The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 18 , ISSUE 6 ( June, 2017 ) > List of Articles

REVIEW ARTICLE

Ibuprofen and Low-level Laser Therapy for Pain Control during Fixed Orthodontic Therapy: A Systematic Review of Randomized Controlled Trials and Meta-analysis

Faezeh Eslamipour, Saeed R Motamedian, Fahimeh Bagheri

Citation Information : Eslamipour F, Motamedian SR, Bagheri F. Ibuprofen and Low-level Laser Therapy for Pain Control during Fixed Orthodontic Therapy: A Systematic Review of Randomized Controlled Trials and Meta-analysis. J Contemp Dent Pract 2017; 18 (6):527-533.

DOI: 10.5005/jp-journals-10024-2078

Published Online: 00-06-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

To systematically review high-quality randomized controlled trials (RCTs) and meta-analysis on the effectiveness of use of ibuprofen and low-level laser therapy (LLLT) for pain control during fixed orthodontic appliance therapy.

Materials and methods

A web-based systematic search of PubMed and Medline database using relevant keywords was performed in August 2016 limited to the English language studies. Based on inclusion and exclusion criteria, RCTs utilizing blind approach were selected. The quality of studies was analyzed and only high-quality studies were included. Following data extraction, meta-analysis was performed by standardized mean difference Hedges’ (adjusted) g with 95% confidence interval.

Results

A total number of six studies (four ibuprofen and two LLLT) comprising 315 patients were included. Heterogeneity among ibuprofen studies was small, while large heterogeneity was found among LLLT studies. The results showed that both ibuprofen and LLLT could reduce pain intensity during fixed orthodontic therapy and during 17 days follow-up period. However, this reduction was statistically significant only at 6 to 24 hours postoperatively for ibuprofen and 2 hours and 3 to 7 days for LLLT (p < 0.05).

Conclusion

Considering the limitations of the current metaanalysis, ibuprofen could alleviate orthodontic archwire activation pain during the 1st day with relatively high level of evidence. Low-level laser therapy could reduce this pain in the long term with limited evidence. Further well-designed RCTs are required to provide more evidence.

How to cite this article

Eslamipour F, Motamedian SR, Bagheri F. Ibuprofen and Low-level Laser Therapy for Pain Control during Fixed Orthodontic Therapy: A Systematic Review of Randomized Controlled Trials and Meta-analysis. J Contemp Dent Pract 2017;18(6):527-533.


PDF Share
  1. An investigation into the initial discomfort caused by placement of an archwire. Eur J Orthod 1984 Feb;6(1):48-54.
  2. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop 1989 Jul;96(1):47-53.
  3. Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofacial Orthop 2006 Sep;130(3):371-377.
  4. Clinical considerations of the periodontium. Am J Orthod 1972 Feb;61(2):138-155.
  5. Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain. Angle Orthod 2005 Sep;75(5):791-796.
  6. Pain in orthodontics. A review and discussion of the literature. J Orofac Orthop 2000 Mar;61(2):125-137.
  7. Textbook and color atlas of tooth impactions. Am J Orthod Dentofac Orthop 1997 Sep;112(3):354.
  8. Experience of pain during an orthodontic procedure. Eur J Oral Sci 2002 Apr;110(2):92-98.
  9. The effect of acetaminophen, ibuprofen, and misoprostol on prostaglandin E2 synthesis and the degree and rate of orthodontic tooth movement. Angle Orthod 1996 Oct;66(5):339-349.
  10. The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop 1994 Jul;106(1):88-95.
  11. Computerized morphometric assessment of the effect of low-level laser therapy on bone repair: an experimental animal study. J Clin Laser Med Surg 2002 Apr;20(2):83-87.
  12. Laser etching of teeth for orthodontic bracket placement: a preliminary clinical study. Lasers Surg Med 1992;12(5):467-470.
  13. Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis. Lasers Med Sci 2013 Nov;28(6):1581-1589.
  14. Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 2006 Apr;24(2):158-168.
  15. A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop 1995 Dec;108(6):614-622.
  16. Interventions for pain during fixed orthodontic appliance therapy. A systematic review. Angle Orthod 2010 Sep;80(5):925-932.
  17. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996 Feb;17(1):1-12.
  18. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods 2006 Feb;11(2):193-206.
  19. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 2009 Aug;151(4):W65-W94.
  20. Effect of low-level laser therapy on pain following activation of orthodontic final archwires: a randomized controlled clinical trial. Photomed Laser Surg 2013 Jan;31(1):36-40.
  21. Pain control during fixed orthodontic appliance therapy. Angle Orthod 2005 Mar;75(1):214-219.
  22. Comparison of the efficacy of ibuprofen and acetaminophen in controlling pain after orthodontic tooth movement. Am J Orthod Dentofacial Orthop 2009 Apr;135(4):516-521.
  23. Pain reduction after initial archwire placement in orthodontic patients: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2012 Feb;141(2):169-173.
  24. Pharmacological management of pain during orthodontic treatment: a meta-analysis. Orthod Craniofac Res 2012 Apr;15(2):71-83.
  25. The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis. Lasers Med Sci 2015 Sep;30(7):1881-1893.
  26. Low-level laser therapy for orthodontic pain: a systematic review. Lasers Med Sci 2015 Aug;30(6):1789-1803.
  27. Comparative effectiveness of pharmacologic and nonpharmacologic interventions for orthodontic pain relief at peak pain intensity: a Bayesian network meta-analysis. Am J Orthod Dentofacial Orthop 2016 Jul;150(1):13-32.
  28. Low-level laser therapy for pain caused by placement of the first orthodontic archwire: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2009 Nov;136(5):662-667.
  29. An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement. Am J Orthod Dentofacial Orthop 2000 Dec;118(6):629-635.
  30. A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain. Am J Orthod Dentofacial Orthop 2007 Oct;132(4):511-517.
  31. Effects of preoperative ibuprofen on pain after separator placement. Am J Orthod Dentofacial Orthop 2009 Oct;136(4):510-517.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.