Pain Perception Associated with Mini-Implants and Interventions for Pain Management: A Cross-Sectional Questionnaire-Based Survey

Abstract

Background. Orthodontists use mini-implants temporarily as an effective mode of skeletal anchorage devices. The placement of mini-implants can cause pain and discomfort to the patients. Patients often develop swelling, and the pain could interfere with their daily activities. Practitioners tend to prescribe antibiotics and pain medication for management. Objectives. The main objectives of this study are to evaluate the pain perception and discomfort due to mini-implant placement experienced by the patient and evaluate the interventions for pain management commonly practiced among orthodontists. Materials and Methods. The study was designed as a questionnaire-based cross-sectional study. A total of 271 patients were assessed, for whom 625 mini-implants (ranging from 1.2 to 2 mm diameter and length 8-14 mm) were placed. Pain scores were assessed using the VAS and the “Faces” pain rating scale to collect data about discomfort in daily activity and function. Data was collected from 244 patients. A total of 155 orthodontists were questioned regarding the prescription of medications and the interventions for managing pain and adverse effects. Results. Average pain score among female subjects was 16.71 and among men was 13.5. The highest pain scores were recorded for palatal mini-implants with an average score of 36.29 and the least for interradicular mini-implants with an average score of 9.02. Among the subjects, 47.9% of them took analgesics, and the most commonly prescribed analgesics were paracetamol (39%). Swelling at the site is where the mini-implants were placed, and ulceration due to implants were commonly dealt with the excision of the surrounding soft tissue, composite placement, and palliative care with oral analgesic gels. Conclusion. Female subjects had more mini-implants placed, and female subjects had also given more pain scores than their male counterparts. Palatal mini-implants caused the highest pain, followed by mini-implants placed at the infrazygomatic crest and the buccal shelf region. Palatal mini-implants caused maximum discomfort during speech and eating, followed by the mini-implant in the buccal shelf and the infrazygomatic crest region that also caused difficulty in yawning and laughing. Infiltration anesthesia was commonly given for the placement of interradicular implants and extra-alveolar mini-implants. Paracetamol was the most prescribed by the orthodontists, and more than half the doctors did not regularly prescribe antibiotics.

Effects of posterior intrusion using skeletal anchorage on treating anterior open bite: A systematic review and meta-analysis

“…Post-insertion pain levels are significant considerations. Sreenivasagan et al 27 and Kawaguchi et al 28 reported elevated pain levels after miniplate placement, often requiring extended analgesic prescriptions. This discomfort, potentially amplified in cases of poor oral hygiene and resultant inflammation, could negatively influence patient compliance and satisfaction.…”

The Use of Questionnaires in Pain Assessment during Orthodontic Treatments: A Narrative Review

“…Another recent study based on VAS and the Wong–Baker Faces Pain Rating Scale was carried out ( Figure 5 ). The study recorded the self-pain perception experienced by patients after a mini-implant placement, concluding that the maximum pain was recorded in the case of a palatal miniscrew [ 53 ].…”

“…Another recent study based on VAS and the Wong-Baker Faces Pain Rating Scale was carried out (Figure 5). The study recorded the self-pain perception experienced by patients after a mini-implant placement, concluding that the maximum pain was recorded in the case of a palatal miniscrew [53]. Since pain is defined as a multidimensional emotion, a multidimensional tool permits a much more comprehensive and exhaustive pain assessment.…”

Stability of Mini Implants in the Periodontum during Orthodontic Treatment

“…In other cases, mini-implants become trapped due to excessive growth of soft tissue around the implant. This would require excision of the soft tissue to expose the implant head, which is a minor surgical operation [29]. The inflammatory response increases in the periodontal tissues around the mini-implant along with the increase in microbial colonization of the mini-implants after placement in the oral cavity and results in a production of pro-inflammatory cytokines that regulate the immune response [10].…”