Comparison of self-rated pain and salivary alpha-amylase and cortisol levels during early stages of fixed orthodontic and clear aligner therapy

Abstract

Objectives

To compare self-rated orthodontic pain (OP) and whole salivary alpha-amylase (αA) and cortisol levels (CL) during early stages of fixed orthodontic and clear aligner therapy (CAT).

Methods

In groups 1 and 2, malocclusions were treated using fixed orthodontic appliances and CAT, respectively. In Group-3, individuals had normal occlusion and had never undergone orthodontic therapy. Self-rated OP was assessed using the visual-analogue-scale at baseline (T0); after 24-hours (T1) of appliance activation; and after 30 days (T2). Unstimulated whole saliva was collected and αA and CL were measured using enzyme-linked immunosorbent assay. p < .01 was considered statistically significant.

Results

Twenty-four (Group-1), 24(Group-2) and 25 (Group-3) patients were included. In groups 1 and 2, participants had Class-I malocclusion with anterior-crowding in both arches. At baseline (T0) none of the participants reported pain on mastication. In groups 1 (p < .01) and 2 (p < .01), OP was higher at T1 than T2. In groups 1 and 2, αA and CL were higher at T1 (p < .01) than T0 and T2. At T1 and T2, salivary αA and CL were higher in groups 1 (p < .01) and 2 (p < .01) than Group-3. In groups 1 and 2, a significant correlation was recorded between OP and αA (p < .01) and CL (p < .01) at T1 interval.

Conclusion

Self-rated OP and salivary αA and CL during the early stages of fixed OT and CAT are similar. Whole salivary αA and CL and OP and are high during the first 24 hours of fixed OT and CAT activation.

Keywords:

• Alpha amylase
• clear aligner therapy
• cortisol
• fixed orthodontic therapy
• pain
• saliva

Authors’ contributions

DA: Conceptualization, Supervision, Methodology, Software, Original draft preparation, Reviewing and Editing. DA and HA: Data curation, Literature search, Writing- Original draft preparation, Reviewing and Editing. DA, HA, and MA: Quantitative analysis; DA, HA, and MA: Writing- Original draft preparation Visualization, Writing- Reviewing and Editing, Writing- Reviewing and Editing. DA, HA, and MA: Methodology, Original draft preparation. DA, HA, and MA: Original draft preparation and revision of manuscript prior to submission, Writing- Reviewing and Editing.

Disclosure statement

The authors declare that they have no conflict of interest.

Data availability statement

Data supporting the findings of the present study is available upon reasonable request.

Additional information

Funding

There was no source of funding for the present study.