Perceived pain during rapid maxillary expansion in children with different expanders.

OBJECTIVES: To evaluate and compare the intensity of pain caused by rapid maxillary expansion (RME) with two expanders: Hyrax and Haas type, in growing patients. MATERIALS AND METHODS: Thirty-nine patients (23 girls and 16 boys) with an average age of 9.3 years (SD = 1.39 years) were randomized into two groups and treated with Hyrax- and Haas-type expanders. In both groups, initial activation of the expander screw was one full turn on the first day followed by 2/4 of a turn two times a day (morning and night) for 7 days. Inclusion criteria were patients presenting with a posterior crossbite or maxillary atresia between 7 and 12 years old. To evaluate the intensity of pain during the active phase of the treatment, a combination of the Numerical Rating Scale and Wong-Baker Faces Pain Scale was used. Mann-Whitney test was used to compare the two treatment groups. RESULTS: There was significant inverse correlation between days following insertion and pain. During the expansion period, 100% of the children reported some pain. Hyrax expander subjects reported greater pain than those treated with the Haas-type expander only on the first day. The level of pain remained greater in girls throughout treatment. CONCLUSIONS: Pain was reported regardless of the type of expander and was higher in the Hyrax group only on the first day of activation.

Tomographic evaluation of dentoskeletal effects of rapid maxillary expansion using Haas and Hyrax palatal expanders in children: A randomized clinical trial.

BACKGROUND: Rapid maxillary expansion (RME) is a usual procedure for correcting the transversal maxillary deficiency. Among the most used appliances are the Haas type (tooth-tissue-borne) and Hyrax (tooth-borne) whose main difference is the design. This study aimed to evaluate the dentoskeletal effects of RME using two different expanders in children. MATERIAL AND METHODS: The sample was composed of 42 children of both gender presenting unilateral or bilateral posterior crossbite with mean age 9.49 (SD± 1.35). Patients were randomized into two groups according to the type of expander: Hyrax (n= 21, 9 boys and 12 girls) and Haas (n= 21, 11 boys and 10 girls). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images (i-Cat, Hartsfield, PA, USA) were used at pretreatment (T1) and after 6 months when the expander was removed (T2). Measurements were performed on Dolphin Imaging Systems 11.7 software (Chatsworth, California, USA). The following variables were evaluated: inclinations of the posterior teeth, transverse skeletal widths, length of maxillary dental arch, buccal bone thickness and level of buccal alveolar crest. Statistical analysis performed using chi-squared test to compare the sex ratios between groups and independent t test with the Bonferroni correction for multiple tests. RESULTS: RME increased all maxillary transverse dimensions, regardless of the type of expanders used. Subjects in the Hyrax group experienced significantly increase in the lingual bone thickness (0.94 mm) compare to Haas group (0.21 mm). CONCLUSIONS: The Hyrax-type expander produced greater increase in the lingual bone thickness than did the Haas-type expander, but this effect might not be clinically significant. Both appliances presented similar transversal gain and tended to produce similar orthopedic and orthodontic effects. Key words:Cone-beam computed tomography, palatal expansion technique, palate.

Kinesio taping use to reduce pain and edema after third molar extraction surgery: A randomized controlled split-mouth study.

OBJECTIVE: Evaluating Kinesio Taping (KT) use to reduce pain and edema in individuals subjected to surgical extraction of impacted mandibular third molars. MATERIALS AND METHODS: Thirteen individuals (5 men and 8 women, mean age: 23.25 years) were subjected to mutual extraction of two mandibular third molars based on the same surgical protocol and pharmacological approach. All individuals were subjected to kinesio taping application on one side of patients' face (test group - KT), in the immediate postoperative period. The other side of the face was not subjected to KT application, and it was used as control (No KT). An examiner assessed individuals' pain and edema based on the visual analog scale (VAS) and on the Todorovic-Markovic method, respectively, at the preoperative, immediate postoperative, and second and fifth postoperative days. Statistical analysis was based on the Scheirer-Ray-Hare test. RESULTS: Edema (48 h and 120 h after surgery) and pain intensity (24 h, 48 h and 120 h after surgery) were lower on the KT side (p < 0.05). Moreover, edema and pain intensity fully reduced on the KT side 120 h after surgery (p < 0.05). CONCLUSION: Kinesio taping adopted in the current study was effective in reducing edema and postoperative pain in patients subjected to oral surgery. CLINICAL RELEVANCE: KT enables patients to experience a more comfortable postoperative period and helps improving their quality of life.