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Effect of menstrual cycle on orthodontic pain perception

A controlled clinical trial

Effekt des Menstruationszyklus auf die Wahrnehmung kieferorthopädisch bedingter Schmerzen

Eine kontrollierte klinische Studie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Background and objective

The aim of this prospective, single-center, controlled clinical trial was to evaluate the effects of menstrual cycle phases on orthodontic pain perception.

Materials and methods

A total of 48 women between 16 and 20 years old with regular menstrual periods who were scheduled to undergo extraction of two upper first premolars for orthodontic treatment were enrolled in this study. Laceback ligatures were used to move canines distally. After activating the laceback ligatures, each patient completed a questionnaire in order to assess pain and quality of life. Pain perception was recorded by patients on a visual analogue scale (VAS) and a verbal rating scale-4 (VRS) immediately after activation (T1) and 24 h after activation (T2). During the appointment, each patient’s menstrual-cycle phase (follicular or luteal) was determined by asking some questions about her cycle. For statistical analysis of data, the Mann–Whitney U, independent t test, and Wilcoxon tests were applied.

Results

Mean orthodontic pain score was 1.96 ± 0.80 and 47.08 ± 21.68 in the follicular phase, 1.92 ± 0.82 and 46.25 ± 18.92 in the luteal phase at T1 using the VRS and VAS, respectively. Orthodontic pain scores were worse in those patients in the luteal phase than those in the follicular phase (p < 0.05) in terms of both VRS (p = 0.025) and VAS (p = 0.046). No significant difference between pain scores at T1 and those at T2 in both luteal and follicular phases (p > 0.05) were observed.

Conclusion

The menstrual phase has an influence on the perception of orthodontic pain which is higher in the luteal phase following the activation of laceback ligatures. In clinical practice, the phases of the menstrual cycle may have a significant role in how women perceive orthodontic pain.

Zusammenfassung

Hintergrund und Zielsetzung

Ziel dieser prospektiven, monozentrischen, kontrollierten klinischen Studie war es, Auswirkungen der Zyklusphase auf die Wahrnehmung von kieferorthopädisch bedingtem Schmerz zu evaluieren.

Material und Methoden

In die Studie aufgenommen wurden insgesamt 48 Frauen im Alter zwischen 16 und 20 Jahren mit regelmäßigem Menstruationszyklus, bei denen im Rahmen einer kieferorthopädischen Behandlung die Extraktion von 2 oberen ersten Prämolaren geplant war. Zur distalen Verschiebung der Eckzähne wurden Laceback-Ligaturen eingesetzt. Nach Aktivierung dieser Ligaturen füllte jede Patientin einen Fragebogen zu Schmerzen und Lebensqualität aus. Die Schmerzwahrnehmung wurde auf einer visuellen Analogskala (VAS) und einer verbalen Skala (“verbal rating scale”, VRS-4) angegeben, sowohl unmittelbar nach der Aktivierung (T1) als auch 24 h danach (T2). Die Zyklusphase (Follikel- bzw. Lutealphase) wurde im Rahmen des Patientinnenkontakts durch Befragen ermittelt. Zur statistischen Analyse wurden der Mann–Whitney-U-Test, der t Test für unabhängige Stichproben und der Wilcoxon-Test verwendet.

Ergebnisse

Zum Zeitpunkt T1 lagen die mittleren Scores bei 1,96 ± 0,80 (VRS) bzw. 47,08 ± 21,68 (VAS) in der Follikelphase und bei 1,92 ± 0,82 bzw. 47,08 ± 21,68 in der Lutealphase. Die Scores der kieferorthopädisch bedingten Schmerzen waren bei den Patientinnen in der Lutealphase höher als bei denen in der Follikelphase (p < 0,05), jeweils mit beiden Tools bestimmt (VRS: p = 0,025; VAS: p = 0,046). Beim Vergleich der Schmerzscores zu den Zeitpunkten T1 und T2 zeigten sich in beiden Zyklusphasen keine statistisch signifikanten Unterschiede (p > 0,05).

Schlussfolgerungen

Im Lauf des Menstruationszyklus verändert sich die Wahrnehmung kieferorthopädisch bedingter Schmerzen, nach Aktivierung von Laceback-Ligaturen ist sie erhöht in der Lutealphase. In der klinischen Praxis kann die Zyklusphase eine wesentliche Rolle dabei spielen, wie kieferorthopädisch bedingte Schmerzen von Patientinnen empfunden werden.

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Authors and Affiliations

  1. Department of Orthodontics, Faculty of Dentistry, Selcuk University, 42079, Konya, Turkey

    Zehra Ileri, Zeliha Muge Baka & Mehmet Akin

  2. Department of Anesthesia and Intensive Care, Medical Faculty, Selcuk University, Konya, Turkey

    Seza Apiliogullari

  3. Department Chair, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey

    Faruk Ayhan Basciftci

Authors
  1. Zehra Ileri
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  2. Zeliha Muge Baka
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  3. Mehmet Akin
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  4. Seza Apiliogullari
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  5. Faruk Ayhan Basciftci
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Correspondence to Zeliha Muge Baka.

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Conflict of interest

Zehra Ileri, Zeliha Muge Baka, Mehmet Akin, Seza Apiliogullari, and Faruk Ayhan Basciftci state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Dr. Zeliha Muge Baka.

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Ileri, Z., Baka, Z.M., Akin, M. et al. Effect of menstrual cycle on orthodontic pain perception. J Orofac Orthop 77, 168–175 (2016). https://doi.org/10.1007/s00056-016-0013-9

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  • DOI: https://doi.org/10.1007/s00056-016-0013-9

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