PURPOSE: To evaluate, via a visual analog scale (VAS) questionnaire, patient postoperative pain when receiving two miniscrews during the third palatal rugae site orthodontic treatment. METHODS: The same orthodontist placed two miniscrews 3–5 mm from the median suture immediately posterior to the third palatal rugae. Before miniscrew insertion, patients were asked to complete questions 1 to 6 of The Modified Dental Anxiety Scale, which had two questions related to the Expected and/or Pain Felt. Patients were also instructed to complete a questionnaire at several time points to report whether they were experiencing pain and at what level. Timepoints were 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 hours after miniscrew insertion. RESULTS: A total of 102 patients (64 F, 38 M; mean age 14.20 ± 4.59 years) were analyzed for a total of 204 screws. All VAS scores significantly improved compared to the baseline and previous measurements, with improvements in reported pain ceasing at 60 h post-miniscrew insertion. Further, the median reported pain was equal to zero at 36 h post-insertion. A positive correlation was found between the Total score of the Anxiety scale and the Expected pain (r = 0.437, P < 0.001) and between the Total score of the Anxiety scale and the felt pain (r = 0.764, P < 0.001). CONCLUSION: The study showed a positive correlation between the Total score of the Anxiety scale and the Expected pain. The postoperative discomfort was efficiently managed using Paracetamol.
CONTEXT: Although the clinical use of computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated fixed lingual retainers has increased globally, evidence about their adoption among orthodontists in the Middle East remains limited. AIMS: This study aimed to evaluate current knowledge levels, attitudes, and clinical practices of Iraqi orthodontists regarding CAD/CAM fixed lingual retainers and, which demographic or professional factors influence their clinical use. SETTINGS AND DESIGN: Over a period of 3 months, a 25-item questionnaire was distributed via Google Forms to collect data on clinical preferences and CAD/CAM use and awareness. METHODS AND MATERIALS: Over a period of 3 months, a 25-item questionnaire was distributed to the Iraqi orthodontists via Google Forms to collect data on clinical preferences and CAD/CAM use and awareness. STATISTICAL ANALYSIS USED: Descriptive statistics and Chi-square test with Bonferroni correction for multiple comparisons. RESULTS: Only 12.6% of the participants had incorporated CAD/CAM retainers into routine clinical work. After Bonferroni correction for multiple comparisons, CAD/CAM implementation remained significantly associated with practice setting. Orthodontists in private practice were the primary adopters of CAD/CAM technology. CONCLUSION: The preference of Iraqi orthodontists for CAD/CAM retention technology over conventional procedures remains limited. Expanding continuing education initiatives and including digital workflows training in postgraduate orthodontic programs may have potential for broader clinical implementation.
OBJECTIVE: This study was conducted to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating maxillary canine retraction and to assess patient-reported discomfort during orthodontic treatment for Angle Class I malocclusion. SETTING AND SAMPLE POPULATION: This single-blinded, split-mouth, randomized controlled trial was conducted from January to May 2025 at Can Tho University of Medicine and Pharmacy, Vietnam. Forty patients (16–25 years) requiring bilateral maxillary first premolar extractions were randomly assigned to MOPs-assisted or conventional canine retraction. MATERIAL AND METHODS: On the experimental side, three MOPs (1.5 mm × 5 mm) were performed distal to the maxillary canine using the Excellerator device under local anesthesia. NiTi closed-coil springs (150 g) with miniscrew anchorage were used for canine retraction on both sides. Distalization was quantified on digital scans at 4-week intervals, and pain was assessed using a Visual Analog Scale at 1, 3, and 7 days. Data were analyzed using paired t-tests and Wilcoxon signed-rank tests (P < 0.05). RESULTS: Canine distalization was significantly greater on the MOPs side (6.26 ± 0.36 mm) than on the control side (4.09 ± 0.35 mm) throughout the 16-week period (P < 0.001), representing a 1.5-fold acceleration in tooth movement. The mean distalization rate was 1.56 ± 0.08 mm/4 weeks for MOPs and 1.02 ± 0.08 mm/4 weeks for controls. Pain intensity was slightly higher on the MOPs side initially but remained mild and transient. No adverse events were observed. CONCLUSION: MOPs are a safe, minimally invasive adjunctive technique that effectively accelerates orthodontic tooth movement and reduces treatment duration. Registration: ClinicalTrials.gov Identifier: NCT07155018.
OBJECTIVE: To assess the effectiveness of a two-miniscrew MARPE appliance on midpalatal suture (MPS) width in post-pubertal patients with incomplete sutural ossification. MATERIALS AND METHODS: This prospective, non-controlled interventional study included 14 patients aged 16 to 22 years with transverse maxillary deficiency. Maxillary expanders supported by two paramedian miniscrews were placed in the anterior palate. Cone-beam computed tomography (CBCT) scans were obtained before expansion (T1) and after 3 weeks of active expansion (T2) to evaluate changes in MPS width at the premolar and first molar regions. RESULTS: Post-expansion measurements demonstrated a statistically significant increase in midpalatal sutural width at all evaluated sites—including the first premolar, second premolar, and first molar regions—compared with baseline (P = 0.001). Greater sutural opening was observed in the premolar regions than in the molar region, indicating a V-shaped expansion pattern. Increased variability in post-expansion measurements was also noted. Patients classified as stage C showed statistically significant increases in sutural width at all sites following expansion (P = 0.005), whereas stage D patients exhibited minimal, non-significant changes (P = 0.068). CONCLUSION: The two-miniscrew MARPE appliance produced significant midpalatal sutural expansion in post-pubertal patients with incomplete sutural maturation. Expansion occurred at all evaluated sites and followed a V-shaped pattern, with greater widening in the premolar region than in the molar region. Patients at stage C demonstrated greater and more consistent sutural widening, whereas stage D patients showed limited, and non-significant changes.
OBJECTIVES: Questionnaires are widely used in medicine to collect essential patient information, identify disease etiologies, and assess treatment outcomes. In orthodontics, questionnaire-based assessments facilitate the identification of factors associated with dentoalveolar anomalies and myofunctional disorders. Adenoid hypertrophy (AH) is a significant contributor to the development of these conditions. However, inadequate postoperative follow-up may allow myofunctional disorders to persist or progress, despite surgical treatment. A comprehensive evaluation of factors affecting general and oral health may improve diagnostic accuracy, treatment outcomes, and interdisciplinary collaboration. This study aimed to assess the condition of children after surgical treatment for AH, determine the need for orthodontic intervention and associated risk factors, and evaluate the extent of interdisciplinary collaboration in identifying and managing myofunctional disorders through a questionnaire survey and medical record analysis. MATERIALS AND METHODS: This retrospective observational questionnaire-based study included 220 children aged 5–8 years who had undergone surgery for AH. Medical records and questionnaires completed by the children’s legal guardians were analyzed. RESULTS: The findings indicate that a considerable proportion of children continued to experience respiratory, functional, and speech-related complaints after adenoidectomy. Parents frequently reported persistent mouth breathing, pronunciation difficulties, and signs suggestive of myofunctional disorders, despite previous surgical treatment. CONCLUSIONS: Persistent postoperative complaints were identified in a proportion of children, including impaired nasal breathing, harmful oral habits, pronunciation difficulties, and parent-reported signs suggestive of myofunctional disorders. The findings also showed insufficient interdisciplinary follow-up after adenoidectomy, particularly regarding referrals to orthodontists, dentists, speech therapists, and specialists in myofunctional therapy.
