Impact of wearing fixed orthodontic appliances on quality of life among adolescents: Case-control study

Objective:To investigate the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among adolescents.Materials and Methods:A case-control study (1∶2) was carried out with a population-based randomized sample of 327 adolescents aged 11 to 14 years enrolled at public and private schools in the City of Brumadinho, southeast of Brazil. The case group (n  =  109) was made up of adolescents with a high negative impact on OHRQoL, and the control group (n  =  218) was made up of adolescents with a low negative impact. The outcome variable was the impact on OHRQoL measured by the Brazilian version of the Child Perceptions Questionnaire (CPQ_11–14) – Impact Short Form (ISF:16). The main independent variable was wearing fixed orthodontic appliances. Malocclusion and the type of school were identified as possible confounding variables. Bivariate and multiple conditional logistic regressions were employed in the statistical analysis.Results:A multiple conditional logistic regression model demonstrated that adolescents wearing fixed orthodontic appliances had a 4.88-fold greater chance of presenting high negative impact on OHRQoL (95% CI: 2.93–8.13; P < .001) than those who did not wear fixed orthodontic appliances. A bivariate conditional logistic regression demonstrated that malocclusion was significantly associated with OHRQoL (P  =  .017), whereas no statistically significant association was found between the type of school and OHRQoL (P  =  .108).Conclusions:Adolescents who wore fixed orthodontic appliances had a greater chance of reporting a negative impact on OHRQoL than those who did not wear such appliances.     

Assessing anteroposterior basal bone discrepancy with the Dental Aesthetic Index

Objective:To investigate dental appearance and cephalometric features, using a sample of orthognathic and/or orthodontic patients. A special interest was to identify the relationship of the Dental Aesthetic Index (DAI) with anteroposterior basal bone discrepancy (APBBD) and cephalometric indicators.Materials and Methods:A full sample of 159 patients in two Japanese hospitals was used. Each patient was assessed with a preorthodontic dental cast and cephalometric radiography.Results:Malocclusion with APBBD was more prevalent among high DAI subjects (P  =  .034, OR  =  1.04, 95% CI: 1.00–1.08), Class III malocclusion patients (P  =  .048, OR  =  2.32, 95% CI: 1.01–5.34) and male patients (P  =  .008, OR  =  2.96, 95% CI: 1.33–6.61). Participants scoring 88 points (the highest score in this sample) of the DAI had 16.84 times the risk of APBBD of those who scored 17 points (the lowest score in this sample). Patients with APBBD presented with a greater adjusted ANB angle (t  =  −8.10, P < .001) and a larger adjusted A-B/NF appraisal (t  =  −9.65, P < .001). The SNA angle (P < .001), the SNB angle (P  =  .002), the adjusted ANB angle (P  =  .001), and the adjusted A-B/NF appraisal (P  =  .035) were associated with DAI scores in cubic regression models.Conclusion:This study has demonstrated a relationship between the DAI and APBBD. Feasibility of using the adjusted ANB angle and the adjusted A-B/NF appraisal to assess severity of APBBD has been confirmed. The DAI may provide a supportive method to evaluate orthognathic needs. Future investigations are indicated.     

Trends in orthodontic management strategies for patients with congenitally missing lateral incisors and premolars

ObjectivesTo identify changes in orthodontic management strategies in patients with hypodontia seen in 2000, 2010, and 2017/2018 (during a 1-year period).Materials and MethodsAn assessment of the panoramic radiographs of 3701 patients from a Western Australian private practice identified 276 individuals demonstrating hypodontia. The location of missing teeth, age, sex, type of malocclusion, and the management strategies (space closure or opening) for each patient were noted.ResultsMost hypodontia involved agenesis of three or fewer teeth (90%). Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. Female preponderance was noted. When considering treatment, the odds ratio for orthodontic space opening and prosthetic replacement in 2000 was 3.266 (P value = 7e-04; 95% confidence interval [CI], 1.464–4.633) compared with patients seen in 2010 and 1.632 (P value = 7e-04; 95% CI, 0.811–2.434) compared with patients in 2017/2018. For patients demonstrating bilateral absence of maxillary lateral incisors, the odds ratio for orthodontic space opening was 3.185 (P value = 0.0215; 95% CI, 1.182–9.243) compared with counterparts with unilateral agenesis. None of the factors investigated were significantly associated with the types of treatment planned/provided for the patients with missing mandibular second premolars.ConclusionsMaxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. A trend away from space opening and prosthetic replacement toward orthodontic space closure was observed from 2000 to 2017/2018. This may reflect a change in attitude toward prosthetic replacement options and/or greater optimism with biomechanical strategies since the implementation of temporary anchorage devices to assist in space closure.     

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

Objective:To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction.Materials and Methods:Panoramic radiographs of 21 Class II subdivision adolescents (eight boys, 13 girls; mean age, 12.8 years; standard deviation, 1.7 years) before treatment, after treatment with extraction of one maxillary first molar and Begg appliances and after at least 1.8 years in retention were retrospectively collected from a private practice. M2 and M3 inclination angles (M2/ITP, M2/IOP, M3/ITP, M3/IOP), constructed by intertuberosity (ITP) and interorbital planes (IOP), were calculated for the extracted and nonextracted segments. Random effects regression analysis was performed to evaluate the effect on the molar angulation of extraction, time, and gender after adjusting for baseline measurements.Results:Time and extraction status were significant predictors for M2 angulation. M2/ITP and M2/IOP decreased by 4.04 (95% confidence interval [CI]: −6.93, 1.16; P  =  .001) and 3.67 (95% CI: −6.76, −0.58; P  =  .020) in the extraction group compared to the nonextraction group after adjusting for time and gender. The adjusted analysis showed that extraction was the only predictor for M3 angulation that reached statistical significance. M3 mesial inclination increased by 7.38° (95% CI: −11.2, −3.54; P < .001) and 7.33° (95% CI: −11.48, −3.19; P  =  .001).Conclusions:M2 and M3 uprighting significantly improved in the extraction side after orthodontic treatment with unilateral maxillary M1 extraction. There was a significant increase in mesial tipping of maxillary second molar crowns over time.     

Cariogram caries risk profiles in adolescent orthodontic patients with and without some salivary variables

Objective:To compare the Cariogram caries risk profiles with and without salivary buffer capacity and mutans streptococci (MS) counts in adolescents with fixed orthodontic appliances.Materials and Methods:The sample consisted of 90 healthy Greek adolescents who were undergoing orthodontic treatment. The Cariogram risk model was applied through a questionnaire and clinical and salivary examinations. The actual chance of avoiding new caries was calculated, and participants were categorized into three groups (0–40%  =  high caries risk, 41–60%  =  medium caries risk, and 61–100%  =  low caries risk) using a nine-item Cariogram or by excluding either salivary buffer capacity or MS or both. Cohen''s Kappa statistical analysis was used for comparing the Cariogram outcome with and without salivary variables. The distribution of variables was compared by nonparametric marginal homogeneity tests.Results:Using the Cariogram with nine variables, 62% of the patients were assigned to the high caries risk category, 13% to the medium risk category, and 24% to the low risk category. Omission of salivary buffer capacity did not alter the risk categories significantly, while more subjects were assigned to the medium risk category when MS counts were excluded. The difference between the nine-item Cariogram and the MS-reduced version, however, was not statistically significant (P  =  .07).Conclusions:The Cariogram model may be used both with and without salivary tests for risk grouping in orthodontic practice.     

Patient attitudes toward retention and perceptions of treatment success

Objective:To discern patients'' opinions regarding responsibility for orthodontic retention and to determine whether patient attitudes toward retention are related to perceptions of treatment success.Materials and Methods:Questionnaires regarding orthodontic retention were distributed to first-year undergraduate college students (n  =  158), first-year dental students (n  =  183), and retention patients at orthodontic offices (n  =  214). Items included treatment satisfaction, perceived responsibility for retention, type of retainer prescribed, reasons for discontinuing use of retainers, and relapse experienced.Results:Four hundred twenty-eight of 555 participants indicated that they had received orthodontic treatment. Most indicated they were either “satisfied” or “very satisfied” with their teeth, both at the end of treatment (96%) and currently (84%). There was a strong relationship between the perception of stability of tooth position and current satisfaction level (P < .0001). Most individuals (88%) indicated that they themselves were responsible for maintaining the alignment and fit of their teeth. Those who indicated that someone else was responsible were nearly twice as likely to be dissatisfied with their teeth (P  =  .0496). Patients who had been prescribed clear, invisible retainers were significantly more likely to be “very satisfied” currently (50%) compared to those with Hawley (35%) or permanently bonded (36%) retainers (P  =  .0002). Patients with Hawley retainers were significantly less likely to be wearing them currently as prescribed (45%) than those with invisible (65%) or bonded (68%) retainers (P < .0001).Conclusions:Satisfaction with orthodontic results after treatment is related to patient perceptions of responsibility for retention and perceived stability of tooth position. Patients should play a contributory role in formulating orthodontic retention plans.     

Factors associated with long-term patient satisfaction

Objective:To identify factors associated with patient satisfaction at least 5 years after orthodontic treatment.Materials and Methods:A total of 209 orthodontic patients were included in the study. All subjects were treated with upper and lower fixed orthodontic appliances. Dental casts (n  =  627) were examined using the Peer Assessment Rating (PAR) Index pretreatment (T1), at the end of treatment (T2) and at a long-term follow-up (mean, 8.5 years; T3). At T3, a Dental Impact on Daily Living questionnaire was used to assess the long-term effects of orthodontic treatment on daily living and satisfaction with the dentition. Multiple regression analyses were used to quantify associations between patient satisfaction and changes produced by the orthodontic treatment (PAR T2-T1), posttreatment stability (PAR T3), age at the start of treatment (T1), treatment duration (T2-T1), gender, and extraction.Results:Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at least 5 years after treatment. Regression analysis showed that satisfaction was significantly associated only with the long-term posttreatment PAR index (r²  =  0.125, P < .0001). No significant association was observed with the severity of malocclusion at the beginning (PAR-T1) or end of the orthodontic treatment (PAR-T2), age at T1, the amount of time taken during orthodontic treatment, gender, or extraction.Conclusions:Over the long term, patient satisfaction is slightly associated with the stability of the orthodontic treatment regardless of the initial occlusal condition or the final result of the orthodontic treatment.     

Influence of fixed orthodontic treatment on the menstrual cycle of adult females: A prospective longitudinal study

Objective:To investigate the influence of fixed orthodontic treatment on the menstrual cycle, including menstrual cycle length (MCL) and duration of menstrual bleeding (DMB), in adult female patients.Materials and Methods:This was a prospective longitudinal study conducted in Chengdu, China. A total of 164 adult women with normal menstrual cycles were recruited in the study, with 79 patients undergoing orthodontic treatment and 85 serving as controls. Data of MCL, DMB, and accompanying symptoms were collected over six consecutive menstrual cycles in each participant. Student’s t test, Chi-square test, Moses extreme reaction test, and repeated measures analysis of variance were used for statistical analysis.Results:The MCL of the first menstrual cycle (T1) was significantly elongated by 2.1 ± 0.5 days compared with baseline (P  =  .003, 95% CI [−3.7, −0.5]). Variability of MCL of the orthodontic group at T1 was also significantly greater (range, 15–46 days) than that of the control group (range, 24–36 days) (P < .05). No significant difference in MCL was found in the subsequent five menstrual cycles (T2–T6) compared with baseline, and no significant differences in DMB or other accompanying symptoms were observed throughout the study.Conclusion:Fixed orthodontic treatment may influence the MCL of adult females in the first month after bonding, but showed no effect on DMB or subsequent MCL through the follow-ups.     

Dentoskeletal changes following mini-implant molar intrusion in anterior open bite patients

Objective:To evaluate skeletal and dental changes after intrusion of the maxillary molars in subjects with anterior open bite.Materials and Methods:This retrospective cephalometric study evaluated skeletal and dental changes resulting from the use of maxillary orthodontic mini-implants in 31 consecutively treated patients. Radiographs were taken at the start and end of maxillary molar intrusion to evaluate the associated changes. Statistical analysis was performed using a one-sample t-test.Results:The mean treatment observation time was 1.31 years (SD  =  2.03). The maxillary first molars (P  =  0.0026) and second molars (P  =  0.039) were intruded. However, the mandibular first molars (P  =  0.0004) and second molars (P  =  0.003) erupted in adolescent patients. Both the maxillary and mandibular first molars inclined distally (P  =  0.025 and P  =  0.044, respectively). The mandibular plane angle decreased (P  =  0.036), lower facial height decreased (P  =  0.002), and the occlusal plane angle increased (P  =  0.009). The overbite increased (P < .0001). The ANB angle decreased (P < .0001). Mandibular dental and skeletal changes were more apparent in adolescents, while adults tended toward maxillary changes.Conclusions:Vertical traction from orthodontic mini-implants reduces the maxillary posterior dentoalveolar height, thereby assisting orthodontic closure of anterior open bite. However, simultaneous eruption or extrusion of the mandibular molars should be controlled. Adolescent patients tend to demonstrate more favorable effects of mandibular autorotation than do adults.     

Impact of malocclusion and dentofacial anomalies on the prevalence and severity of dental caries among adolescents

Objectives:To investigate the association between malocclusion/dentofacial anomalies and dental caries among adolescents.Materials and Methods:A cross-sectional study was conducted with 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório in southern Brazil. Parents/caregivers answered a structured questionnaire on demographic and socioeconomic variables. A trained examiner recorded the presence of malocclusion (Dental Aesthetic Index [DAI]), traumatic dental injury, and dental caries. Data analysis involved the chi-square, Mann-Whitney, and Kruskal-Wallis tests. Poisson regression with robust variance was used for the multivariable analysis.Results:A total of 44.8% of the adolescents had dental caries (mean DFMT  =  1.33 ± 1.84). The DAI index ranged from 15 to 77 (mean  =  29.0 ± 7.9); 43.6% of the sample had severe malocclusion and 11.6% had traumatic dental injury. The prevalence and severity of dental caries were significantly greater among adolescents with severe malocclusion. The multivariate analysis demonstrated that adolescents with severe or handicapping malocclusion had a 31% greater probability of having dental caries (prevalence ratio: 1.31; 95% CI: 1.02–1.67), independently of demographic, socioeconomic, or clinical aspects. The orthodontic characteristics associated with the occurrence and severity of caries were maxillary irregularity ≥3 mm (P  =  .021) and abnormal molar relationship (P  =  .021).Conclusions:Handicapping malocclusion, maxillary irregularity, and abnormal molar relationship were associated with the occurrence and severity of dental caries. The findings suggest that the prevention and treatment of these conditions can contribute to a reduction in dental caries among adolescents.     

Third molar tooth agenesis and pattern of impaction in patients with palatally displaced canines

Objectives:To investigate the association between third molar agenesis and pattern of impaction, missing teeth, and peg-shaped lateral incisor with palatal canine displacement (PDC).Materials and Methods:The pretreatment orthodontic orthopantomograms of 438 patients (122 males and 316 females) diagnosed with PDC were included. A total of 338 patients with normally erupted canines who had a preexisting radiograph as part of their orthodontic treatment (125 males and 313 females) served as controls. Orthopantomograms were evaluated for missing third molars, third molar eruption status, and type of impaction, third molar spaces, third molar width, and angulation.Results:In the PDC group, at least one third molar was missing in 48% and 19% in the upper and lower arches, respectively. Also, 38% and 67% of PDC patients had at least one third molar impaction in the upper and lower arches, respectively. The difference between the PDC and control groups was significant for both missing and impacted third molars (P < .001 for each). The most common type of third molar impaction in the upper arch was vertical and distoangular in the PDC and control groups, respectively. Upper and lower third molar width and spaces were reduced in PDC patients when compared with the control group (P < .001). In PDC patients, missing teeth and peg-shaped lateral incisors were recorded in 5.6% and 9.1%, respectively.Conclusions:PDC patients showed a high prevalence of third molar agenesis and impaction. Upper and lower third molar width and space were reduced in the PDC patients. There were no significant associations between tooth agenesis (other than third molars) and the PDC anomaly.     

The inclination of mandibular incisors revisited

Objective: To reassess the inclination of lower incisors and evaluate possible associations with gender, age, symphyseal parameters, and skeletal pattern.Materials and Methods:Twelve hundred and seventy-two (605 females, 667 males) cephalograms of untreated subjects of a craniofacial growth study (age: 8–16 years) were evaluated. Correlations between the angulation of the lower incisors and age, symphyseal distances (height, width, and depth), symphyseal ratios (height-width, height-depth), and skeletal angles (divergence of the jaws and gonial angle) were investigated for all ages separately and for both sexes independently.Results:The inclination of lower incisors increased over age (8 years: girls  =  93.9° [95% CI, 92.3°–95.7°], boys  =  93.3° [95% CI, 91.8°–94.9°]; 16 years: girls  =  96.1° [95% CI, 94.1°–98.2°], boys  =  97.1° [95% CI, 95.6°–98.6°]). Inclination of lower incisors correlated with the divergence of the jaws for all ages significantly or highly significantly, except for boys and girls 9 years of age and girls 11 and 12 years of age, for which only a tendency was observed. Similarly, a strong correlation to gonial angle could be observed. No correlation could be found between the inclination of lower incisors and any symphyseal parameters (absolute measurements and ratios), except for symphyseal depth.Conclusion:Lower incisor inclination is linked to the subject''s sex, age, and skeletal pattern. It is not associated with symphyseal dimensions, except symphyseal depth. Factors related to natural inclination of lower incisors should be respected when establishing a treatment plan.     

The effect of changes in primary attending doctor coverage frequency on orthodontic treatment time and results

Objective:To determine whether changes in primary attending (PA) doctor coverage frequency caused an increase in orthodontic treatment time or a decrease in the quality of treatment results in a postgraduate orthodontic clinic. The effect of T1 Peer Assessment Rating (PAR) scores on PA doctor coverage frequency, treatment times, and results was also evaluated.Materials and Methods:A sample of 191 postorthodontic subjects was divided into three groups based on PA doctor coverage (high, medium, or low). Treatment times, treatment results, and other variables were compared between the three PA coverage groups. Additionally, the sample was divided into three groups based on T1 PAR scores. Attending coverage frequency, treatment times, and results were compared between the T1 PAR groups.Results:No statistically significant differences were found in treatment time (P  =  .128) or results (P  =  .052). There were no statistically significant differences in the mean scores for T1 PAR (P  =  .056), T2 PAR (P  =  .602), patient age at T1 (P  =  .747), total appointments (P  =  .128), missed appointments (P  =  .177), or cancelled appointments (P  =  .183). Statistically significant differences were found between the low T1 PAR group and the medium and high T1 PAR groups (attending coverage, P  =  .008; results, P < .001; treatment time, P  =  .001).Conclusions:Under the conditions of this study, variations in PA doctor coverage frequency did not lengthen orthodontic treatment or reduce the quality of treatment results. Low T1 PAR scores were associated with less PA coverage, less change in PAR, and shorter treatment times.     

Association between third mandibular molar impaction and degree of root development in adolescents

Objective:To compare the root development and the growth rate of the mandibular third molar (M3 inf) in individuals where the M3 inf erupted vs individuals exhibiting M3 inf impaction.Materials and Methods:Serial standardized intraoral radiographs (Eggen technique) were taken annually of the mandibular third molar region from 132 subjects (71 male and 61 female) from 15 to 20 years of age. Based on the films, 264 lower third molars were classified into an eruption and an impaction group. Root development was recorded according to a quantitative method described by Haavikko (1970), and the eruption status was analyzed using logistic regression.Results:In total, 155 (59%) of the M3 inf erupted, and 109 (41%) were impacted at age 20. In 44 (33%) patients both M3 inf were impacted, in 21 (16%) patients one tooth was erupted and the contralateral tooth impacted, and in 67 (51%) patients both M3 inf were erupted. The more mature a tooth was at age 15, the higher was the probability of eruption (odds ratio: 3.89, P < .001). The growth rate of the root development stage was statistically significantly associated with the probability of eruption (odds ratio: 10.50, P  =  .041).Conclusions:Delayed mandibular third molar root development is associated with impaction. Radiographs taken at age 15 may predict the risk of impaction and thereby guide decision making for the orthodontist or the oral and maxillofacial surgeon.     

Desire for orthodontic treatment and associated factors among adolescents in southern Brazil

Objective:To estimate the prevalence of the desire for orthodontic treatment and investigate associated factors among adolescents in southern Brazil.Materials and Methods:A cross-sectional study was carried out with 704 adolescents aged 12 and 13 years at municipal public schools in the city of Balneário Camboriú (southern Brazil). The adolescents answered a previously tested questionnaire addressing satisfaction with their dental appearance, speech function, chewing function, and the desire for orthodontic treatment. The parents/guardians answered a questionnaire addressing satisfaction with their child''s dental appearance and socioeconomic variables. A trained and calibrated orthodontist collected clinical data on malocclusion using the Dental Aesthetic Index (DAI). Statistical analysis was performed using multivariate Poisson regression with robust variance.Results:The prevalence of the desire for orthodontic treatment was 69.6% (490/704). In the adjusted analysis, the outcome was significantly more prevalent among girls (P < .001), those with difficulty chewing (P  =  .026), those dissatisfied with their dental appearance (P < .001), and those with greater malocclusion severity (P < .001). The following orthodontic characteristics were associated with the desire for orthodontic treatment in the multivariate model: diastema in anterior segment (P < .001), anterior maxillary irregularity (P < .001), maxillary overjet ≥6 mm (P < .001), and mandibular overjet (P  =  .047).Conclusions:The desire for orthodontic treatment among 12- and 13-year-old adolescents is influenced by gender, dissatisfaction with one''s dental appearance, difficulty chewing, malocclusion severity, and orthodontic characteristics. These findings should be considered together with normative indications regarding the need for orthodontic treatment in adolescents.     

Three-dimensional evaluation of the relationship between jaw divergence and facial soft tissue dimensions

Objective:To evaluate the relationship between mandibular divergence and vertical and transverse dimensions of the face.Materials and Methods:A sample was recruited from the orthodontic clinic of the University of Otago, New Zealand. The recruited participants (N  =  60) were assigned to three different groups based on the mandibular plane angle (hyperdivergent, n  =  20; normodivergent, n  =  20; and hypodivergent, n  =  20). The sample consisted of 31 females and 29 males, with a mean age of 21.1 years (SD ± 5.0). Facial scans were recorded for each participant using a three-dimensional (3D) white-light scanner and then merged to form a single 3D image of the face. Vertical and transverse measurements of the face were assessed from the 3D facial image.Results:The hyperdivergent sample had a significantly larger total and lower anterior facial height than the other two groups (P < .05), although no difference was found for the middle facial height (P > .05). Similarly, there were no significant differences in the transverse measurements of the three study groups (P > .05). Both gender and body mass index (BMI) had a greater influence on the transverse dimension.Conclusions:Hyperdivergent facial types are associated with a long face but not necessarily a narrow face. Variations in facial soft tissue vertical and transversal dimensions are more likely to be due to gender. Body mass index has a role in mandibular width (GoGo) assessment.     

Comparison of personality traits,attitude toward orthodontic treatment,and pain perception and experience before and after orthodontic treatment

Objective:To compare personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment.Materials and Methods:One hundred subjects (50 male and 50 female) were included in this study. The mean (SD) age was 17.5 (2.05) years at T1 and 19.15 (2.32) years at T2. The instruments for data collection were questionnaires that included assessment of patients'' personality traits, attitudes toward orthodontic treatment, and pain perception/experience. Subjects completed the questionnaires at two different times: before orthodontic treatment (T1) and after fixed orthodontic treatment (T2). Subjects were treated by fixed orthodontic appliances for an average (SD) period of 18.64 (0.35) months. Paired sample t-test and chi-square test were used to detect any differences.Results:Significant changes in personality traits were detected after orthodontic treatment irrespective of gender. Neuroticism, openness, agreeableness, and conscientiousness scores were improved (P < .001). A positive attitude toward orthodontic treatment was reported at T1 (4.31 [±1.26]) and improved at T2 (3.98 [±1.16]) irrespective of gender (P < .05). The average (SD) expected pain score (T1) was 4.73 (1.88) and the average (SD) experienced pain score (T2) was 4.63 (1.58). Significant difference in the expected and experienced pain scores was not detected (P  =  .11).Conclusions:Personality traits and attitude toward orthodontic treatment improved after orthodontic treatment. Reported actual pain experience during orthodontic treatment was similar to that expected before treatment.