Patient-reported outcomes of slow vs rapid miniscrew-supported maxillary expansion in adolescents: secondary outcomes of a randomized clinical trial

Abstract

Objectives To compare patient-reported experience between a Penn expander activated every other day vs twice daily. Materials and Methods A total of 30 patients aged 12–16 years with transverse maxillary deficiency were recruited from the outpatient clinic, Faculty of Dentistry, Alexandria University (February 2019–December 2020). They were randomly allocated to two groups using block randomization (block size of six) and an allocation ratio of 1:1, which was concealed using opaque, sealed, sequentially numbered envelopes. Both groups received Penn expanders anchored by four palatal miniscrews. The slow maxillary expansion (SME) group activated the appliance once every other day. The rapid maxillary expansion (RME) group activated the appliance twice daily. Outcome measures were pain, pressure, headache, dizziness, speech difficulty, chewing difficulty, and swallowing difficulty scores rated by the participants on an 11-point numeric rating scale (NRS) at the following four time points: before appliance insertion (t1), after first activation (t2), after 1 week of activation (t3), and after last activation (t4). Results Data of 24 patients in the SME group (n = 12, mean age = 14.30 ± 1.37 years) and RME group (n = 12, mean age = 15.07 ± 1.59 years) were analyzed. Median scores for all outcomes were in the bottom quartiles of the NRS. No difference was found between the two groups at t1 or t2. Significantly higher scores for all variables, except dizziness and headache, were reported in the RME group at t4. Conclusions Activation of miniscrew-supported expanders resulted in mild to moderate discomfort and functional limitation. Slow activation resulted in a better overall patient experience compared with rapid activation.

Unusual systemic and nondental effects of maxillary expansion therapy: A comprehensive and updated review of literature

“…The appliance was turned on by the SME group once every other day. [ 31 ] At any time point, there was no statistically significant difference in the headache scores between RME and SME. At t4, the RME group was found to have significantly higher scores for every measure, with the exception of headache and dizziness.…”

“…Compared to rapid activation, slow activation produced a superior overall patient experience. [ 31 ]…”