Editor's Comment and Q&A

Introduction In this study, we evaluated the pain and discomfort experienced by orthodontic patients by comparing how they rated the pain associated with microimplant placement, tooth extraction, and gingival tissue removal in preparation for implant placement. Methods Fifty-six microimplants were placed in 28 consecutive orthodontic patients for anchorage reinforcement in the maxilla for en-masse retraction. For all patients, extractions of maxillary, or maxillary and mandibular, premolars had been planned. The recruited patients were randomized into 2 groups according to the timing of the extractions. In group A, at least 1 extraction was performed during the evaluation period; the extractions in group B were after the evaluations. Furthermore, all patients had 2 different surgical procedures for placement. On 1 side, the gingival tissue was removed before placement. On the contralateral side, the implant was placed transgingivally. Each patient's perception of pain and discomfort was evaluated by a questionnaire before, immediately after, and 1 week after the intervention. Results The discomfort experienced during the extractions was described as very painful by 50% of the patients. It was significantly greater than during tissue removal and microimplant placement ( P P P Conclusions Microimplant surgery seems to be a well-accepted treatment option in orthodontic patients, with significantly lower pain levels than for tooth extractions. Furthermore, transgingival placement is clearly favored by patients who do not need tissue removed before placement.