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Pain and discomfort during the first week of maxillary expansion using two different expanders: patient-reported outcomes in a randomized controlled trial
Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden; Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.ORCID iD: 0000-0002-3223-0068
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
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2023 (English)In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 45, no 3, p. 271-280Article in journal (Refereed) Published
Abstract [en]

Background

Quad Helix (QH) is the appliance most preferred by orthodontists to correct unilateral posterior crossbite in the early mixed dentition while other orthodontists suggest rapid maxillary expansion (RME) on deciduous teeth in these patients.

Objectives

To evaluate and compare perceived pain intensity, discomfort, functional jaw impairment, and analgesic consumption during the first week of treatment with either RME or QH appliances.

Trial design

Two-arm parallel group, two-centre, randomized controlled trial.

Material and methods

Seventy-two patients, mean age 9.5 (SD +/- 0.8) years, with unilateral posterior crossbite requiring maxillary expansion were randomly allocated to either the RME (22 boys, 14 girls) or QH (22 boys, 14 girls) group. Validated questionnaires were used to assess pain intensity, discomfort, jaw function impairment, and analgesic consumption, on the first, fourth, and seventh days after appliance insertion and activation.

Blinding

Due to clinical limitations, only the outcome assessors were blinded to the groups to which the patients were allocated.

Results

Seventy patients completed the questionnaires. Pain from the tongue and chafe from the appliance were significantly higher in the QH group on the first day of treatment (P = 0.003 and P = 0.000, respectively). On the fourth day, the chafe from the appliance was still significantly higher in the QH group (P = 0.007). Speech was affected in both groups on day 1; this impairment continued and was significantly higher in the RME group days 4 and 7. No significant difference in analgesic consumption was found between the groups at any time. The analgesic consumption was highest at day 1 of treatment.

Harms

No harm was observed in any patient.

Limitations

Double blinding was not possible due to the clinical limitations.

Conclusion

During the initial 4 days of treatment, pain from the tongue and chafe from the appliance caused the most reported inconvenience in the patients in the QH group. A majority of reported visual analogue scale values were in the lower mid-range, suggesting low to moderate pain and discomfort in both groups.

Place, publisher, year, edition, pages
Oxford University Press, 2023. Vol. 45, no 3, p. 271-280
National Category
Dentistry
Identifiers
URN: urn:nbn:se:hj:diva-58991DOI: 10.1093/ejo/cjac067ISI: 000878758100001PubMedID: 36331513Scopus ID: 2-s2.0-85160873791Local ID: HOA;;843647OAI: oai:DiVA.org:hj-58991DiVA, id: diva2:1713324
Available from: 2022-11-24 Created: 2022-11-24 Last updated: 2023-06-12Bibliographically approved

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Josefsson, EvaLindsten, Rune

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