Effect of menstrual cycle on orthodontic pain perception : A controlled clinical trial.
OBJECTIVE
The aim of this prospective, single-center, controlled clinical trial was to evaluate the effects of menstrual cycle phases on orthodontic pain perception.


METHODS
A total of 48 women between 16 and 20 years old with regular menstrual periods who were scheduled to undergo extraction of two upper first premolars for orthodontic treatment were enrolled in this study. Laceback ligatures were used to move canines distally. After activating the laceback ligatures, each patient completed a questionnaire in order to assess pain and quality of life. Pain perception was recorded by patients on a visual analogue scale (VAS) and a verbal rating scale-4 (VRS) immediately after activation (T1) and 24 h after activation (T2). During the appointment, each patient's menstrual-cycle phase (follicular or luteal) was determined by asking some questions about her cycle. For statistical analysis of data, the Mann-Whitney U, independent t test, and Wilcoxon tests were applied.


RESULTS
Mean orthodontic pain score was 1.96 ± 0.80 and 47.08 ± 21.68 in the follicular phase, 1.92 ± 0.82 and 46.25 ± 18.92 in the luteal phase at T1 using the VRS and VAS, respectively. Orthodontic pain scores were worse in those patients in the luteal phase than those in the follicular phase (p < 0.05) in terms of both VRS (p = 0.025) and VAS (p = 0.046). No significant difference between pain scores at T1 and those at T2 in both luteal and follicular phases (p > 0.05) were observed.


CONCLUSIONS
The menstrual phase has an influence on the perception of orthodontic pain which is higher in the luteal phase following the activation of laceback ligatures. In clinical practice, the phases of the menstrual cycle may have a significant role in how women perceive orthodontic pain.
Department of Orthodontics, Faculty of Dentistry, Selcuk University, 42079, Konya, Turkey.
Zehra
Z
Ileri
Department of Orthodontics, Faculty of Dentistry, Selcuk University, 42079, Konya, Turkey. mugen97@hotmail.com.
Zeliha Muge
ZM
Baka
Department of Orthodontics, Faculty of Dentistry, Selcuk University, 42079, Konya, Turkey.
Mehmet
M
Akin
Department of Anesthesia and Intensive Care, Medical Faculty, Selcuk University, Konya, Turkey.
Seza
S
Apiliogullari
Department Chair, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey.
Faruk Ayhan
FA
Basciftci
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000523:psychology*; D009971:Orthodontics, Corrective / Q000009:adverse effects* / Q000295:instrumentation; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D058748:Pain Perception; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult
Follicular phase; Luteal phase; Menstrual cycle; Orthodontic treatment; Pain perception