Pain and discomfort following insertion of miniscrews and premolar extractions: A randomized controlled trial

Angle Orthod. 2016 Nov;86(6):891-899. doi: 10.2319/123115-899.1. Epub 2016 Mar 29.


Objective: To investigate and compare the experience of pain and discomfort between insertion of miniscrews and premolar extractions in adolescent patients.

Materials and methods: A total of 80 adolescents were recruited and randomized into groups A and B. Both groups were treated with extraction of the upper first premolars and fixed appliance. Beyond the fixed appliance, patients in group A received anchorage reinforcement with miniscrews. Miniscrews were inserted buccally between the second premolar and first molar when space closure started. Space closure was performed as en masse retraction with immediate loading by 150-g coil springs. Pain, discomfort, impact on daily activities, and functional jaw impairment were assessed with patient-reported questionnaires. Questionnaires were filled in at baseline, the evening after tooth extraction, 1 week after tooth extraction, the evening after screw placement, and 1 week after screw placement.

Results: Patients reported significantly lower levels of pain (P < .001) and discomfort (P = .012) after screw placement compared with premolar extractions. The ability to drink (P = .035) and the ability to take a big bite (P < .001) were also significantly less disturbed in the evening after screw placement. During the first week after screw placement, the impact on leisure time activities was significantly lower (P = .015) compared with premolar extractions.

Conclusion: The use of miniscrews in adolescents can be recommended from a pain and discomfort perspective.

Keywords: MSI; Miniscrew; Orthodontic anchorage procedures; Orthodontics; TAD; Temporary anchorage device.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Bicuspid*
  • Bone Screws
  • Female
  • Humans
  • Male
  • Molar
  • Orthodontic Anchorage Procedures*
  • Orthodontic Appliance Design
  • Pain*
  • Tooth Movement Techniques*