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Impacto dos alinhadores transparentes na sensibilidade muscular mastigatória e na dor ortodôntica : revisão narrativa da literatura
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Advisor(s)
Abstract(s)
Os Alinhadores Transparentes (AT) são amplamente utilizados como alternativa aos Aparelhos Fixos (AF), oferecendo vantagens estéticas e maior conforto. No entanto, o seu impacto na Sensibilidade Muscular Mastigatória (SMM) e na dor ortodôntica ainda é tema de investigação. A literatura sugere que os AT estão associados a menor intensidade de SMM e dor ortodôntica em comparação com os AF, devido à aplicação gradual e controlada de forças nos dentes (Sasaki et al., 2017; Ferreira et al., 2019). A dor tende a atingir o pico entre 24 e 48 horas após a inserção do alinhador, reduzindo-se progressivamente (Ali et al., 2023; Cengiz & Goymen, 2025). Além disso, os AT permitem aos pacientes manter suas atividades diárias sem limitações funcionais significativas, favorecendo a adesão ao tratamento (Gameiro et al., 2015; Kaklamanos et al., 2023).
Fatores como a espessura dos AT, padrões de movimentação dentária e hábitos parafuncionais, como bruxismo, podem influenciar a SMM. Alterações na atividade dos músculos mastigatórios, especialmente no masséter, foram observadas por eletromiografia, sugerindo uma adaptação neuromuscular ao longo do tratamento (Lou et al., 2021; Tepedino et al., 2023). Estratégias farmacológicas, como anti-inflamatórios não esteroides, e não farmacológicas, como terapia com laser de baixa intensidade (LILT), mostraram eficácia na gestão desses sintomas (Gao et al., 2024; Tran et al., 2020).
Esta revisão narrativa baseou-se na análise qualitativa de estudos obtidos nas bases PubMed, Scopus, Google Scholar, Cochrane Library e LILACS, usando operadores booleanos para combinar termos como "clear aligners" OR "removable orthodontic appliances;" AND "toothache" AND "masticatory muscles". Foram incluídos artigos
publicados nos últimos 10 anos que abordassem o uso de AT, excluindo-se os não disponíveis em português, inglês ou espanhol, ou sem dados relevantes. Referências mais antigas foram pontualmente integradas para contextualização histórica. Embora os resultados apontem benefícios evidentes, destaca-se a necessidade de mais estudos que avaliem os efeitos a longo prazo dos AT nas estruturas orofaciais e na saúde geral.
Clear aligners (CA) are widely used as an alternative to fixed appliances (FA), Clear aligners (CA) are widely used as an alternative to fixed appliances (FA), offering aesthetic advantages and greater comfort. However, their impact on masticatory muscle sensitivity (MMS) and orthodontic pain remains a subject of ongoing investigation. The literature suggests that CAs are associated with lower levels of MMS and orthodontic pain compared to FAs, due to the gradual and controlled application of forces on the teeth (Sasaki et al., 2017; Ferreira et al., 2019). Pain typically peaks within 24 to 48 hours following aligner insertion and gradually subsides thereafter (Ali et al., 2023; Cengiz & Goymen, 2025). Furthermore, CAs allow patients to maintain their daily activities without significant functional limitations, thereby enhancing treatment adherence (Gameiro et al., 2015; Kaklamanos et al., 2023). Factors such as aligner thickness, patterns of tooth movement, and parafunctional habits like bruxism may influence MMS. Changes in masticatory muscle activity— particularly in the masseter—have been observed via electromyography, suggesting neuromuscular adaptation throughout the course of treatment (Lou et al., 2021; Tepedino et al., 2023). Both pharmacological strategies, such as non-steroidal anti-inflammatory drugs, and non-pharmacological approaches, such as low-intensity laser therapy (LILT), have shown effectiveness in managing these symptoms (Gao et al., 2024; Tran et al., 2020). This narrative review was based on a qualitative analysis of studies retrieved from PubMed, Scopus, Google Scholar, Cochrane Library, and LILACS, using Boolean operators to combine terms such as “clear aligners” OR “removable orthodontic appliances;” AND “toothache” AND “masticatory muscles.” Articles published in the last ten years focusing on the use of CAs were included, while studies unavailable in English, Portuguese, or Spanish, or those lacking relevant data, were excluded. Older references were occasionally incorporated for historical context. Although current findings highlight several advantages of CAs, further research is required to fully understand their long-term effects on orofacial structures and overall patient health.
Clear aligners (CA) are widely used as an alternative to fixed appliances (FA), Clear aligners (CA) are widely used as an alternative to fixed appliances (FA), offering aesthetic advantages and greater comfort. However, their impact on masticatory muscle sensitivity (MMS) and orthodontic pain remains a subject of ongoing investigation. The literature suggests that CAs are associated with lower levels of MMS and orthodontic pain compared to FAs, due to the gradual and controlled application of forces on the teeth (Sasaki et al., 2017; Ferreira et al., 2019). Pain typically peaks within 24 to 48 hours following aligner insertion and gradually subsides thereafter (Ali et al., 2023; Cengiz & Goymen, 2025). Furthermore, CAs allow patients to maintain their daily activities without significant functional limitations, thereby enhancing treatment adherence (Gameiro et al., 2015; Kaklamanos et al., 2023). Factors such as aligner thickness, patterns of tooth movement, and parafunctional habits like bruxism may influence MMS. Changes in masticatory muscle activity— particularly in the masseter—have been observed via electromyography, suggesting neuromuscular adaptation throughout the course of treatment (Lou et al., 2021; Tepedino et al., 2023). Both pharmacological strategies, such as non-steroidal anti-inflammatory drugs, and non-pharmacological approaches, such as low-intensity laser therapy (LILT), have shown effectiveness in managing these symptoms (Gao et al., 2024; Tran et al., 2020). This narrative review was based on a qualitative analysis of studies retrieved from PubMed, Scopus, Google Scholar, Cochrane Library, and LILACS, using Boolean operators to combine terms such as “clear aligners” OR “removable orthodontic appliances;” AND “toothache” AND “masticatory muscles.” Articles published in the last ten years focusing on the use of CAs were included, while studies unavailable in English, Portuguese, or Spanish, or those lacking relevant data, were excluded. Older references were occasionally incorporated for historical context. Although current findings highlight several advantages of CAs, further research is required to fully understand their long-term effects on orofacial structures and overall patient health.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Clear aligners Masticatory muscles Orthodontic pain Removable orthodontic appliances