Comparison of stress and pain developed in patients who had hyrax and leaf expansion appliance in prepubertal period

Objectives: Aim of this study is to evaluate stress and pain developed in the application of leaf expander and hyrax in patients with maxillary deficiency in the prepubertal period by physiological and psychometric methods. Material and Methods: A total of 39 patients, 19 girls and 20 boys, aged between 6 and 11 years, with transversal maxillary deficiency were included in the study. Leaf expander was applied to 19 patients and hyrax was applied to 20 patients who were selected by closed envelope method. Hyrax was activated twice a week at equal day intervals until overcorrection was achieved. Leaf expander was activated at the beginning of the treatment and remained active until overcorrection were achieved, and the activation was stopped as a result of the treatment. Cortisol and substance P levels were evaluated in saliva samples taken from patients in both groups in 8 different time periods, pain and anxiety levels were examined with psychometric tests. Results: The variation of VAS pain scores, cortisol, substance P and STAI (state-trait anxiety) values were examined in between groups and in each group over time. As a result of double group comparisons, cortisol levels at T4, T5, T6 and T7 points were found to be statistically significantly higher in the hyrax group than in the leaf group (p<0,05). The substance P level was found to be statistically significantly higher in hyrax group than in leaf group at all time points (p<0,05). VAS and STAI values were found to be similar between groups at all time points (p>0,05). Conclusion: Results of our study show, leaf expander and the hyrax caused changes in cortisol, substance p, STAI and VAS scores in patients. It was observed that the symptoms of pain and anxiety were different in patients treated with leaf expander compared to patients treated with hyrax. Keywords: Pain, Cortisol, Leaf expansion, state-trait anxiety