{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:43:55Z","timestamp":1790142235313,"version":"4.0.1"},"reference-count":44,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To compare the perception of pain and discomfort of patients and guardians during treatment between miniscrew-anchored maxillary protraction (MAMP) therapy using Hybrid (HH) and Conventional Hyrax (CH) expanders.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n Group HH was composed of 18 subjects (8 female, 10 male; initial age: 10.80 years) with Class III malocclusion treated with a hybrid expander in the maxilla and two miniscrews in the anterior region of the mandible. Class III elastics were used from maxillary first molar to mandibular miniscrews. Group CH was composed of 14 subjects (6 female, 8 male; initial age: 11.44 years) treated with a similar protocol except for conventional Hyrax expander. Pain and discomfort of patients and guardians were assessed using a visual analog scale immediately after placement (T1), after 24 hours (T2), and 1 month after appliance installation (T3). Mean differences (MD) were obtained. Intergroup and intragroup timepoint comparisons were performed using independent\n t<\/jats:italic>\n -tests, analysis of variance for repeated measures and Friedman test (\n P<\/jats:italic>\n < 5%).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both groups demonstrated similar levels of pain and discomfort with a significant decrease after 1 month of appliance placement (MD: 4.21;\n P<\/jats:italic>\n = .608). Compared to patient perceptions, guardians reported a higher level of pain and discomfort at all timepoints (MD, T1: 13.91,\n P<\/jats:italic>\n < .001; T2: 23.15,\n P<\/jats:italic>\n < .001; T3: 9.35,\n P<\/jats:italic>\n = .008).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n MAMP therapy with HH and CH produced similar levels of pain and discomfort after appliance installation until 1 month after treatment. Pain and discomfort may not influence the choice between HH and CH expanders.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/092022-655.1","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T10:16:18Z","timestamp":1676542578000},"page":"313-319","source":"Crossref","is-referenced-by-count":4,"title":["Pain and discomfort perception during miniscrew-anchored maxillary protraction: secondary data analysis of a randomized clinical trial"],"prefix":"10.2319","volume":"93","author":[{"given":"Felicia","family":"Miranda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Duarte","family":"Parra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Carlos da Cunha","family":"Bastos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Magno dos","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan de Souza","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Quevedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Aliaga-Del Castillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Garib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-93-3-313-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"675","article-title":"The effectiveness of protraction face mask therapy: a meta-analysis","volume":"115","author":"Kim","year":"1999","unstructured":"Kim\n JH,\n \n \n Viana\n MA,\n \n \n Graber\n TM,\n \n \n Omerza\n FF,\n \n \n BeGole\n EA.\n \n \n The effectiveness of protraction face mask therapy: a meta-analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1999;115:675\u2013685."},{"key":"i0003-3219-93-3-313-b02","series-title":"J Oral Maxillofac Surg","first-page":"2123","article-title":"Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency","volume":"67","author":"De Clerck","year":"2009","unstructured":"De Clerck\n HJ,\n \n \n Cornelis\n MA,\n \n \n Cevidanes\n LH,\n \n \n Heymann\n GC,\n \n \n Tulloch\n CJ.\n \n \n Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency.\n\t\t\t\t\tJ Oral Maxillofac Surg.\n\t\t\t\t\t2009;67:2123\u20132129."},{"key":"i0003-3219-93-3-313-b03","series-title":"Angle Orthod","first-page":"799","article-title":"Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion","volume":"80","author":"Cevidanes","year":"2010","unstructured":"Cevidanes\n L,\n \n \n Baccetti\n T,\n \n \n Franchi\n L,\n \n \n McNamara\n JA,\n Jr,\n \n \n De Clerck\n H.\n \n \n Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2010;80:799\u2013806."},{"key":"i0003-3219-93-3-313-b04","series-title":"Prog Orthod","first-page":"42","article-title":"Early Class III treatment with Hybrid-Hyrax - Facemask in comparison to Hybrid-Hyrax-Mentoplate - skeletal and dental outcomes","volume":"19","author":"Willmann","year":"2018","unstructured":"Willmann\n JH,\n \n \n Nienkemper\n M,\n \n \n Tarraf\n NE,\n \n \n Wilmes\n B,\n \n \n Drescher\n D.\n \n \n Early Class III treatment with Hybrid-Hyrax - Facemask in comparison to Hybrid-Hyrax-Mentoplate - skeletal and dental outcomes.\n\t\t\t\t\tProg Orthod.\n\t\t\t\t\t2018;19:42."},{"key":"i0003-3219-93-3-313-b05","series-title":"J Clin Orthod","first-page":"84","article-title":"Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol","volume":"48","author":"Wilmes","year":"2014","unstructured":"Wilmes\n B,\n \n \n Ngan\n P,\n \n \n Liou\n EJ,\n \n \n Franchi\n L,\n \n \n Drescher\n D.\n \n \n Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol.\n\t\t\t\t\tJ Clin Orthod.\n\t\t\t\t\t2014;48:84\u201393."},{"key":"i0003-3219-93-3-313-b06","series-title":"J Clin Orthod","first-page":"15","article-title":"Early Class III treatment with a hybrid hyrax-mentoplate combination","volume":"45","author":"Wilmes","year":"2011","unstructured":"Wilmes\n B,\n \n \n Nienkemper\n M,\n \n \n Ludwig\n B,\n \n \n Kau\n CH,\n \n \n Drescher\n D.\n \n \n Early Class III treatment with a hybrid hyrax-mentoplate combination.\n\t\t\t\t\tJ Clin Orthod.\n\t\t\t\t\t2011;45:15\u201321."},{"key":"i0003-3219-93-3-313-b07","series-title":"J Orthod","first-page":"170","article-title":"Miniscrew-anchored maxillary protraction in growing Class III patients","volume":"47","author":"Miranda","year":"2020","unstructured":"Miranda\n F,\n \n \n Bastos\n J,\n \n \n Dos Santos\n AM,\n \n \n Vieira\n LS, Aliaga-Del\n \n \n Castillo\n A,\n \n \n Janson\n G\n \n et al.\n\t\t\t\t\t\n Miniscrew-anchored maxillary protraction in growing Class III patients.\n\t\t\t\t\tJ Orthod.\n\t\t\t\t\t2020;47:170\u2013180."},{"key":"i0003-3219-93-3-313-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"774","article-title":"Magno Dos Santos A, Janson G, Pereira Lauris JR, Garib D. Dentoskeletal comparison of miniscrew-anchored maxillary protraction with hybrid and conventional hyrax expanders: a randomized clinical trial","volume":"160","author":"Miranda","year":"2021","unstructured":"Miranda\n F,\n \n \n Cunha Bastos\n JCD,\n \n \n Magno Dos Santos A, Janson G, Pereira Lauris JR, Garib D. Dentoskeletal comparison of miniscrew-anchored maxillary protraction with hybrid and conventional hyrax expanders: a randomized clinical trial.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2021;160:774\u2013783."},{"issue":"1","key":"i0003-3219-93-3-313-b09","series-title":"Eur J Orthod","first-page":"349","article-title":"Perception of pain as a result of orthodontic treatment with fixed appliances","volume":"18","author":"Scheurer","year":"1996","unstructured":"Scheurer\n PA,\n \n \n Firestone\n AR,\n \n \n B\u00fcrgin\n WB.\n \n \n Perception of pain as a result of orthodontic treatment with fixed appliances.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t1996;18(1):349\u2013357."},{"key":"i0003-3219-93-3-313-b10","series-title":"Br J Orthod","first-page":"179","article-title":"Attitudes to orthodontic treatment","volume":"12","author":"Oliver","year":"1985","unstructured":"Oliver\n RG,\n \n \n Knapman\n YM.\n \n \n Attitudes to orthodontic treatment.\n\t\t\t\t\tBr J Orthod.\n\t\t\t\t\t1985;12:179\u2013188."},{"key":"i0003-3219-93-3-313-b11","series-title":"Angle Orthod","first-page":"1141","article-title":"The relationship between personality traits, pain perception and attitude toward orthodontic treatment","volume":"80","author":"Abu Alhaija","year":"2010","unstructured":"Abu Alhaija\n ES,\n \n \n Aldaikki\n A,\n \n \n Al-Omairi\n MK,\n \n \n Al-Khateeb\n SN.\n \n \n The relationship between personality traits, pain perception and attitude toward orthodontic treatment.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2010;80:1141\u20131149."},{"key":"i0003-3219-93-3-313-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"47","article-title":"Perception of discomfort by patients undergoing orthodontic treatment","volume":"96","author":"Ngan","year":"1989","unstructured":"Ngan\n P,\n \n \n Kess\n B,\n \n \n Wilson\n S.\n \n \n Perception of discomfort by patients undergoing orthodontic treatment.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1989;96:47\u201353."},{"key":"i0003-3219-93-3-313-b13","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\t\t\t\t\t\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;39:767\u2013775."},{"key":"i0003-3219-93-3-313-b14","series-title":"Aust Orthod J","first-page":"225","article-title":"Subjective symptoms of RME patients treated with three different screw activation protocols: a randomised clinical trial","volume":"28","author":"Halicioglu","year":"2012","unstructured":"Halicioglu\n K,\n \n \n Kiki\n A,\n \n \n Yavuz\n I.\n \n \n Subjective symptoms of RME patients treated with three different screw activation protocols: a randomised clinical trial.\n\t\t\t\t\tAust Orthod J.\n\t\t\t\t\t2012;28:225\u2013231."},{"key":"i0003-3219-93-3-313-b15","series-title":"Pediatr Dent","first-page":"221","article-title":"Berde C. Reports of pain by children undergoing rapid palatal expansion","volume":"22","author":"Needleman","year":"2000","unstructured":"Needleman\n HL,\n \n \n Hoang\n CD,\n \n \n Allred\n E,\n \n \n Hertzberg\n J,\n \n \n Berde C. Reports of pain by children undergoing rapid palatal expansion.\n\t\t\t\t\tPediatr Dent.\n\t\t\t\t\t2000;22:221\u2013226."},{"key":"i0003-3219-93-3-313-b16","series-title":"Angle Orthod","first-page":"1015","article-title":"Influence of activation protocol on perceived pain during rapid maxillary expansion","volume":"85","author":"Baldini","year":"2015","unstructured":"Baldini\n A,\n \n \n Nota\n A,\n \n \n Santariello\n C,\n \n \n Assi\n V,\n \n \n Ballanti\n F,\n \n \n Cozza\n P.\n \n \n Influence of activation protocol on perceived pain during rapid maxillary expansion.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2015;85:1015\u20131020."},{"key":"i0003-3219-93-3-313-b17","series-title":"Angle Orthod","first-page":"578","article-title":"Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction: a randomized controlled trial","volume":"77","author":"Feldmann","year":"2007","unstructured":"Feldmann\n I,\n \n \n List\n T,\n \n \n Feldmann\n H,\n \n \n Bondemark\n L.\n \n \n Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction: a randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2007;77:578\u2013585."},{"key":"i0003-3219-93-3-313-b18","series-title":"Angle Orthod","first-page":"891","article-title":"Pain and discomfort following insertion of miniscrews and premolar extractions: a randomized controlled trial","volume":"86","author":"Ganzer","year":"2016","unstructured":"Ganzer\n N,\n \n \n Feldmann\n I,\n \n \n Bondemark\n L.\n \n \n Pain and discomfort following insertion of miniscrews and premolar extractions: a randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;86:891\u2013899."},{"key":"i0003-3219-93-3-313-b19","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;87:391\u2013396."},{"key":"i0003-3219-93-3-313-b20","series-title":"Spec Care Dent","first-page":"395","article-title":"Applications of sensory and physiological measurement in oral-facial dental pain","volume":"38","author":"Dabiri","year":"2018","unstructured":"Dabiri\n D,\n \n \n Harper\n DE,\n \n \n Kapila\n Y,\n \n \n Kruger\n GH,\n \n \n Clauw\n DJ,\n \n \n Harte\n S.\n \n \n Applications of sensory and physiological measurement in oral-facial dental pain.\n\t\t\t\t\tSpec Care Dent.\n\t\t\t\t\t2018;38:395\u2013404."},{"key":"i0003-3219-93-3-313-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"9","article-title":"Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort","volume":"131","author":"Kuroda","year":"2007","unstructured":"Kuroda\n S,\n \n \n Sugawara\n Y,\n \n \n Deguchi\n T,\n \n \n Kyung\n HM,\n \n \n Takano-Yamamoto\n T.\n \n \n Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2007;131:9\u201315."},{"key":"i0003-3219-93-3-313-b22","series-title":"Int J Paediatr Dent","first-page":"686","article-title":"Evaluating the agreement between children and their parents on dental pain in children using the self-reported method","volume":"32","author":"Brilhante","year":"2022","unstructured":"Brilhante\n VOM,\n \n \n Costa\n LR,\n \n \n Correa-Faria\n P.\n \n \n Evaluating the agreement between children and their parents on dental pain in children using the self-reported method.\n\t\t\t\t\tInt J Paediatr Dent.\n\t\t\t\t\t2022;32:686\u2013692."},{"key":"i0003-3219-93-3-313-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"675","article-title":"The effectiveness of protraction face mask therapy: a meta-analysis","volume":"115","author":"Kim","year":"1999","unstructured":"Kim\n JH,\n \n \n Viana\n MA,\n \n \n Graber\n TM,\n \n \n Omerza\n FF,\n \n \n BeGole\n EA.\n \n \n The effectiveness of protraction face mask therapy: a meta-analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1999;115:675\u2013685."},{"key":"i0003-3219-93-3-313-b02","series-title":"J Oral Maxillofac Surg","first-page":"2123","article-title":"Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency","volume":"67","author":"De Clerck","year":"2009","unstructured":"De Clerck\n HJ,\n \n \n Cornelis\n MA,\n \n \n Cevidanes\n LH,\n \n \n Heymann\n GC,\n \n \n Tulloch\n CJ.\n \n \n Orthopedic traction of the maxilla with miniplates: a new perspective for treatment of midface deficiency.\n\t\t\t\t\tJ Oral Maxillofac Surg.\n\t\t\t\t\t2009;67:2123\u20132129."},{"key":"i0003-3219-93-3-313-b03","series-title":"Angle Orthod","first-page":"799","article-title":"Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion","volume":"80","author":"Cevidanes","year":"2010","unstructured":"Cevidanes\n L,\n \n \n Baccetti\n T,\n \n \n Franchi\n L,\n \n \n McNamara\n JA,\n Jr,\n \n \n De Clerck\n H.\n \n \n Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2010;80:799\u2013806."},{"key":"i0003-3219-93-3-313-b04","series-title":"Prog Orthod","first-page":"42","article-title":"Early Class III treatment with Hybrid-Hyrax - Facemask in comparison to Hybrid-Hyrax-Mentoplate - skeletal and dental outcomes","volume":"19","author":"Willmann","year":"2018","unstructured":"Willmann\n JH,\n \n \n Nienkemper\n M,\n \n \n Tarraf\n NE,\n \n \n Wilmes\n B,\n \n \n Drescher\n D.\n \n \n Early Class III treatment with Hybrid-Hyrax - Facemask in comparison to Hybrid-Hyrax-Mentoplate - skeletal and dental outcomes.\n\t\t\t\t\tProg Orthod.\n\t\t\t\t\t2018;19:42."},{"key":"i0003-3219-93-3-313-b05","series-title":"J Clin Orthod","first-page":"84","article-title":"Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol","volume":"48","author":"Wilmes","year":"2014","unstructured":"Wilmes\n B,\n \n \n Ngan\n P,\n \n \n Liou\n EJ,\n \n \n Franchi\n L,\n \n \n Drescher\n D.\n \n \n Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol.\n\t\t\t\t\tJ Clin Orthod.\n\t\t\t\t\t2014;48:84\u201393."},{"key":"i0003-3219-93-3-313-b06","series-title":"J Clin Orthod","first-page":"15","article-title":"Early Class III treatment with a hybrid hyrax-mentoplate combination","volume":"45","author":"Wilmes","year":"2011","unstructured":"Wilmes\n B,\n \n \n Nienkemper\n M,\n \n \n Ludwig\n B,\n \n \n Kau\n CH,\n \n \n Drescher\n D.\n \n \n Early Class III treatment with a hybrid hyrax-mentoplate combination.\n\t\t\t\t\tJ Clin Orthod.\n\t\t\t\t\t2011;45:15\u201321."},{"key":"i0003-3219-93-3-313-b07","series-title":"J Orthod","first-page":"170","article-title":"Miniscrew-anchored maxillary protraction in growing Class III patients","volume":"47","author":"Miranda","year":"2020","unstructured":"Miranda\n F,\n \n \n Bastos\n J,\n \n \n Dos Santos\n AM,\n \n \n Vieira\n LS, Aliaga-Del\n \n \n Castillo\n A,\n \n \n Janson\n G\n \n et al.\n\t\t\t\t\t\n Miniscrew-anchored maxillary protraction in growing Class III patients.\n\t\t\t\t\tJ Orthod.\n\t\t\t\t\t2020;47:170\u2013180."},{"key":"i0003-3219-93-3-313-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"774","article-title":"Magno Dos Santos A, Janson G, Pereira Lauris JR, Garib D. Dentoskeletal comparison of miniscrew-anchored maxillary protraction with hybrid and conventional hyrax expanders: a randomized clinical trial","volume":"160","author":"Miranda","year":"2021","unstructured":"Miranda\n F,\n \n \n Cunha Bastos\n JCD,\n \n \n Magno Dos Santos A, Janson G, Pereira Lauris JR, Garib D. Dentoskeletal comparison of miniscrew-anchored maxillary protraction with hybrid and conventional hyrax expanders: a randomized clinical trial.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2021;160:774\u2013783."},{"issue":"1","key":"i0003-3219-93-3-313-b09","series-title":"Eur J Orthod","first-page":"349","article-title":"Perception of pain as a result of orthodontic treatment with fixed appliances","volume":"18","author":"Scheurer","year":"1996","unstructured":"Scheurer\n PA,\n \n \n Firestone\n AR,\n \n \n B\u00fcrgin\n WB.\n \n \n Perception of pain as a result of orthodontic treatment with fixed appliances.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t1996;18(1):349\u2013357."},{"key":"i0003-3219-93-3-313-b10","series-title":"Br J Orthod","first-page":"179","article-title":"Attitudes to orthodontic treatment","volume":"12","author":"Oliver","year":"1985","unstructured":"Oliver\n RG,\n \n \n Knapman\n YM.\n \n \n Attitudes to orthodontic treatment.\n\t\t\t\t\tBr J Orthod.\n\t\t\t\t\t1985;12:179\u2013188."},{"key":"i0003-3219-93-3-313-b11","series-title":"Angle Orthod","first-page":"1141","article-title":"The relationship between personality traits, pain perception and attitude toward orthodontic treatment","volume":"80","author":"Abu Alhaija","year":"2010","unstructured":"Abu Alhaija\n ES,\n \n \n Aldaikki\n A,\n \n \n Al-Omairi\n MK,\n \n \n Al-Khateeb\n SN.\n \n \n The relationship between personality traits, pain perception and attitude toward orthodontic treatment.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2010;80:1141\u20131149."},{"key":"i0003-3219-93-3-313-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"47","article-title":"Perception of discomfort by patients undergoing orthodontic treatment","volume":"96","author":"Ngan","year":"1989","unstructured":"Ngan\n P,\n \n \n Kess\n B,\n \n \n Wilson\n S.\n \n \n Perception of discomfort by patients undergoing orthodontic treatment.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1989;96:47\u201353."},{"key":"i0003-3219-93-3-313-b13","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\t\t\t\t\t\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;39:767\u2013775."},{"key":"i0003-3219-93-3-313-b14","series-title":"Aust Orthod J","first-page":"225","article-title":"Subjective symptoms of RME patients treated with three different screw activation protocols: a randomised clinical trial","volume":"28","author":"Halicioglu","year":"2012","unstructured":"Halicioglu\n K,\n \n \n Kiki\n A,\n \n \n Yavuz\n I.\n \n \n Subjective symptoms of RME patients treated with three different screw activation protocols: a randomised clinical trial.\n\t\t\t\t\tAust Orthod J.\n\t\t\t\t\t2012;28:225\u2013231."},{"key":"i0003-3219-93-3-313-b15","series-title":"Pediatr Dent","first-page":"221","article-title":"Berde C. Reports of pain by children undergoing rapid palatal expansion","volume":"22","author":"Needleman","year":"2000","unstructured":"Needleman\n HL,\n \n \n Hoang\n CD,\n \n \n Allred\n E,\n \n \n Hertzberg\n J,\n \n \n Berde C. 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