The Use of Questionnaires in Pain Assessment during Orthodontic Treatments: A Narrative Review.

Pain is a complex multidimensional feeling combined with sensorial and emotional features. The majority of patients undergoing orthodontic treatment report various degrees of pain, which is perceived as widely variable between individuals, even when the stimulus is the same. Orthodontic pain is considered the main cause of poor-quality outcomes, patients' dissatisfaction, and lack of collaboration up to the interruption of therapy. A deep understanding of pain and how it influences a patient's daily life is fundamental to establishing proper therapeutic procedures and obtaining the correct collaboration. Because of its multifaced and subjective nature, pain is a difficult dimension to measure. The use of questionnaires and their relative rating scales is actually considered the gold standard for pain assessment. Choosing the most appropriate instrument for recording self-reported pain depends on a patient's age and cognitive abilities. Although several such scales have been proposed, and a lot of them are applied, it remains uncertain which of these tools represents the standard and performs the most precise, universal, and predictable task. This review aims to give an overview of the aspects which describe pain, specifically the pain experienced during orthodontic treatment, the main tool to assess self-perceived pain in a better and more efficient way, the different indications for each of them, and their correlated advantages or disadvantages.

Consistency of diet and its effects on mandibular morphogenesis in the young rat.

The purpose of this study was to evaluate the relationship between mandibular morphogenesis and masticatory function in 30 male Sprague-Dawley rats, 28 days of age. Animals were randomly divided into three groups and they received diets of different consistency: liquid, normal (as control group) and elastic diet. The experiment lasted 28 days, at the end of which lateral radiographs of the cranium and photographs of the hemimandibles were made. These images were magnified fourfold and analysed in two dimensions (V = vertical dimension; S = sagittal dimension). Condylar morphology was also assessed. The photographic analysis of the hemimandible showed a significantly higher growth of the mandibular ramus stimulated by the elastic diet: V2 2.4 mm, V3 2.4 mm, V4 1.9 mm, V5 4.1 mm (p < 0.05). In contrast, a statistically significant (p < 0.05) lengthening of the mandibular corpus occurred in the rats subjected to liquid diet (S1 4.5 mm, S2 2.7 mm, S3 1.6 mm, S4 2.6 mm). Measurements were taken on both the radiographic and the photographic records. The variation coefficient showed that photographic analysis was more accurate than the radiographic analysis. From these data it appears that an increase in the tonus of the protrusive muscles could be beneficial in mandibular hypoplasia and the increased tonus of the masticatory muscles in skeletal open bite.