Evaluation of stress and pain in patients used with hyrax and memory expansion apparatus during the pubertal period

ABSTRACT EVALUATION OF STRESS AND PAIN IN PATIENTS USED WITH HYRAX AND MEMORY EXPANSION APPARATUS DURING THE PUBERTAL PERIOD Güran O. Aydın Adnan Menderes University Health Sciences Institute of Orthodontic Doctorate Program, Doctor of Philosophy Thesis, Aydın, 2024 Objectives: The purpose of this study is to evaluate the stress and pain occurring during expansion in patients treated with memory-based expansion appliances and hyrax appliances during the pubertal period. Material and Methods: In the study, a total of 36 patients (18 girls and 18 boys) with transverse maxillary constriction, aged between 10 and 14 years, were included. Closed envelope method was used to select 18 patients for memory expansion appliances, while 18 patients received hyrax appliances. The screw of the hyrax appliance was activated once a day until sufficient expansion was achieved. The memory-based expansion appliance was activated at the beginning of treatment and remained active until sufficient expansion was achieved. In both groups, cortisol and substance P levels were evaluated in saliva samples taken from the patients at 8 different time intervals. Additionally, pain and anxiety levels were assessed using psychometric tests. Results: VAS pain scores, cortisol, substance P and state-trait anxiety values were examined between groups and within each group over time. For cortisol levels using variance analysis revealed a statistically significant main effect of time (p<0,001), while the main effect of group (p=0,756) and the time-group interaction (p=0,162) were statistically insignificant. Regarding substance P values, the main effect of time (p<0,001) and the time-group interaction (p=0,030) were statistically significant, whereas the main effect of group (p=0,700) was not significant. State and trait anxiety values were statistically similar between groups at all time points (p>0,05). For the assessment of VAS pain levels, the repeated measurements using variance analysis showed a statistically significant main effect of time (p<0,001) and a significant time-group interaction (p=0,004), while the main effect of group (p=0,100) was statistically insignificant. Conclusion: Pain perception can vary individually. Understanding the effects of different orthodontic appliances on pain and quality of life is crucial for the success and continuity of treatment. In this study comparing the effects of expanders with different mechanisms, it can be said that memory expansion appliances make the treatment process more comfortable. Key Words: Pain, Anxiety, Maxillary expansion, Cortisol.