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Expectations, acceptance and preferences of patients in treatment with orthodontic mini-implants

Part II: implant removal

Erwartungen, Akzeptanz und Präferenzen der Patienten bei Behandlungen mit orthodontischen Mini-Implantaten: Eine randomisierte kontrollierte Studie

Teil II: Implantatexplantation

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objective

The objective of this study was to compare mechanical and manual techniques to remove orthodontic mini-implants. We also investigated whether the treated patients preferred local anesthetics. The study’s focus is on the patients’ perceptions and the resulting preferences.

Patients and methods

A total of 25 patients were randomly assigned to Group A or Group B. In Group A, the mini-implants were removed with a handpiece, while the Group-B patients’ mini-implants were removed completely by hand. In addition, all patients received an injection of local anesthetic into one half of the jaw. No anesthetic was used on the other half of the jaw. The patients were asked about their pain perception before treatment, immediately after treatment and one day after treatment.

Results

We observed no significant differences between the two groups with respect to the intensity of their symptoms. However, the noise associated with the handpiece was found to be unpleasant and tended to lead to more symptoms than when no handpiece was used. Pain perceived during mini-implant removal was relatively slight and not much affected by the use of local anesthetics. The most severe symptoms were associated with the injection itself. The non-injected side experienced significantly less discomfort and was thus the preferred side in both groups.

Conclusion

The patients tolerated the two removal procedures equally well. As the noise associated with the handpiece increased discomfort, manual removal of the mini-implants is preferable. As regards the injection technique, our results show that local anesthesia during removal does not provide a benefit. The most pain was caused by the injection, not by removal of the mini-implants.

Zusammenfassung

Ziel

Ziel dieser Studie war der Vergleich einer maschinellen mit einer manuellen Technik zur Entfernung orthodontischer Mini-Implantate. Des Weiteren wurde untersucht, ob die behandelten Patienten lokale Anästhesien bevorzugen würden. Im Fokus der Studie standen die Empfindungen der Patienten und resultierende Präferenzen.

Patienten und Methodik

Insgesamt 25 Patienten wurden zufällig in zwei Gruppen A und B eingeteilt. Bei den Patienten der Gruppe A wurden die Mini-Implantate mit einem Handstück entfernt. In Gruppe B wurden die Mini-Implantate komplett manuell entfernt. Ferner wurde bei allen Patienten auf der einen Kieferhälfte ein Lokalanästhetikum injiziert. Auf der anderen Kieferseite wurde keine Anästhesie verwendet. Die Patienten wurden vor, unmittelbar nach und einen Tag nach der Behandlung bezüglich ihrer Schmerzwahrnehmung befragt.

Ergebnisse

Hinsichtlich der Stärke der beschriebenen Beschwerden gab es keine signifikanten Unterschiede zwischen beiden Gruppen. Das Geräusch des Handstückes wurde jedoch als unangenehm empfunden und führte zu tendenziell größeren Beschwerden als ohne Handstück. Die Schmerzempfindung während der Entfernung der Mini-Implantate war relativ gering und differierte nicht stark bei Nutzung oder Nichtnutzung der Lokalanästhesie. Die höchsten zu verzeichnenden Beschwerden ließen sich auf die Injektion selbst zurückführen. In beiden Gruppen zeigte die Seite, auf der keine Injektion gesetzt wurde, signifikant geringere Missempfindungen und war daher die bevorzugte Seite.

Schlussfolgerung

Die Patienten tolerierten die verschiedenen Entfernungsvorgänge gleichermaßen gut. Da das Geräusch des Handstückes zu einem Anstieg des Missempfindens führte, ist die manuelle Entfernung der Mini-Implantate vorzuziehen. Hinsichtlich der Injektionstechnik zeigen die Ergebnisse, dass die lokale Betäubung bei dem eigentlichen Vorgang der Entfernung keinen Vorteil brachte. Das höchste Schmerzniveau wurde durch die Injektion hervorgerufen und nicht durch die Entfernung der Mini-Implantate.

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Conflict of interest

The corresponding author declares, that there is no conflict of interest.

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Authors and Affiliations

  1. Private Orthodontic Practice, Bonn, Germany

    S. Lehnen

  2. Department of Orthodontics and Paediatric Dentistry, King’s College London, London, United Kingdom

    F. McDonald &  M. Baxmann

  3. Cendres+Métaux Endowed Professor of Oral Technology, Dental Clinic, University of Bonn, Bonn, Germany

    C. Bourauel

  4. Department of Orthodontics, University of Bonn, Bonn, Germany

    A. Jäger &  M. Baxmann

Authors
  1. S. Lehnen
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  2. F. McDonald
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  3. C. Bourauel
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  4. A. Jäger
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  5. M. Baxmann
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Corresponding author

Correspondence to M. Baxmann.

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Lehnen, S., McDonald, F., Bourauel, C. et al. Expectations, acceptance and preferences of patients in treatment with orthodontic mini-implants. J Orofac Orthop 72, 214–222 (2011). https://doi.org/10.1007/s00056-011-0026-3

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