What is the Oral Health-related Quality of Life following Miniscrew-Assisted Rapid Palatal Expansion (MARPE)? A prospective clinical cohort study

Abstract

Background Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical orthodontic treatment for transverse maxillary deficiency. This study aimed to investigate the Oral Health-related Quality of Life (OHRQoL) and pain perception of patients undergoing MARPE treatment. Methods 42 consecutive patients (9 men, 33 women) from the age of 16 onwards (mean: 27.4 ± 9.3 years; range 17.1–55.7 years) who received a MARPE treatment were included. OHRQoL was assessed with the short form of the Oral Health Impact Profile (OHIP-14) questionnaire. Patients filled out the questionnaire at baseline (T0) and weekly during the expansion phase (P1) and in the post-expansion phase (P2). Pain intensity was assessed with a Visual Analogue Scale (VAS) questionnaire and filled out daily during expansion, along with a question on the intake of analgesics. The mean weekly and total OHIP-score and OHIP-score per domain were calculated at T0, P1 and P2, as well as mean weekly and total VAS-scores for average pain, maximum pain and analgesics intake during P1. Kruskal–Wallis tests were used to test for differences in OHIP between T0, P1 and P2. The level of significance was set at 0.05. Results The mean OHIP-score was 10.86 ± 9.71 at T0 and increased to 17.18 ± 10.43 during P1 (p < 0.001), after which it returned to pre-expansion levels, 9.27 ± 7.92 (p = 0.907) during P2. At the domain level, there was a statistically significant increase in OHIP-score at P1 for functional limitation, physical pain, psychological discomfort and social disability. The mean VAS-score for average pain during expansion was 16.00 ± 19.73 mm. Both OHIP-score (25.00 ± 10.25), average pain (33.72 ± 16.88 mm), maximum pain (44.47 ± 17.99 mm) and analgesics intake (59%) were highest at initiation of the expansion and decreased by the end of expansion. Conclusions MARPE is a generally well-tolerated expansion treatment. A temporary decline in OHRQoL and moderate pain are present at the start of expansion, followed by a recovery of OHRQoL and very mild pain during the rest of treatment. Clinicians should be aware of the effects of MARPE on patients’ quality of life and manage the expected discomfort and impediments with adequate communication and patient education.

The Power of Customized Clear Aligners in Closing Molar Edentulous Spaces: Clinical and Medico-Legal Considerations in a Scoping Review and Case Report

“…The first-generation aligner systems have introduced hybrid systems (elastics, mini-screws, corticotomies, etc.) to support complex movements scarcely achievable with a pure system [ 9 , 10 , 13 , 16 , 17 , 18 , 19 , 20 , 21 ], but little is known about other systems in both pure and hybrid forms [ 6 , 11 , 12 , 36 ]. Thus, the attempt to find data relating to MMSC through the reciprocal movement of mesialization of other molars present and the distalization of latero-posterior teeth, brings out an important fact: this movement has not yet been described with any CA system [ 37 ].…”

“…Both approaches, mini-screws and corticotomies, although considered safe, are not always easily accepted by patients. They are often perceived as invasive methods, as opposed to the comfortable protocols expected from therapies with CAs [ 20 , 21 , 22 , 23 ]. The experiences reported in the literature on complex cases treated with hybrid therapies for extraction-space closures refer exclusively to traditional systematics proposed by the trademark founder of CAs (Invisalign ® , Align Technology, Inc., Tempe, AZ, USA).…”

Factors in oral-related quality of life of betel quid users receiving oral mucosal screening: a cross‑sectional study in Taiwan

“…Statistical power was calculated using the G*Power 3.1.9 program [ 38 , 39 ] for hierarchical multiple linear regression [ 40 ]. For this study, a total of 175 subjects was found to reach a statistical power of 0.80 and effect size of 0.35 [ 40 ] for 3 independent variables in step 1 analysis, and 4 independent variables in step 2 analysis, with a significance level (α) of 0.05.…”

What is the impact of miniscrew-assisted rapid palatal expansion on the midfacial soft tissues? A prospective three-dimensional stereophotogrammetry study

“…MARPE appliances, such as the maxillary skeletal expander (MSE) or the Dutch Maxillary Expansion Device (D-MED), are tooth-bone-borne hybrid expanders using miniscrews to transmit the forces of the expansion screw into the palate in order to overcome the resistance of the midpalatal and circummaxillary sutures [ 10 , 11 ]. MARPE was reported to be an effective and well-tolerated treatment in patients from the age of 16 onwards, with limited dental and periodontal side effects and a relatively short treatment duration [ 12 , 13 ].…”