Non-Cochrane · intervention · PM41847626
Evaluation of Pain and Oral Health-Related Quality of Life Associated With Fixed Orthodontic Treatment in Adults: A Systematic Review and Meta-Analysis.
Rasol Omar A, Hajeer Mohammad Y, Burhan Ahmad S, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.105336
Findings
Population Adults (18 years or older) treated with conventional fixed orthodontic appliances
2 findings
| Conventional fixed orthodontic appliance treatment | Pain at day 1 versus week 1 after appliance placement | Pain intensity (VAS 0-100 mm) Day 1 versus week 1 · Not specified | MD 20.83 [11.7, 29.97] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 56 participants |
| Conventional fixed orthodontic appliance treatment | OHRQoL at week 1 versus month 1 after appliance placement | Oral health-related quality of life (OHIP-14; higher score = worse) Week 1 versus month 1 · Not specified | MD 9.5 [7.5, 11.5] Low Downgraded: risk of bias, imprecision 2 studies · 40 participants |
Included primary studies 23
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Alfawal 2024 The impact of non-extraction orthodontic treatment on oral health-related quality of life: clear aligners versus fixed appliances-a… PMID:35395075 | 2022 | 3 other reviews | Oral health-related quality of life (OHIP-14; higher score = worse) | not extracted yet |
| Alhafi 2024 The Impact of Non-Extraction Orthodontic Treatment on the Oral-Health-Related Quality of Life between a Modified Aligner Appliance with… PMID:39064568 | 2024 | 2 other reviews | not stated | not extracted yet |
| Antonio-Zancajo 2020 Pain and Oral-Health-Related Quality of Life in Orthodontic Patients During Initial Therapy with Conventional, Low-Friction, and Lingual… PMID:32635196 | 2020 | 2 other reviews | not stated | not extracted yet |
| Gao 2021 Comparison of pain perception, anxiety, and impacts on oral health-related quality of life between patients receiving clear aligners and… PMID:32613250 | 2021 | 2 other reviews | not stated | not extracted yet |
| Miller 2007 A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. PMID:17346581 | 2007 | 2 other reviews | not stated | not extracted yet |
| Tunca 2024 Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic… PMID:38760747 | 2024 | 2 other reviews | not stated | not extracted yet |
| Alcon 2021 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Diddige 2020 Comparison of pain levels in patients treated with 3 different orthodontic appliances - a randomized trial. PMID:32133451 | 2020 | 1 other review | not stated | not extracted yet |
| Jaber 2022 The Effect of Treatment With Clear Aligners Versus Fixed Appliances on Oral Health-Related Quality of Life in Patients With Severe… PMID:35663697 | 2022 | 1 other review | Oral health-related quality of life (OHIP-14; higher score = worse) | not extracted yet |
| Johal 2018 Pain experience in adults undergoing treatment: A longitudinal evaluation. PMID:29509026 | 2018 | 1 other review | not stated | not extracted yet |
| Wu 2010 A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances. PMID:20018798 | 2010 | 1 other review | not stated | not extracted yet |
| Alcon 2021 [Injected nitroglycerin to follow extracorporeal circulation]. PMID:122021 | 1979 | this review only | not stated | not extracted yet |
| Alfawal 2022 The impact of non-extraction orthodontic treatment on oral health-related quality of life: clear aligners versus fixed appliances—a… DOI:10.1093/ejo/cjac012 | 2022 | this review only | Oral health-related quality of life (OHIP-14; higher score = worse) | not extracted yet |
| Curto 2020 Influence of a Lubricating Gel (Orthospeed®) on Pain and Oral Health-Related Quality of Life in Orthodontic Patients during Initial… PMID:32423007 | 2020 | this review only | Pain intensity (VAS 0-100 mm) | not extracted yet |
| Curto 2022 Oral-Health-Related Quality of Life and Anxiety in Orthodontic Patients with Conventional Brackets DOI:10.3390/ijerph191710767 | 2022 | this review only | not stated | not extracted yet |
| Curto 2022 Oral-Health-Related Quality of Life and Anxiety in Orthodontic Patients with Conventional Brackets. PMID:36078481 | 2022 | this review only | not stated | not extracted yet |
| Diddige 2020 Comparison of pain levels in patients treated with 3 different orthodontic appliances - a randomized trial DOI:10.15386/mpr-1311 | 2020 | this review only | not stated | not extracted yet |
| Gao 2021 Comparison of pain perception, anxiety, and impacts on oral health-related quality of life between patients receiving clear aligners and… DOI:10.1093/ejo/cjaa037 | 2020 | this review only | not stated | not extracted yet |
| Johal 2018 Pain experience in adults undergoing treatment: A longitudinal evaluation DOI:10.2319/082317-570.1 | 2018 | this review only | not stated | not extracted yet |
| Miller 2007 A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment DOI:10.1016/j.ajodo.2006.05.031 | 2007 | this review only | not stated | not extracted yet |
| Sirri 2022 Evaluation of Perceived Pain, Discomfort, Functional Impairments, and Satisfaction When Relieving Crowded Lower Anterior Teeth in Young… PMID:35815305 | 2022 | this review only | Pain intensity (VAS 0-100 mm) | not extracted yet |
| Tunca 2024 Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic… DOI:10.1186/s12903-024-04335-1 | 2024 | this review only | not stated | not extracted yet |
| Wu 2010 A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances DOI:10.1093/ejo/cjp117 | 2009 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients aged 18 years or older treated with a conventional fixed metallic appliance | Adults, mean age 18.87 to 38 years, about 61% female (n=1,022 patients across 14 studies; n=396 with conventional fixed appliances) |
| Intervention | Conventional fixed orthodontic appliance | Conventional fixed appliance treatment (n=396) |
| Comparison | No direct comparison targeted; studies comparing fixed appliances with other orthodontic appliances included if they reported relevant outcomes | Clear aligners; lingual fixed appliances; low-friction brackets; self-ligating brackets; corticision; Orthospeed gel; modified aligner appliance; or none (two studies of fixed appliances alone) |
| Outcomes | Primary: patient-reported pain; secondary: oral health-related quality of life (OHRQoL) | Pain on VAS (9 studies); OHRQoL on OHIP-14 (8 studies) or GOHAI (1 study) |
| Study designs | Observational studies (cross-sectional, cohort) primarily; RCTs and controlled clinical trials also included | 7 RCTs, 3 CCTs, 3 cohort studies, 1 cross-sectional study (n=14) |
| Timing | One day, one week, two weeks, one month and three months | Pain: 4 h to 12 months; OHRQoL: 1 day to 12 months or end of treatment |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |