This study aimed to evaluate the efficacy of ibuprofen, bite wafer and low power red and infrared lasers in orthodontic pain management. One hundred subjects were randomly assigned to 5 groups of 20 each. The patients in each group received one of the following treatments after the placement of fixed orthodontic appliances: 1. placebo medication, 2. ibuprofen, 3. bite wafer, 4. irradiation from a low level red laser (LLRL; 660 nm, 200 mW, 1 J/point, 6 points), 5. irradiation from a low level infrared laser (LLIL; 810 nm, 200 mW, 1 J/point, 6 points). A Visual Analogue Scale (VAS) was used to record pain intensity while chewing, biting, fitting front teeth, and fitting back teeth at 2 hours, 6 hours, bedtime, 24 hours, 2 days, 3 days and 7 days following arch wire placement. Significant between-group differences were found in pain at chewing, biting, fitting front teeth and fitting back teeth at all time points (p<0.001). Generally, VAS scores in the LLIL, ibuprofen and bite wafer groups were close to each other and significantly lower than those in the LLRL and control groups (p<0.05), which showed comparable pain level at most intervals. The infrared laser group (LLIL) showed significantly lower pain than all other groups at some points over the experiment (p<0.05). A single irradiation from a low level infrared laser proved to be the best strategy for orthodontic pain control. Alternatively, chewing on a bite wafer could be recommended. These methods should be considered as suitable alternatives for ibuprofen in orthodontic patients.
Background The aim of the present three-arm parallel trial was to compare the effectiveness of chewing gum and ibuprofen in the control of orthodontic pain. Methods Patients to undergo orthodontic treatment at a private orthodontic clinic were randomly divided into three parallel groups, each of which took either a placebo, ibuprofen or chewing gum. The eligibility criteria included patients in the full permanent dentition with moderate crowding requiring the extraction of two mandibular and two maxillary premolars. The main outcome was the patient’s level of discomfort, which was assessed by a 0–10 numeric rating scale (NRS) at two hours, six hours, at bedtime, 24 hours, two days, three days and seven days after the placement of initial arch wires in four functions including chewing, biting, occluding back teeth, and occluding front teeth. Randomisation was accomplished according to the patient’s clinic entrance number and by using a table of random numbers. The patients in the placebo and ibuprofen groups were blinded to the type of medication used. The differences in the groups were analysed using repeated measures ANOVA. Results Sixty-six patients between 12 and 30 years were randomised in a 1:1:1 ratio. The pain questionnaire response rate was 100% in the three groups, but six patients were excluded and consequently 60 patients were analysed (N = 20 in each group). There was no significant difference between the chewing gum and ibuprofen groups during any oral function at any time point (p > 0.05). However, repeated measures ANOVA showed that patients in the placebo group experienced significantly higher pain scores compared with patients in the ibuprofen and chewing gum groups at two hours, six hours, at bedtime, at 24 hours and two days after initial arch wire placement (p < 0.05). No patient harm was observed in this study. Conclusions In contrast to the common orthodontic belief that gum chewing may lead to bracket breakage, it seems that chewing gum is as beneficial as medication for pain relief and can be a recommended alternative during orthodontic treatment.
Background:With the introduction of skeletal anchorage system, recently it is possible to successfully intrude molar teeth. On the other hand, there have been concerns about periodontal changes associated with intrusion and there are few studies on this topic, especially for posterior teeth.Materials and Methods:Ten female patients were enrolled in this study. Maxillary molar intrusion was achieved by inserting two miniscrews and a 17 × 25 titanium molybdenum alloy spring. Crestal height changes were evaluated at three intervals including: Baseline (T0), end of active treatment (T1) and 6 months after retention (T2). Other variables including probing depth, gingival recession, attachment level and bleeding on probing were evaluated by clinical measurements in the three above mentioned intervals. One-sample Kolmogrov-Smirnov test ascertained the normality of the data. For all patients, the changes in tooth position and crestal height were evaluated using one-sample t-test. (P < 0.05)Results:Supra-erupted molars were successfully intruded a mean of 2.1 ± 0.9 mm during active treatment (T0-T1). A mean bone resorption of 0.9 ± 0.9 mm in mesial crest and 1 ± 0.8 mm in distal crest had occurred in total treatment (T0-T2). A mean of 0.6 ± 1.4 mm bone was deposited on mesial crest during the retention period (T1-T2) following tooth relapse. On average, 0.8 ± 0.4 mm attachment gain was obtained. Gingival margin coronalized a mean of 0.8 ± 0.6 mm throughout the entire treatment. Probing depth showed no significant change during treatment.Conclusion:Within the limitations of this study, these results suggest that not only periodontal status was not negatively affected by intrusion, but also there were signs of periodontal improvement including attachment gain and shortening of clinical crown height.
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