Pain control during orthodontic treatment first

Aim: The introduction of aligner treatment has recently modified patients’ expectations regarding orthodontic treatment. Since their demand for smart, fast and comfortable treatments cannot be neglected, interest for new techniques and devices in this field has raised. Among these, AcceleDent® (OrthoAccel Technologies, Inc., Houston, TX) has been drawing the attention of the scientific community. AcceleDent® is a vibrating device (frequency 30 Hz, force 20 g), which, through a daily 20 minutes usage, promises to accelerate orthodontic tooth movement and reduce treatment-related pain. This device is currently being employed during both fixed orthodontic appliance and aligner therapy all over the world and received FDA approval and CE marking. In particular, pain control has been little investigated up to now. It seems to be due to reduction of periodontal ligament compression and/or to ‘gate control’ mechanism activation. Both theories are valid, but we still need a good amount of data to assess if this effect is clinically relevant or not.Therefore, our aim with this study is to investigate the effectiveness of vibrational forces in reducing aligner treatment-related pain during initial alignment.Methods: Adult patients who began an aligner treatment (Lineo®, Micerium, Italy) were allocated to two arms. The first one (group A) used 20 minutes per day the AcceleDent® device, while the second one (group B) did not use any additional device. We registered pain perception during first week of treatment, which is usually the most troublesome when it comes to patients’ pain and discomfort. We made use of VAS analogic scale to record pain perception and quantify it. Strict selection and exclusion criteria were applied in order to obtain a sample as much homogeneous as possible.Results: Twenty-four patients were allocated to group A or B depending on the acceptance of AcceleDent® use. Four patients discontinued treatment and ten of each group were analysed. The two groups were found to be homogeneous for age and malocclusion type. Group A, which used AcceleDent®, reported a lower perception of pain, with a mean value of 2,4±1,0 versus an average of 4,4±1,4 in group B. According to Student’s t-test, the difference is statistically significant (p<0,05).Conclusions: Our initial aim was to assess if vibrational forces had a potential of reduction of pain perception in subjects undertaking an aligner treatment. Data contained in this controlled clinical trial show that AcceleDent® has a significant effect on patients’ pain perception, if compared to patients that are not using any device. Authors believe that pain control effect can be added to other reported effects of vibrational forces, such as shortening of treatment duration and complex dental movements’ facilitation.