{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:36:52Z","timestamp":1784327812582,"version":"3.55.0"},"reference-count":40,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate and compare perceived pain and jaw function impairment during the first 4 weeks with slow maxillary expansion (SME) using quadhelix and rapid maxillary expansion (RME) using conventional banded hyrax.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n Sixty patients aged 10.2 to 15 years were enrolled and consecutively recruited to either the quadhelix group (QG) or hyrax group (HG). A questionnaire was used to evaluate pain, jaw function impairment, and analgesic consumption in the first 7 days, at 2 weeks, and at 4 weeks.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Fifty-five patients (43 girls and 12 boys) completed the questionnaire at all time points (27 in the QG and 28 in the HG). Except at 4 hours, there were no significant differences between the groups regarding pain from teeth, tongue, and palate. Patients started to adapt after day 3. Patients in the HG group reported significantly higher scores for difficulty in swallowing (moderate to severe) during the first 6 days. In both groups, minimal effects were found on speech and the majority of patients did not experience difficulty in yawning or laughing. There was no significant difference in analgesic consumption between the groups. No correlations were found between age, gender, or malocclusion type and any of the investigated outcomes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Quadhelix for SME and conventional banded hyrax for RME were well tolerated by patients after 1 week. The decision to use either appliance could be based on factors not related to patient experiences.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/020221-100.1","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T14:20:53Z","timestamp":1621952453000},"page":"725-732","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of self-perceived pain and jaw function impairment in children undergoing slow and rapid maxillary expansion:"],"prefix":"10.2319","volume":"91","author":[{"given":"Feras H.","family":"Abed Al Jawad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najah A.","family":"Alhashimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-91-6-725-b01","series-title":"Soc Sci Med","first-page":"1087","article-title":"Patient-centredeness: a conceptual framework and review of the empirical literature","volume":"51","author":"Mead","year":"2000","unstructured":"Mead\n N,\n \n \n Bower\n P.\n \n \n Patient-centredeness: a conceptual framework and review of the empirical literature.\n\t\t\t\t\tSoc Sci Med.\n\t\t\t\t\t2000;\n\t\t\t\t\t51:\n\t\t\t\t\t1087\u2013\n\t\t\t\t\t1110."},{"key":"i0003-3219-91-6-725-b02","series-title":"Eur J Orthod","first-page":"173","article-title":"Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition","volume":"14","author":"Kurol","year":"1992","unstructured":"Kurol\n J,\n \n \n Berglund\n L.\n \n \n Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t1992;\n\t\t\t\t\t14:\n\t\t\t\t\t173\u2013\n\t\t\t\t\t179."},{"key":"i0003-3219-91-6-725-b03","series-title":"Angle Orthod","first-page":"73","article-title":"Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture","volume":"31","author":"Hass","year":"1961","unstructured":"Hass\n AJ.\n \n \n Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t1961;\n\t\t\t\t\t31:\n\t\t\t\t\t73\u2013\n\t\t\t\t\t90."},{"key":"i0003-3219-91-6-725-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"108","article-title":"Root surface resorption, repair, and periodontal attachment following rapid maxillary expansion in man","volume":"81","author":"Langford","year":"1982","unstructured":"Langford\n SR,\n \n \n Sims\n MR.\n \n \n Root surface resorption, repair, and periodontal attachment following rapid maxillary expansion in man.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1982;\n\t\t\t\t\t81:\n\t\t\t\t\t108\u2013\n\t\t\t\t\t115."},{"key":"i0003-3219-91-6-725-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"1","article-title":"Slow maxillary expansion: skeletal versus dental response to low magnitude force in Macaca mulatta","volume":"73","author":"Cotton","year":"1978","unstructured":"Cotton\n LA.\n \n \n Slow maxillary expansion: skeletal versus dental response to low magnitude force in Macaca mulatta.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1978;\n\t\t\t\t\t73:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t23."},{"key":"i0003-3219-91-6-725-b06","series-title":"Angle Orthod","first-page":"86","article-title":"Patient discomfort: a comparison between lingual and labial appliances","volume":"75","author":"Caniklioglu","year":"2005","unstructured":"Caniklioglu\n C,\n \n \n \u00d6zt\u00fcrk\n Y.\n \n \n Patient discomfort: a comparison between lingual and labial appliances.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2005;\n\t\t\t\t\t75:\n\t\t\t\t\t86\u2013\n\t\t\t\t\t91."},{"key":"i0003-3219-91-6-725-b07","series-title":"Angle Orthod","first-page":"462","article-title":"Effects of fixed labial orthodontic appliances on speech sound production","volume":"86","author":"Paley","year":"2016","unstructured":"Paley\n JS,\n \n \n Cisneros\n GJ,\n \n \n Nicolay\n OF,\n \n \n LeBlanc\n EM.\n \n \n Effects of fixed labial orthodontic appliances on speech sound production.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t86:\n\t\t\t\t\t462\u2013\n\t\t\t\t\t467."},{"key":"i0003-3219-91-6-725-b08","series-title":"Eur J Orthod","first-page":"411","article-title":"A clinical comparison of the quadhelix appliance and the nickel titanium (tandem loop) palatal expander: a preliminary, prospective investigation","volume":"26","author":"Donohue","year":"2004","unstructured":"Donohue\n VE,\n \n \n Marshman\n LA,\n \n \n Winchester\n LJ.\n \n \n A clinical comparison of the quadhelix appliance and the nickel titanium (tandem loop) palatal expander: a preliminary, prospective investigation.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2004;\n\t\t\t\t\t26:\n\t\t\t\t\t411\u2013\n\t\t\t\t\t420."},{"key":"i0003-3219-91-6-725-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"48","article-title":"Influence of palatal expanders on oral comfort, speech, and mastication","volume":"137","author":"De Felippe","year":"2010","unstructured":"De Felippe\n NL,\n \n \n Da Silveira\n AC,\n \n \n Viana\n G,\n \n \n Smith\n B.\n \n \n Influence of palatal expanders on oral comfort, speech, and mastication.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2010;\n\t\t\t\t\t137:\n\t\t\t\t\t48\u2013\n\t\t\t\t\t53."},{"key":"i0003-3219-91-6-725-b10","series-title":"Aust Orthod J","first-page":"225","article-title":"Subjective symptoms of RME patients treated with three different screw activation protocols: a randomized clinical trial","volume":"28","author":"Halicio\u011flu","year":"2012","unstructured":"Halicio\u011flu\n K,\n \n \n Kiki\n A,\n \n \n Yavus\n I.\n \n \n Subjective symptoms of RME patients treated with three different screw activation protocols: a randomized clinical trial.\n\t\t\t\t\tAust Orthod J.\n\t\t\t\t\t2012;\n\t\t\t\t\t28:\n\t\t\t\t\t225\u2013\n\t\t\t\t\t231."},{"key":"i0003-3219-91-6-725-b11","series-title":"J Oral Rehabil","first-page":"767","article-title":"Evaluation of stress and pain during rapid maxillary expansion treatments","volume":"39","author":"Gecgelen","year":"2012","unstructured":"Gecgelen\n M,\n \n \n Aksoy\n A,\n \n \n Kirdemir\n P,\n \n et al.\n \n Evaluation of stress and pain during rapid maxillary expansion treatments.\n\t\t\t\t\tJ Oral Rehabil.\n\t\t\t\t\t2012;\n\t\t\t\t\t39:\n\t\t\t\t\t767\u2013\n\t\t\t\t\t775."},{"key":"i0003-3219-91-6-725-b12","series-title":"Angle Orthod","first-page":"925","article-title":"Assessment of vertical changes during maxillary expansion using quad helix or bonded rapid maxillary expander","volume":"86","author":"Conroy-Piskai","year":"2016","unstructured":"Conroy-Piskai\n C,\n \n \n Galang-Boquiren\n MT,\n \n \n Obrez\n A,\n \n et al.\n \n Assessment of vertical changes during maxillary expansion using quad helix or bonded rapid maxillary expander.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t86:\n\t\t\t\t\t925\u2013\n\t\t\t\t\t933."},{"key":"i0003-3219-91-6-725-b13","series-title":"Am J Public Health","first-page":"361","article-title":"Standards for reporting non-randomized evaluations of behavioral and public health interventions: the TREND statement","volume":"94","author":"Des Jarlais","year":"2004","unstructured":"Des Jarlais\n DC,\n \n \n Lyles\n L,\n \n \n Crepaz\n N,\n \n TREND Group.\n \n Standards for reporting non-randomized evaluations of behavioral and public health interventions: the TREND statement.\n\t\t\t\t\tAm J Public Health.\n\t\t\t\t\t2004;\n\t\t\t\t\t94:\n\t\t\t\t\t361\u2013\n\t\t\t\t\t366."},{"key":"i0003-3219-91-6-725-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"567","article-title":"Maxillary transverse deficiency","volume":"117","author":"McNamara","year":"2000","unstructured":"McNamara\n JA.\n \n \n Maxillary transverse deficiency.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2000;\n\t\t\t\t\t117:\n\t\t\t\t\t567\u2013\n\t\t\t\t\t570."},{"key":"i0003-3219-91-6-725-b15","series-title":"Angle Orthod","first-page":"391","article-title":"Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: a randomized controlled trial","volume":"87","author":"Feldmann","year":"2017","unstructured":"Feldmann\n I,\n \n \n Bazargani\n F.\n \n \n Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: a randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2017;\n\t\t\t\t\t87:\n\t\t\t\t\t391\u2013\n\t\t\t\t\t396."},{"key":"i0003-3219-91-6-725-b16","series-title":"Angle Orthod","first-page":"46","article-title":"Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system: a randomized controlled clinical trial","volume":"79","author":"Fleming","year":"2009","unstructured":"Fleming\n PS,\n \n \n DiBiase\n AT,\n \n \n Sarri\n G,\n \n \n Lee\n RT.\n \n \n Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system: a randomized controlled clinical trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2009;\n\t\t\t\t\t79:\n\t\t\t\t\t46\u2013\n\t\t\t\t\t50."},{"key":"i0003-3219-91-6-725-b17","series-title":"J Orofac Orthop","first-page":"125","article-title":"Pain in orthodontics. A review and discussion of the literature","volume":"61","author":"Bergius","year":"2000","unstructured":"Bergius\n M,\n \n \n Kiliaridis\n S,\n \n \n Berggren\n U.\n \n \n Pain in orthodontics. A review and discussion of the literature.\n\t\t\t\t\tJ Orofac Orthop.\n\t\t\t\t\t2000;\n\t\t\t\t\t61:\n\t\t\t\t\t125\u2013\n\t\t\t\t\t137."},{"key":"i0003-3219-91-6-725-b18","series-title":"Eur J Orthod","first-page":"170","article-title":"Orthodontic pain: from causes to management\u2014a review.","volume":"29","year":"2007","unstructured":"Orthodontic pain: from causes to management\u2014a review.\n \n Eur J Orthod\n .\n\t\t\t\t\t2007;\n\t\t\t\t\t29:\n\t\t\t\t\t170\u2013\n\t\t\t\t\t179."},{"key":"i0003-3219-91-6-725-b19","series-title":"Eur J Orthod","article-title":"Comparison between two screws for maxillary expansion: a multicenter randomized controlled trial on patient's reported outcome measures","author":"Nieri","year":"2020","unstructured":"Nieri\n M,\n \n \n Paoloni\n V,\n \n \n Lione\n R,\n \n et al.\n \n Comparison between two screws for maxillary expansion: a multicenter randomized controlled trial on patient's reported outcome measures.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2020.\n\t\t\t\t\tEpub ahead of print."},{"key":"i0003-3219-91-6-725-b20","series-title":"Phys Med Rehabil Clin N Am","first-page":"691","article-title":"Anatomy and physiology of feeding and swallowing: normal and abnormal","volume":"19","author":"Matsuo","year":"2008","unstructured":"Matsuo\n K,\n \n \n Palmer\n JB.\n \n \n Anatomy and physiology of feeding and swallowing: normal and abnormal.\n\t\t\t\t\tPhys Med Rehabil Clin N Am.\n\t\t\t\t\t2008;\n\t\t\t\t\t19:\n\t\t\t\t\t691\u2013\n\t\t\t\t\t707."},{"key":"i0003-3219-91-6-725-b01","series-title":"Soc Sci Med","first-page":"1087","article-title":"Patient-centredeness: a conceptual framework and review of the empirical literature","volume":"51","author":"Mead","year":"2000","unstructured":"Mead\n N,\n \n \n Bower\n P.\n \n \n Patient-centredeness: a conceptual framework and review of the empirical literature.\n\t\t\t\t\tSoc Sci Med.\n\t\t\t\t\t2000;\n\t\t\t\t\t51:\n\t\t\t\t\t1087\u2013\n\t\t\t\t\t1110."},{"key":"i0003-3219-91-6-725-b02","series-title":"Eur J Orthod","first-page":"173","article-title":"Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition","volume":"14","author":"Kurol","year":"1992","unstructured":"Kurol\n J,\n \n \n Berglund\n L.\n \n \n Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t1992;\n\t\t\t\t\t14:\n\t\t\t\t\t173\u2013\n\t\t\t\t\t179."},{"key":"i0003-3219-91-6-725-b03","series-title":"Angle Orthod","first-page":"73","article-title":"Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture","volume":"31","author":"Hass","year":"1961","unstructured":"Hass\n AJ.\n \n \n Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t1961;\n\t\t\t\t\t31:\n\t\t\t\t\t73\u2013\n\t\t\t\t\t90."},{"key":"i0003-3219-91-6-725-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"108","article-title":"Root surface resorption, repair, and periodontal attachment following rapid maxillary expansion in man","volume":"81","author":"Langford","year":"1982","unstructured":"Langford\n SR,\n \n \n Sims\n MR.\n \n \n Root surface resorption, repair, and periodontal attachment following rapid maxillary expansion in man.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1982;\n\t\t\t\t\t81:\n\t\t\t\t\t108\u2013\n\t\t\t\t\t115."},{"key":"i0003-3219-91-6-725-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"1","article-title":"Slow maxillary expansion: skeletal versus dental response to low magnitude force in Macaca mulatta","volume":"73","author":"Cotton","year":"1978","unstructured":"Cotton\n LA.\n \n \n Slow maxillary expansion: skeletal versus dental response to low magnitude force in Macaca mulatta.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1978;\n\t\t\t\t\t73:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t23."},{"key":"i0003-3219-91-6-725-b06","series-title":"Angle Orthod","first-page":"86","article-title":"Patient discomfort: a comparison between lingual and labial appliances","volume":"75","author":"Caniklioglu","year":"2005","unstructured":"Caniklioglu\n C,\n \n \n \u00d6zt\u00fcrk\n Y.\n \n \n Patient discomfort: a comparison between lingual and labial appliances.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2005;\n\t\t\t\t\t75:\n\t\t\t\t\t86\u2013\n\t\t\t\t\t91."},{"key":"i0003-3219-91-6-725-b07","series-title":"Angle Orthod","first-page":"462","article-title":"Effects of fixed labial orthodontic appliances on speech sound production","volume":"86","author":"Paley","year":"2016","unstructured":"Paley\n JS,\n \n \n Cisneros\n GJ,\n \n \n Nicolay\n OF,\n \n \n LeBlanc\n EM.\n \n \n Effects of fixed labial orthodontic appliances on speech sound production.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t86:\n\t\t\t\t\t462\u2013\n\t\t\t\t\t467."},{"key":"i0003-3219-91-6-725-b08","series-title":"Eur J Orthod","first-page":"411","article-title":"A clinical comparison of the quadhelix appliance and the nickel titanium (tandem loop) palatal expander: a preliminary, prospective investigation","volume":"26","author":"Donohue","year":"2004","unstructured":"Donohue\n VE,\n \n \n Marshman\n LA,\n \n \n Winchester\n LJ.\n \n \n A clinical comparison of the quadhelix appliance and the nickel titanium (tandem loop) palatal expander: a preliminary, prospective investigation.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2004;\n\t\t\t\t\t26:\n\t\t\t\t\t411\u2013\n\t\t\t\t\t420."},{"key":"i0003-3219-91-6-725-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"48","article-title":"Influence of palatal expanders on oral comfort, speech, and mastication","volume":"137","author":"De Felippe","year":"2010","unstructured":"De Felippe\n NL,\n \n \n Da Silveira\n AC,\n \n \n Viana\n G,\n \n \n Smith\n B.\n \n \n Influence of palatal expanders on oral comfort, speech, and mastication.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2010;\n\t\t\t\t\t137:\n\t\t\t\t\t48\u2013\n\t\t\t\t\t53."},{"key":"i0003-3219-91-6-725-b10","series-title":"Aust Orthod J","first-page":"225","article-title":"Subjective symptoms of RME patients treated with three different screw activation protocols: a randomized clinical trial","volume":"28","author":"Halicio\u011flu","year":"2012","unstructured":"Halicio\u011flu\n K,\n \n \n Kiki\n A,\n \n \n Yavus\n I.\n \n \n Subjective symptoms of RME patients treated with three different screw activation protocols: a randomized clinical trial.\n\t\t\t\t\tAust Orthod J.\n\t\t\t\t\t2012;\n\t\t\t\t\t28:\n\t\t\t\t\t225\u2013\n\t\t\t\t\t231."},{"key":"i0003-3219-91-6-725-b11","series-title":"J Oral Rehabil","first-page":"767","article-title":"Evaluation of stress and pain during rapid maxillary expansion treatments","volume":"39","author":"Gecgelen","year":"2012","unstructured":"Gecgelen\n M,\n \n \n Aksoy\n A,\n \n \n Kirdemir\n P,\n \n et al.\n \n Evaluation of stress and pain during rapid maxillary expansion treatments.\n\t\t\t\t\tJ Oral Rehabil.\n\t\t\t\t\t2012;\n\t\t\t\t\t39:\n\t\t\t\t\t767\u2013\n\t\t\t\t\t775."},{"key":"i0003-3219-91-6-725-b12","series-title":"Angle Orthod","first-page":"925","article-title":"Assessment of vertical changes during maxillary expansion using quad helix or bonded rapid maxillary expander","volume":"86","author":"Conroy-Piskai","year":"2016","unstructured":"Conroy-Piskai\n C,\n \n \n Galang-Boquiren\n MT,\n \n \n Obrez\n A,\n \n et al.\n \n Assessment of vertical changes during maxillary expansion using quad helix or bonded rapid maxillary expander.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t86:\n\t\t\t\t\t925\u2013\n\t\t\t\t\t933."},{"key":"i0003-3219-91-6-725-b13","series-title":"Am J Public Health","first-page":"361","article-title":"Standards for reporting non-randomized evaluations of behavioral and public health interventions: the TREND statement","volume":"94","author":"Des Jarlais","year":"2004","unstructured":"Des Jarlais\n DC,\n \n \n Lyles\n L,\n \n \n Crepaz\n N,\n \n TREND Group.\n \n Standards for reporting non-randomized evaluations of behavioral and public health interventions: the TREND statement.\n\t\t\t\t\tAm J Public Health.\n\t\t\t\t\t2004;\n\t\t\t\t\t94:\n\t\t\t\t\t361\u2013\n\t\t\t\t\t366."},{"key":"i0003-3219-91-6-725-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"567","article-title":"Maxillary transverse deficiency","volume":"117","author":"McNamara","year":"2000","unstructured":"McNamara\n JA.\n \n \n Maxillary transverse deficiency.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2000;\n\t\t\t\t\t117:\n\t\t\t\t\t567\u2013\n\t\t\t\t\t570."},{"key":"i0003-3219-91-6-725-b15","series-title":"Angle Orthod","first-page":"391","article-title":"Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: a randomized controlled trial","volume":"87","author":"Feldmann","year":"2017","unstructured":"Feldmann\n I,\n \n \n Bazargani\n F.\n \n \n Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: a randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2017;\n\t\t\t\t\t87:\n\t\t\t\t\t391\u2013\n\t\t\t\t\t396."},{"key":"i0003-3219-91-6-725-b16","series-title":"Angle Orthod","first-page":"46","article-title":"Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system: a randomized controlled clinical trial","volume":"79","author":"Fleming","year":"2009","unstructured":"Fleming\n PS,\n \n \n DiBiase\n AT,\n \n \n Sarri\n G,\n \n \n Lee\n RT.\n \n \n Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system: a randomized controlled clinical trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2009;\n\t\t\t\t\t79:\n\t\t\t\t\t46\u2013\n\t\t\t\t\t50."},{"key":"i0003-3219-91-6-725-b17","series-title":"J Orofac Orthop","first-page":"125","article-title":"Pain in orthodontics. A review and discussion of the literature","volume":"61","author":"Bergius","year":"2000","unstructured":"Bergius\n M,\n \n \n Kiliaridis\n S,\n \n \n Berggren\n U.\n \n \n Pain in orthodontics. 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