A multicenter, prospective, randomized trial of pain and discomfort during maxillary expansion: Leaf expander versus hyrax expander

Abstract

BackgroundPain suffered by the young patient is the most frequent symptom during orthodontic treatment and is the one that most frightens children and causes worry in their families.AimTo investigate pain perception and function impairment during the first week of activation of two palatal expansion screws.DesignA total of 101 subjects were randomly divided into two groups: RME group included patients treated with the standard hyrax expansion screw and LEAF group included patients treated with Leaf Expander appliance. Pain intensity was assessed via the Wong‐Baker scale. A questionnaire on oral function impairments was also compiled by the patients.ResultsThe Pain Scale analysis showed that patients in the RME group suffered from a significantly higher level of pain than those in the LEAF group (88.6% vs 25%, P < .01). RME group showed highest pain indexes from day 1 to day 4 (51.4% RME vs 9.7% LEAF suffered at least once from strong pain in the first 4 days, P < .01). Furthermore, oral functions were similarly affected in both groups.ConclusionsPain reported during maxillary arch expansion is influenced by clinical activation protocol and by the screw type. Patients treated with Leaf Expander reported significantly lower pain level in the first 7 days of treatment.

Volumetric Changes in the Upper Airways after Rapid and Slow Maxillary Expansion in Growing Patients: A Case-Control Study

“…Moreover, it was demonstrated by Ugolini et al [62] constant forces exerted by the NiTi spring during maxillary expansion allow to avoid most of the pain that occurs at the beginning of the activation of a RME.…”

Assessment of Patient-Centered Outcomes When Treating Maxillary Constriction Using a Slow Removable Versus a Rapid Fixed Expansion Appliance in the Adolescence Period: A Randomized Controlled Trial

“…This is the first randomized controlled trial assessing and comparing the levels of pain, discomfort, and various functional impairments between a removable slow maxillary expander and a bonded rapid maxillary expander in the treatment of skeletal maxillary constriction in growing patients between the ages of 12 and 16. Some researchers have reported that maxillary expansion has caused greater pain and discomfort at such ages in comparison with younger children between the ages of nine and twelve [ 21 , 28 , 29 ].…”

“…The sample size was determined using Minitab® Version 17 (Minitab Inc., State College, Pennsylvania, USA). It was assumed that the smallest detectable difference in pain levels between the two groups was 1 cm on a VAS (with a standard deviation of 1.2 from a previous study) [ 21 ]. Using an independent-samples t-test with a significance level of 5% and a power of 80%, 24 patients were required in each group.…”

“…It has been shown that the majority of RME patients have experienced different levels of pain [ 15 , 18 , 20 ]. Ugolini et al found that pain starts during the initial phase of activation [ 21 ]. The pain increased to reach its highest levels in the first four days, with a maximum peak on the second day, then gradually diminished [ 21 ].…”

“…Ugolini et al found that pain starts during the initial phase of activation [ 21 ]. The pain increased to reach its highest levels in the first four days, with a maximum peak on the second day, then gradually diminished [ 21 ]. Needleman et al reported that the greatest pressure generated by every activation existed instantly after turning the jackscrew, with the highest intensity of pain during the first six turns [ 20 ].…”