Effect of ibuprofen and low-intensity pulsed ultrasound on the reduction of pain after initial archwire placement: a double-blind randomized clinical trial

Abstract

Objective: This study aimed to compare the effect of ibuprofen and low-intensity pulsed ultrasound (LIPUS) on the reduction of pain after the placement of initial archwire in orthodontic patients. Material and Methods: This double-blind clinical trial study was carried out on 60 female candidates for fixed orthodontic treatment referring to the Orthodontic Department of School of Dentistry in Mashhad University of Medical Sciences, Mashhad, Iran, during 2015-2016. The subjects were divided into four groups of ibuprofen, LIPUS, placebo, and mock LIPUS. A questionnaire and a rectangular and flexible cubic silicone were given to each patient to record the severity of pain based on the visual analog scale at specified time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days after archwire placement) when biting the silicone block with the anterior and posterior teeth and without biting at all. Repeated measures analysis of variance was used in order to compare the pain severity at different time points. Results: The comparison of pain severity at various time points showed that the highest and lowest mean scores of pain were reported at bedtime and seven days after the intervention (p<0.001). In each of the three conditions (i.e., biting the silicone block with the anterior and posterior teeth and without biting the teeth) at six time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days following archwire placement), no significant difference was observed in the severity of pain (p>0.05). Conclusion: In conclusion, LIPUS (with a frequency of 1 MHz and an intensity of 100 mW) and ibuprofen have no significant effects on reduction of the pain severity at different time points and various conditions in orthodontic patients.

Comparison of the Effects of Nano Micelles Curcumin and Ibuprofen on Pain Reduction After Initial Arch Wire Placement: A Double-Blind Randomized Clinical Trial Study

“…Their observations affirmed the higher efficacy of combined preoperative and postoperative ibuprofen than paracetamol in controlling the pain of orthodontic treatment. In another RCT study, Farzanegan et al 7 studied the effects of ibuprofen and low-intensity pulsed ultrasound (LIPUS) on decreasing the succeeding pain of initial archwire placement in orthodontic patients, which resulted the lack of observing any appreciable impact in the intensity of the pain at various times and under varied circumstances. Polat et al 30 evaluated the analgesic effects of nonsteroidal anti-inflammatory drugs on finding control over the pain of orthodontic treatment.…”

“…5 Various pain-controlling methods were trialed on orthodontic patients that include pharmacological procedures similar to the application of NSAIDs and anesthetic gels, as well as nonpharmacological approaches such as chewing gum, vibratory stimulation, low-level laser therapy, plastic wafers, and transcutaneous electrical nerve stimulation. 1,6,7 However, there are challenges to the exertion of NSAIDs due to its potent interference with tooth movement since its action mechanism could inhibit the synthesis of prostaglandin, which is responsible for the process of bone resorption. 8 Although Ibuprofen and acetaminophen/ paracetamol are frequently prescribed for this issue, various treatments, including low-level laser therapy, anesthetic gel, transcutaneous electrical nerve stimulation, and even bite wafers, were also investigated in several clinical trials.…”