Abstract
Abstract Aims To compare the analgesic effect of topical benzocaine (5%) and ketoprofen (1.60 mg/mL) after 2 mm activation of 7 mm long delta loops used for maxillary en-masse orthodontic space closure. Subjects and methods Twenty patients (seven males, 13 females, 15–25 years of age, mean age of 19.5 years) participated in a randomised crossover, double-blind trial. After appliance activation, participants were instructed to use analgesic gels and record pain perception at 2, 6, 24 hours and 2, 3 and 7 days (at 18.00 hrs), using a visual analogue scale ruler (VAS, 0–4). Each patient received all three gels (benzocaine, ketoprofen, and a control (placebo)) randomly, but at three different appliance activation visits following a wash-over gap of one month. After the first day, the patients were instructed to repeat gel application twice a day at 10:00 and 18:00 hrs for three days. The recorded pain scores were subjected to non-parametric analysis. Results The highest pain was recorded at 2 and 6 hours. Pain scores were significantly different between the three groups (Kruskal–Wallis test, p < 0.01). The overall mean (SD) pain scores for the benzocaine 5%, ketoprofen, and control (placebo) groups were 0.89 (0.41), 0.68 (0.34), and 1.15 (0.81), respectively. The pain scores were significantly different between the ketoprofen and control groups (mean difference = 0.47, p = 0.005). All groups demonstrated significant differences in pain scores at the six different time intervals (p < 0.05) and there was no gender difference (p > 0.05). Conclusion A significant pain reduction was observed following the use of ketoprofen when tested against a control gel (placebo). The highest pain scores were experienced in patients administered the placebo and the lowest scores in patients who applied ketoprofen gel. Benzocaine had an effect mid-way between ketoprofen and the placebo. The highest pain scores were recorded 2 hours following force application, which decreased to the lowest scores after 7 days.
Highlights
Following the activation of orthodontic appliances, patients may experience pain and discomfort
There was a steady reduction in recorded pain intensity over the seven day evaluation period
The design of the present study allowed the assessment of the effectiveness of topical ketoprofen and benzocaine (5%) in reducing pain produced by the activation of stainless steel looped archwires, used for the retraction of maxillary anterior teeth
Summary
Following the activation of orthodontic appliances, patients may experience pain and discomfort. Pain is the most frequent complaint of orthodontic patients[1] and considered as the contributory factor. The exact mechanism of pain related to orthodontic treatment is not clearly understood. A number of strategies have been proposed to reduce orthodontic pain, including the oral administration of non-steroidal anti-inflammatory drugs (NSAIDs),[1,2,3,4,5,6,7,10] chewing gum or a bite wafer[9,11,12,13] and topical anaesthesia gel application.[14]
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