Patients’ perceptions of micro-implants as orthodontic anchorage

Abstract

AIM: In orthodontics, the paradigm is shifting since the introduction of micro-implants as anchorage units. However, patients’ perceptions and acceptance of micro-implants is not fully understood. The aims of this investigation were to examine patients’ levels of pain in micro-implant surgery both intra- and post-operatively compared with other orthodontic procedures, and to investigate their perception and acceptance of this technique. MATERIALS AND METHOD: Seventy-eight micro-implants (Dentos, Absoanchor® System) were placed in 37 patients (13 males, 24 females, mean age: 23.5 years) as anchorage units. This study consisted of two parts: (1) Level of pain perceived by patients undergoing various orthodontic procedures, including separation, initial tooth alignment and micro-implant surgery, were rated by visual analogue scale corresponding to the level of pain expected and perceived in various procedures, and pain experienced over a 7-day period post-operatively. (2) Questionnaires concerning the patients’ post-operative perceptions, functional disturbance and satisfaction with micro-implant treatment were collected one month after micro-implant insertion. RESULTS: The expected level of pain was signifi cantly higher than that experienced during micro-implant surgery (P < 0.001); in contrast to separation and initial tooth alignment procedures, where the pain level experienced was similar to that of patients’ expectations (P > 0.05). Post-operative pain experienced following one week decreased continuously from day 1 to day 7 in all procedures. The total area under curve of initial tooth alignment over the 7-day period was signifi cantly larger than that of separation and micro-implant surgery (P < 0.05). The questionnaire study showed that 94.9 per cent of patients reported only moderate pain or even less during micro-implant surgery. Satisfaction was expressed by 75.8 per cent of patients with micro-implant treatment who would consider the treatment again if necessary, and 77.8 per cent of patients would recommend micro-implants to friends and relatives. CONCLUSIONS: (1) Subjects signifi cantly over-estimated the pain level of micro-implant surgery (2) The pain perceived one week post-operatively of micro-implant surgery is lower than that of initial tooth alignment. (3) Micro-implants as anchorage in orthodontics is highly accepted and welcomed by orthodontic patients as they caused minimal post-operative discomfort.