Letters From Our Readers

To: Editor, The Angle Orthodontist

Re: Pain and discomfort following insertion of miniscrews and premolar extractions: A randomized controlled trial by N Ganzer, I Feldmann and L Bondemark. The Angle Orthodontist ; 2016;86:891–899.

Thank you for publishing this interesting study that explored an important issue in clinical orthodontics. There were a few points that we wanted to clarify and request that you provide information regarding the following:

• Can you please explain why you recruited two groups of 40 patients each? It appears that the comparison of pain and discomfort between extraction and implant placement could have been accomplished with only the one group who experienced both of these procedures.

• The questionnaire asks for patient assessment of “pain” and “discomfort” separately. Can you discuss what the difference is between the two and how patients were instructed to distinguish pain from discomfort?

• Patients completed the questionnaires but the paper does not explain whether this was done in the office, at home, by phone, or some other way. Can you please elaborate on this and comment on how the method may have affected the results?

• Can you please present the age and sex distribution of the two groups?

• If patients all required maximum anchorage, was it ethical to randomly allocate them to miniscrew and non-miniscrew groups? Wouldn't you expect that miniscrews provide a higher level of anchorage than the group without miniscrews? Can you please elaborate on the method of anchorage used in the non-miniscrew group during space closure?

Thank you for providing this additional information about your study.