Pain during Rapid Maxillary Expansion: A Systematic Review

Abstract

Aim: The aim of the present systematic review is to evaluate the pain perceived by patients during rapid maxillary expansion (RME) in relation to factors such as demographic characteristics, appliance type, activation protocol, and the eventual use of medication or pain management strategies. Materials and methods: An electronic search of available articles on the subject was conducted on three electronic databases, using predefined keywords. Sequential screenings based on pre-established eligibility criteria were performed. Results: Ten studies were ultimately included in this systematic review. The main data of the reviewed studies were extracted according to the PICOS approach. Conclusions: Pain is a common effect of RME treatment that tends to decrease over time. Gender and age differences in pain perception are not clear. Perceived pain is influenced by the expander design and expansion protocol used. Some pain management strategies can be useful for reducing RME-associated pain.

Pain Perception in Children and Adolescents in Rapid Maxillary Expansion: Scope Review.

“…7 However, it is common for this intervention to be associated with reports of pain. 5,13,20 Given this context, the objective of this scoping review is to evaluate pain perception during rapid maxillary expansion, considering factors such as age, sex and type of expander.…”

“…Not all studies included in the analysis provided information on the difference in pain perception during RME between the sexes. 14,20 In six studies, 1,5,6,10,11,12 no signi cant disparity in the perception of pain between girls and boys was identi ed. Abed Al Jawad et al ( 2021) 1 observes that the absence of sex correlation in their research can be justi ed by the predominance of females in both sets analyzed, a circumstance also observed in the study by Halÿcÿoÿlu et al…”

“…The data extracted from the studies are in table 3. The most recent studies included were published in 2023 by Altuhafy et al, 3 Barone et al, 5 Hansson et al, 11 and Pasqua et al, 13 while the oldest was published in 2000 by Needleman et al 12 Regarding the study design, the articles included were randomized clinical trials (n=10), non-randomized clinical trials (n=3) and systematic reviews (n=2).…”

“…The literature, however, does not reach a consensus regarding the possibility of sex in uencing the perception of pain. 5 3. Pain and type of expander used Different types of MRE devices have been compared for their in uence on patient-reported pain intensity in several studies.…”

“…4,7 However, a limit of this scoping review is the subjective assessment of pain in all included studies, which was done using scales , considering only the pain reported by patients. The literature suggests that the pain reported by patients does not seem to be directly related to the magnitude of the force exerted, 5 but rather depends heavily on the psychological well-being of the individual. 6 The way pain is perceived can signi cantly in uence adherence to treatment and quality of life during this process.…”