Perceived Pain during Rapid Maxillary Expansion (RME): Trends, Anatomical Distinctions, and Age and Gender Correlations

Abstract

Objectives. To investigate pain trends and characteristics of different facial districts in patients undergoing rapid maxillary expansion (RME) and its possible correlations with age and gender. Materials and Methods. 85 subjects (45 males and 40 females) undergoing RME were selected and analyzed during first two weeks of treatment. Patients rated daily two types of pain perception: the general perceived pain (GPP), i.e., the pain overall perceived in the face, and the local perceived pain (LPP), i.e., the pain perceived locally in the following anatomical areas: anterior palate (APA), posterior palate (PPA), nasal (NA), joint (JA), and zygomatic (ZA). Patients were provided the Numeric Rating Scale (NRS) and Wong–Baker Faces Pain Rating Scale (FPS) to correctly assess their GPP and LPP. Pearson correlation coefficient and analysis of variance (ANOVA) were, respectively, used to define the linear relationship between all the variables considered and to verify whether the response variables (gender and age) were significantly different (α < 0.05). Results. Sample’s mean age was 10.11 years. Average pain values of GPP and LPP progressively rise from day 1 to days 2-3 (pain peak) and tended to decrease until day 14, with a linear decrease for GPP and a not linear decrease for LPP. PPA and APA resulted the most painful areas, followed, respectively, by JA, ZA, and NA. Statistically significant differences resulted in average pain values according to patients’ age and gender, both in GPP and LPP. Conclusion. RME causes perception of pain in several maxillofacial areas. Pain reported during RME resulted positively correlated with age and gender of patients.

Comparison of rapid versus slow maxillary expansion on patient-reported outcome measures in growing patients: a systematic review and meta-analysis

“…In orthodontics, the evaluation of PROMs is becoming increasingly important, not only because the patient’s psychosocial well-being improves collaboration during therapy [ 21 ] but also because the results of orthodontic treatment can be improved if the patient is informed and confident about his or her therapy [ 22 , 23 ]. It has been proven that RME often produces discomfort or pain especially during the first week of treatment [ 24 – 28 ], particularly in girls [ 29 – 32 ], and it is often associated with an increased age of the child [ 30 , 31 ]. Other studies showed no differences in gender [ 25 , 27 , 33 ] or age [ 27 , 30 , 33 ] of the patients involved in pain experience after RME treatment.…”