Steen Law S L, Southard K A, Law A S, Logan H L, Jakobsen J R
Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, IA, USA.
Am J Orthod Dentofacial Orthop. 2000 Dec;118(6):629-35. doi: 10.1067/mod.2000.110638.
Patients undergoing orthodontic treatment can experience significant levels of pain. This study assessed the effectiveness of preoperative ibuprofen in reducing the incidence and the severity of pain after orthodontic separator placement. Sixty-three adolescent patients (mean age, 13 years) were included in this randomized, double-blind, placebo-controlled, prospective study. Patients were randomly assigned to 1 of 3 experimental conditions: (1) 400 mg of ibuprofen taken orally 1 hour before separator placement and a lactose placebo taken orally immediately after the appointment, (2) a lactose placebo taken orally 1 hour before separator placement and 400 mg of ibuprofen taken orally immediately after the appointment, or (3) a lactose placebo taken orally 1 hour before separator placement and again immediately after the appointment. The patient's level of discomfort was assessed with a visual analog scale at 2, 6, and 24 hours, as well as at 2, 3, and 7 days after placement of the orthodontic separators. An analysis of variance and Duncan's multiple range test revealed that 2 hours after their orthodontic appointment the patients who had taken ibuprofen 1 hour before separator placement had significantly less pain with chewing than did the patients who received either ibuprofen postoperatively or a placebo. Additional measures suggest a trend for less pain for this group of patients. These results support the use of pretreatment ibuprofen for patients requiring analgesics for orthodontic discomfort. Future study of the use of preemptive analgesics in orthodontics is warranted.
接受正畸治疗的患者可能会经历相当程度的疼痛。本研究评估了术前服用布洛芬对降低正畸分离器放置后疼痛发生率和严重程度的有效性。这项随机、双盲、安慰剂对照的前瞻性研究纳入了63名青少年患者（平均年龄13岁）。患者被随机分配到3种实验条件中的1种：（1）在放置分离器前1小时口服400毫克布洛芬，并在就诊后立即口服乳糖安慰剂；（2）在放置分离器前1小时口服乳糖安慰剂，并在就诊后立即口服400毫克布洛芬；或（3）在放置分离器前1小时口服乳糖安慰剂，并在就诊后再次立即口服。在放置正畸分离器后的2、6和24小时以及2、3和7天，用视觉模拟量表评估患者的不适程度。方差分析和邓肯多重极差检验显示，在正畸就诊后2小时，在放置分离器前1小时服用布洛芬的患者咀嚼时的疼痛明显低于术后服用布洛芬或安慰剂的患者。其他测量结果表明该组患者有疼痛减轻的趋势。这些结果支持对需要缓解正畸不适的患者使用预处理布洛芬。有必要对正畸中使用超前镇痛进行进一步研究。
