Initial tooth movement: force application and pain--a relationship?

Initial dental casts of 24 patients, who had previously completed a discomfort index card for the first 16 days following placement of a fixed appliance, were examined. A method is described whereby the anterior and overall crowding in the relevant dental arch was measured as a tooth/arch discrepancy index using the reflex metrograph. The crowding was measured in three dimensions as the discrepancy between the sum of the anatomic mesiodistal widths of the teeth and the actual mean arch shape canine to canine (3 to 3) and first molar to first molar (6 to 6) inclusive. An additional two-dimensional method using the best "goodness of fit" (least variance) of a parabolic arch shape for the mean arch length in the 6 to 6 crowding measurement is also described. The measurement accuracy of the reflex plotter was less than 0.12 mm. The method error for the crowding measurements expressed as root mean square (RMS) values was 0.97 mm for the anterior tooth/arch, 1.45 mm for the overall tooth/arch discrepancies, and 1.35 mm for the tooth/arch discrepancy based on the best fit of a parabolic curve. It is proposed that since the same bracket width and fully engaged arch wire type were used in every case, some relationship between the initial crowding that reflected the forces applied and the discomfort experienced by the patients might be expected. This was not found to be true. There was no correlation between the total discomfort experienced and the crowding measurements 3 to 3 or 6 to 6.(ABSTRACT TRUNCATED AT 250 WORDS)