Orthodontic pain trajectories in adolescents: Between-subject and within-subject variability in pain perception
The objective of this study was to assess the effects of age, sex, and the age-sex interaction on mean pain trajectories and individual variations in the pain experienced by adolescents after orthodontic separator placement. We included 115 subjects (mean age, 14.99 years; SD, ±1.90 years; 56 boys,...
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| Veröffentlicht in: | American journal of orthodontics and dentofacial orthopedics Jg. 149; H. 4; S. 491 - 500.e4 |
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| Hauptverfasser: | , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
Elsevier Inc
01.04.2016
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| Schlagworte: | |
| ISSN: | 0889-5406, 1097-6752, 1097-6752 |
| Online-Zugang: | Volltext |
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| Zusammenfassung: | The objective of this study was to assess the effects of age, sex, and the age-sex interaction on mean pain trajectories and individual variations in the pain experienced by adolescents after orthodontic separator placement.
We included 115 subjects (mean age, 14.99 years; SD, ±1.90 years; 56 boys, 48.7%; 59 girls, 51.3%) in this study. Orthodontic separators were placed in the mesial and distal contact points of the maxillary and mandibular first molars. A 100-mm visual analog scale was used for pain assessment at 11 prespecified times: 1 hour and 2, 4, 12, 24, 36, 48, 72, 96, 120, and 144 hours. A mixed-effects location scale model was used for the data analysis to directly model between-subject and within-subject variabilities in pain in addition to the usual modeling of mean pain as a function of age, sex, and time.
Mean initial pain after 1 hour of separator placement for the 12- to 15-year-old male group was 13.52 mm on the visual analog scale, which initially increased rapidly (linear estimate, 9.16; P = 0.000; 95% confidence interval [CI], −8.65 to 9.67) but decelerated with time (quadratic estimate, −0.95; P = 0.000; 95% CI, −1.0 to −0.90), suggesting an inverted U-shaped mean pain trajectory. Age, sex, and age-sex interaction effects did not significantly influence initial pain. Compared with the 12- to 15-year-old male group, the 15- to 18-year-old female group reported the steepest rise in pain (estimate, 8.55; P = 0.00; 95% CI, 7.40 to 9.70) and, as a result, experienced the most overall pain. The 12- to 15-year-old male group reported minimum between-subjects variations (SD, ±4.6 mm) as well as within-subjects variations (SD, ±5.5 mm). The between-subjects variations were highest for the 12- to 15-year-old female group (SD, ±9.8 mm), whereas the within-subjects variations were highest for the 15- to 18-year-old female group (SD, ±10.1 mm).
The 12- to 15-year-old boys reported the lowest mean average pain intensity and a minimum subjective variation in between-subject and within-subject variances. The 15- to 18-year-old girls experienced maximum mean pain intensity and the highest daily fluctuations in pain intensity. The 12- to 15-year-old girls were the most different from one another in their overall pain experience.
•We examined pain perception among adolescents after orthodontic separator placement.•A novel “mixed-effects location scale model” was used to analyze pain trajectories.•We explored mean scores and subject variability in pain as functions of age and sex.•Subject variability included both between- and within-subject variations in pain.•Age and sex have significant effects on mean scores and subject variability in pain. |
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| Bibliographie: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| ISSN: | 0889-5406 1097-6752 1097-6752 |
| DOI: | 10.1016/j.ajodo.2015.10.020 |