The impact of tooth-borne vs computer-guided bone-borne rapid maxillary expansion on pain and oral health-related quality of life: A parallel cohort study

Introduction: The primary aim of this study was to investigate and compare perceived pain intensity and oral health-related quality of life (OHRQOL) results during the activation phase of rapid maxillary expansion (RME), with tooth-borne and bone-borne devices. In addition, a secondary aim of this study was to evaluate the correlation between pain scales and the shortened Oral Health Impact Profile (OHIP-14) questionnaire. Methods: Thirty-six subjects (16 girls and 20 boys) with a mean age of 12.3 years (standard deviation, 0.82 years) were randomized into 2 groups. Group A received treatment with hyrax appliance, and group B received a computer-guided skeletal RME appliance. The same type of expansion screw and screw activation or expansion protocol were used. Two rating scales were used to assess the subject's pain during the activation phase of RME: a Graphic Rating Scale for Pain (GRS) and the Wong-Baker Faces Pain Scale (FPS). The OHIP-14 was used to evaluate the impact of RME on OHRQOL before the beginning of the treatment at day 3 and day 7 follow-ups. Painkillers were forbidden during the active phase of RME. Descriptive statistics, Student t test, and Pearson correlation were used. Significance was set at P <= 0.05. Results: A total of 36 subjects, divided into 2 groups, were treated in the study. Regarding the level of pain, the Student t test showed statistically significant higher pain in group B-although only on the first day of screw activation (GRS, P = 0.01; FPS, P < 0.01). For the following days, there were no significant differences in pain levels between groups. The OHIP-14 showed no statistically significant difference at baseline (P = 0.32) and day 3 (P = 0.88) and day 7 (P = 0.85) follow-ups between the 2 groups. The Pearson correlation coefficient showed a statistically significant association between the 2 different scales of pain (GRS and FPS) but not a statistically significant correlation between GRS and FPS scales and OHIP-14. Conclusions: A higher perceived pain intensity in the patients treated using a bone-borne computer-guided skeletal RME appliance was limited to the first day of screw activation. There were no statistically significant differences between the 2 types of treatment in terms of their impact on OHRQOL and no statistically significant correlation between pain scales and the OHIP-14 questionnaire.