Effect of chewing gum on orthodontic pain in patients receiving fixed orthodontic treatment: a systematic review and meta-analysis.

OBJECTIVES: The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage associated with fixed orthodontic appliances. METHODS: This review and its reporting were performed according to the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Six electronic databases were searched up to March 16, 2023, to identify relevant studies that met the inclusion and exclusion criteria. Furthermore, grey literature resources were searched. The Cochrane Collaboration Risk of Bias tool 2 was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan, and sensitivity analysis and publication bias analysis were performed using STATA software. GRADE tool was used to evaluate the certainty of evidence. RESULTS: Fifteen studies with 2116 participants were ultimately included in this review, and 14 studies were included in the meta-analysis. Compared with the blank group, chewing gum had a significant pain relieving effect at all times after fixation of the initial archwire (P ≤ 0.05). No significant difference was found between the chewing gum group and the analgesics group at any timepoints (P > 0.05). Only four studies evaluated the rate of bracket breakage and revealed that chewing gum did not increase the rate of bracket breakage. The sensitivity analysis showed that there was no significant difference in the pooled outcomes after the included studies were removed one at times, and Egger analysis revealed no significant publication bias in included studies (P > 0.05). CONCLUSIONS: Chewing gum is a non-invasive, low-cost and convenient method that has a significant effect on relieving orthodontic pain and has no effect on the rate of bracket breakage. Therefore, chewing gum can be recommended as a suitable substitute for analgesics to reduce orthodontic pain.

[Expression of Forkhead boxO1 and Runt-related transcription factor 2 in periodontal tissue during orthodontic movement of teeth in rats].

PURPOSE: To investigate the expression of FoxO1 and Runx2 in periodontal tissue and their effect during orthodontic teeth movement(OTM) in rats. METHODS: Forty 8-week old male Sprague-Dawley (SD) rats were used to establish animal models of orthodontic teeth movement and divided into 5 groups randomly. The right side of jaws of each rat was set as experimental side, and the left side as control side. At 1, 3, 5, 7, 14 d after orthodontic treatment, the rats were sacrificed and the maxillary bone containing the first molar was dissected. H-E staining and immunohistochemical staining were used to detect the morphological changes, the expression of FoxO1 and Runx2 of the periodontal tissue at different points. Computer image analysis was used to evaluate the expression of FoxO1 and Runx2 in the periodontal tissues of the rats. The differences were analyzed by using SPSS19.0 software package. RESULTS: The expression of FoxO1 in periodontal ligament was mainly in osteoblasts and cementoblasts; and the expression of Runx2 was mainly in osteoblasts, fibroblasts and cementoblasts. In the experimental group,the expressions of FoxO1 and Runx2 in the periodontal tissues of rats increased significantly, reached the peak within 3-5 days, then decreased. There was no significant difference between the experimental group and the control group at 14th day (P>0.05), but significant difference was found between other group and control group (P<0.05). CONCLUSIONS: FoxO1 and Runx2 play a role in the reconstruction of periodontal tissue during orthodontic movement of teeth, and they are mainly involved in the process of osteoblast formation and bone formation.