bite on a cotton roll throughout the debonding process.
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Detailed Description
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Although various methods for bracket debonding, such as ultrasonic instrumentation, lasers, and electro-thermal debonding, are documented in the literature, hand tools like Weingart pliers remain among the most practical solutions. This study focused on using Weingart pliers to compare the pain scores in two techniques-open mouth and biting on a cotton roll-during bracket removal. These methods are widely used in orthodontic clinics and are readily available to orthodontists.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Bracket removal with the mouth open
Using a Weingart orthodontic plier, the patient will be asked to keep his mouth open during bracket removal.
Bracket removal using a Weingart plier with the mouth open
The brackets will be removed using a Weingart plier. The patient will be asked to keep his mouth open during this procedure.
Bracket removal while biting on a cotton roll
During bracket removal with a Weingart orthodontic plier, the patient will be asked to bite on a cotton roll between the upper and lower teeth.
Biting on a cotton roll during brakcet removal
The brackets will be removed using a Weingart plier. During this procedure, the patient will be asked to bite on a cotton roll.
Interventions
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Bracket removal using a Weingart plier with the mouth open
The brackets will be removed using a Weingart plier. The patient will be asked to keep his mouth open during this procedure.
Biting on a cotton roll during brakcet removal
The brackets will be removed using a Weingart plier. During this procedure, the patient will be asked to bite on a cotton roll.
Eligibility Criteria
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Inclusion Criteria
* Undergoing orthodontic treatment with MBT prescription 0.022-inch metal brackets with a single-mesh base (Pinnacle®, MBT compatible 0.022, OrthoTechnology™, Florida, USA) who were in the final stage of their treatment and planned for debonding,
* The brackets bonded with the same bonding cement (Ivoclar Heliosit Orthodontic Adhesive Composite) and the same primer (Ivoclar Vivadent Tetric N-Bond),
* Absence of debonded brackets at the debonding process,
* The 0.017 × 0.025-inch stainless steel finishing archwires in their places for at least one month,
* Good occlusal relationships and strong intercuspation,
* No recent use of medications such as painkillers or corticosteroids in the last day,
* Absence of acute or chronic dental pain induced by periodontal/periapical lesions or caries,
* There is an absence of a history of surgical treatment, including impacted tooth eruption, tooth transplantation, or the presence of mini-screws.
Exclusion Criteria
* Previous facial trauma
* Previous orthodontic treatment
16 Years
25 Years
ALL
No
Sponsors
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Damascus University
OTHER
Responsible Party
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Principal Investigators
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Belal A. Drmch, DDS
Role: PRINCIPAL_INVESTIGATOR
Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
Kinda Sultan, DDS MSc PhD
Role: STUDY_DIRECTOR
Department of Orthodontics, Faculty of Dentistry, Damascus University
Locations
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Department of Orthodontics, Faculty of Dentistry, University of Damascus
Damascus, , Syria
Countries
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References
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Karobari MI, Assiry AA, Mirza MB, Sayed FR, Shaik S, Marya A, Venugopal A, Alam MK, Horn R. Comparative Evaluation of Different Numerical Pain Scales Used for Pain Estimation during Debonding of Orthodontic Brackets. Int J Dent. 2021 Mar 4;2021:6625126. doi: 10.1155/2021/6625126. eCollection 2021.
Almuzian M, Rizk MZ, Ulhaq A, Alharbi F, Alomari S, Mohammed H. Effectiveness of different debonding techniques and adjunctive methods on pain and discomfort perception during debonding fixed orthodontic appliances: a systematic review. Eur J Orthod. 2019 Sep 21;41(5):486-494. doi: 10.1093/ejo/cjz013.
Gupta SP, Rauniyar S, Prasad P, Pradhan PMS. A randomized controlled trial to evaluate the effectiveness of different methods on pain management during orthodontic debonding. Prog Orthod. 2022 Mar 1;23(1):7. doi: 10.1186/s40510-022-00401-y.
Mangnall LA, Dietrich T, Scholey JM. A randomized controlled trial to assess the pain associated with the debond of orthodontic fixed appliances. J Orthod. 2013 Sep;40(3):188-96. doi: 10.1179/1465313313Y.0000000045.
Williams OL, Bishara SE. Patient discomfort levels at the time of debonding: a pilot study. Am J Orthod Dentofacial Orthop. 1992 Apr;101(4):313-7. doi: 10.1016/S0889-5406(05)80324-5.
Other Identifiers
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UDDS-Ortho-3-2025
Identifier Type: -
Identifier Source: org_study_id
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