Evaluation of Pain Between Double Slot Orthodontic Brackets Versus Single Slot by Visual Analogue Scale and Saliva Biomarkers

Brackets and various arch-wires are used in fixed orthodontic appliances to apply forces to the teeth. The amino-acid glutamate is one neurotransmitter that has been discussed in the context of pain processing and has been linked to a variety of pain syndromes. This study aims to evaluate pain between Double slot orthodontic brackets versus single slot with a visual scale and a saliva biomarker (glutamate testing) and CRP. This randomized clinical trial (double-blind) was conducted in Dentistry/Howler Medical University. 41 patients (26 females and 16 males) aged of 18-23 years old with class II malocclusion were selected from patients seeking orthodontic treatment after proper diagnosing using digital cephalometry, OPG. The patients who were chosen randomly received either a single arch-wire (0.014 NiTi) or a double arch-wire (one 0,014 NiTi and the second 0.012 NiTi). Two saliva samples were prepared and analysed to measure glutamate and CRP and evaluate pain using the visual analogue scale. The mean visual scale was 4.38 in the two-wire group compared to the single-wire cases, which was 2.80 showing a significant difference (P ≤ 0.001). There was a significant statistical difference between glutamate after and before treatment for single and double-slot bracket cases. There was a significant difference in mean pain scores between two group with less pain in single wire with a Visual analogue scale, but there is an insignificant difference with saliva glutamate measurement. However, the levels of glutamate before and after applying force were significant in both groups.