title: Subjective symptoms of RME patients treated with three different screw activation protocols: a randomised clinical trial.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the subjective symptoms of patients during the active phase of rapid maxillary expansion (RME) treatment, and further, to assess the differences between three different RME activation protocols.
  
  
  METHODS
  The clinical sample consisted of 60 patients (mean age 13.5 years) with maxillary transverse deficiency requiring expansion. The subjects were randomly divided into three groups on which different expansion protocols were performed. An evaluation of the subjective symptoms was carried out by a Numerical Rating Scale (NRS). The patients completed questionnaires after the first, fifth, tenth, twentieth and final activations. A Shapiro-Wilk test was applied to evaluate homogenity; a Kruskall Wallis test was performed for gender-related differences and to compare the different activation schedules. The Wilcoxon test was used to compare the activations at the various time intervals.
  
  
  RESULTS
  No gender-related differences were found. Ninety-eight percent of the patients reported pain during RME. There were no specific differences between groups except for the pain perceived at the twentieth activation. In all groups, pain, the sensation of pressure and its duration were highest at the fifth activation. Subjective symptoms tended to decrease after the fifth and tenth activations. Headache and dizziness were minimal.
  
  
  CONCLUSIONS
  Different activation protocols did not appear to alter subjective symptoms encountered during RME. The majority of the patients undergoing RME suffered pain and pressure sensations especially after the fifth activation.
authors.affiliation: Department Orthodontics, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey. korayhalicioglu@hotmail.com
authors.forename: Koray
authors.initials: K
authors.lastname: Halicioğlu
authors.forename: Ali
authors.initials: A
authors.lastname: Kiki
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yavuz
mesh_terms: D000293:Adolescent; D002648:Child; D002985:Clinical Protocols; D004244:Dizziness / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000628:therapy; D016382:Orthodontic Appliance Design; D010147:Pain Measurement; D010155:Palatal Expansion Technique / Q000009:adverse effects / Q000295:instrumentation; D011312:Pressure; D011795:Surveys and Questionnaires; D013997:Time Factors