Gupta Mudit, Kandula Srinivas, Laxmikanth Sarala M, Vyavahare Shreyas S, Reddy Satheesha B H, Ramachandra Chanila S
Department of Oral Medicine and Radiology, Uttaranchal Dental and Medical Research Institute, Dehraduun, Uttarakhand, India,
J Orofac Orthop. 2014 Nov;75(6):471-6. doi: 10.1007/s00056-014-0243-7. Epub 2014 Oct 31.
Despite all the technological advances in orthodontics, orthodontic treatment still seems to involve some degree of discomfort and/or pain. Pain control during orthodontic therapy is of great concern to both orthodontists and patients. However, there has been limited research into controlling such pain.
The purpose of this work was to assess patient-perceived pain following fixed orthodontic treatment and to evaluate the comparative analgesic efficacy of non-steroidal anti-inflammatory drugs for controlling pain.
A total of 45 patients about to undergo fixed appliance orthodontic treatment were enrolled in this double-blind prospective study. Patients were evenly and randomly distributed in a blinded manner to one of three groups as follows: paracetamol/acetaminophen 500 mg thrice daily; placebo in the form of empty capsules; and etoricoxib 60 mg once daily. Drug administration began 1 h before initiating the bonding procedure and archwire placement, and given until the day 3. The pain perceived was recorded by the patients on a linear and graded Visual Analogue Scale at time intervals of 2 h after insertion of the appliance; 6 h thereafter and again at nighttime of the same day of the appointment; 24 h later and on the 2nd day at nighttime; 48 h after the appointment and on day 3 at nighttime.
Our results revealed that moderately intense pain is associated with routine orthodontic treatment, and that the amount of pain individuals perceive varies widely. We observed statistically significant differences in the pain control among the three groups, and that etoricoxib 60 mg proved most efficient.
Etoricoxib 60 mg is highly efficacious for controlling pain during fixed orthodontic appliance therapy.
尽管正畸学取得了所有技术进步，但正畸治疗似乎仍会带来一定程度的不适和/或疼痛。正畸治疗期间的疼痛控制是正畸医生和患者都极为关注的问题。然而，关于控制此类疼痛的研究有限。
本研究的目的是评估固定正畸治疗后患者感知的疼痛，并评估非甾体抗炎药控制疼痛的相对镇痛效果。
本双盲前瞻性研究共纳入45例即将接受固定矫治器正畸治疗的患者。患者以盲法均匀随机分为以下三组之一：对乙酰氨基酚500毫克，每日三次；空胶囊形式的安慰剂；依托考昔60毫克，每日一次。在开始粘结程序和放置弓丝前1小时开始给药，持续至第3天。患者在矫治器插入后2小时的时间间隔内，通过线性分级视觉模拟量表记录感知到的疼痛；此后6小时以及预约当天夜间再次记录；24小时后以及第2天夜间记录；预约后48小时以及第3天夜间记录。
我们的结果显示，常规正畸治疗会伴有中度疼痛，而且个体感知到的疼痛程度差异很大。我们观察到三组之间在疼痛控制方面存在统计学显著差异，并且60毫克依托考昔被证明是最有效的。
60毫克依托考昔在固定正畸矫治器治疗期间控制疼痛方面非常有效。
