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

BACKGROUND

Pain 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.

AIM

To investigate pain perception and function impairment during the first week of activation of two palatal expansion screws.

DESIGN

A 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.

RESULTS

The 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.

CONCLUSIONS

Pain 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.