Background and aims. To compare pain levels experienced during initial alignment with three different orthodontic appliance types and to correlate pain with male and female differences, if any.

Methods. A prospective, randomized 3- arm parallel trial allocated 36 adult orthodontic patients into three appliance groups: MBT 0.022” slot (Mini Twin, Ormco, Glendora, USA), self ligating 0.022" slot Damon 3MX (Ormco, Glendora, USA) and clear aligners (Smile align, Mumbai, India). The level of discomfort was assessed through a questionnaire based on the visual analogue scale at four hours, twenty four hours, third and seventh day after appliance placement.

Results. Patients treated with clear aligners reported less pain than patients treated with conventional and self ligating fixed appliances. Patients treated with MBT conventional appliances showed greater pain levels than Damon appliances. A significantly higher visual analogue scale score was observed at 24 hours and the least visual analogue scale scores on the seventh day post appliance placement.

Conclusion. During the first week of orthodontic treatment, patients treated with clear aligners reported lower pain than those treated with conventional and self-ligating appliances.


pain perception, visual analogue scale (VAS), orthodontic appliances