and discomfort after insertion of orthodontic buccal miniscrews, palatal miniscrews and, orthodontic miniplates
Misuzu Kawaguchi *, Ken Miyazawa, Masako Tabuchi, Mariko Fuyamada, Shigemi Goto
Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan improve open bite, whereas Park et al.  performed fixation of o r th o d on t i c wa v e s 7 3 ( 2 0 1 4 ) 1 – 7 a r t i c l e i n f o
Received 28 September 2012
Received in revised form 25 February 2013
Accepted 2 September 2013
Available online 23 October 2013
Discomfort a b s t r a c t
Purpose: Skeletal anchorage devices have recently been developed for absolute anchorage during edgewise treatment. Such anchorage devices can be divided into miniplate and miniscrew types. However, the differences between these two types of appliance have not been sufficiently evaluated from the patient’s point of view. Therefore, we surveyed patients for two weeks after insertion of miniplates and miniscrews in order to evaluate their pain and discomfort.
Materials and methods: Sixty-four patients were divided into the following three groups: maxillary buccal miniplate (Group A) (19 people, 38 plates); upper buccal miniscrew (Group
B) (14 people, 27 screws); and maxillary palatal miniscrew (Group C) (31 people, 49 screws).
All participants completed questionnaires for 14 days after the operation. The patients responded to questions by placing a mark along a 10-cm-long visual analog scale (VAS).
Results: There were no significant differences in pain and discomfort due to the orthodontic archwire itself, as opposed to the anchorage devices, between all three groups. However,
Available online at www.sciencedirect.com
ScienceDirect .e1. Introduction can be divided into plate and screw types (Fig. 2). Sherwood et al.  conducted molar intrusion using buccal plates to
Conclusion: These results suggest that appropriate skeletal anchorage devices should be selected on a case-by-case basis, considering not only the mechanical effect but also the patients’ pain and discomfort levels. # 2013 Elsevier Ltd and the Japanese Orthodontic Society. All rights reserved.Group A showed significantly higher levels of pain and discomfort after insertion than both miniscrew groups at all periods, and Group C presented prolonged discomfort relative to
Group B. At three days after operation, more than 35% in Group A were taking analgesics, compared to significantly lower percentages in Group C (0%) and Group B (7.1%).Questionnaire survey on painResearch paperjournal homepage: wwwRecently, mini-implants such as titanium screws and plates have been used for absolute anchorage during edgewise treatment [1–7] (Fig. 1). Orthodontic skeletal anchorage devices * Corresponding author at: Department of Orthodontics, School of D
Nagoya 464-8651, Japan. Tel.: +81 52 751 7181x378; fax: +81 52 751 890
E-mail addresses: email@example.com, firstname.lastname@example.org 1344-0241/$ – see front matter # 2013 Elsevier Ltd and the Japanese http://dx.doi.org/10.1016/j.odw.2013.09.001lsevier.com/locate/odwmaxillary molars using buccal miniscrews for treatment of bimaxillary protrusion. On the other hand, Wehrbein et al.  used miniscrews at the median palatine suture to fix maxillary entistry, Aichi-Gakuin University, 2-11 Suemori-Dori, Chikusa-Ku, 0. n.ac.jp (M. Kawaguchi).
Orthodontic Society. All rights reserved. molars for treatment of maxillary protrusion. However, almost no study has been conducted to assess these two device placement in the buccal side of the maxillary and th
Questionnaire topics for patient response were as follows: [(Fig._1)TD$FIG]
Fig. 1 – (a) Intraoral photograph of implanted miniplate at bucc buccal side. (c) Intraoral photograph of implanted miniscrew at o r t h od on t i c wa v e s 7 3 ( 2 0 1 4 ) 1 – 72mandibular premolars and molars, or at the median palatine suture. Group A patients were operated on by oral surgeons.
The muco-periosteal flap was reflected, and cortical bone was exposed and fixed by bone screws. The wound was then closed [(Fig._2)TD$FIG]different types of appliance in terms of effectiveness, pain and discomfort experienced by patients. Therefore, we conducted patient questionnaire surveys for two weeks after implant insertion. 2. Materials and methods
Sixty-four (64) patients were divided into three groups, as follows: maxillary buccal miniplate group (Group A) (SMAP,
Dentsply-Sankin, Tokyo, Japan) (19 people, 3 males and 16 females; mean age 24.3, 38 plates); maxillary buccal miniscrew group (Group B) (Dual-Top Anchor System, Jeil Medical
Corporation, Seoul, Korea, diameter: 1.6 mm; length: 8 mm) (14 people, 4 males and 10 females; mean age 27.8, 27 screws); and mid-palatal miniscrew group (Group C) (Dual-Top Anchor
System, Jeil Medical Corporation, Seoul, Korea, diameter: 2 mm; length: 6 mm) (31 people, 3 males and 28 females; mean age 23.7, 49 screws) (Table 1). All patients received orthodontic treatment with either miniscrews or plates at Aichi-Gakuin
University Hospital and completed questionnaires for 14 days after the operation.
Patients received surgical treatment for skeletal anchorageFig. 2 – Miniplate and miniscrew.1. Degree of pain after the operation 2. The time and frequency of taking analgesics after the operation 3. Degree of discomfort after the operation 4. Degree of pain caused by orthodontic archwire changes 5. Degree of discomfort caused by orthodontic archwire changes
The patients were requested to respond to questions 1, 3, 4 and 5 by placing a mark along a 10-cm-long visual analog scale (VAS), and to answer question 2 concerning analgesics with a ‘‘yes’’ or ‘‘no’’ response. Huskisson  described a visual analog scale as a line, usually 10 cm in length, the extremes of which are taken to represent the limits of the pain experience.
One end is defined as ‘‘no pain’’ and the other as ‘‘severe pain’’.JapaIn by an dis lef re su ph an