Blasini Maxie, Movsas Shira, Colloca Luana
Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA; Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, University of Maryland, Baltimore, USA; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA.
Semin Orthod. 2018 Jun;24(2):259-268. doi: 10.1053/j.sodo.2018.04.001. Epub 2018 May 8.
Placebo and nocebo effects are present within every treatment and intervention, and can be purposefully enhanced and reduced, respectively, in order to improve patients' clinical outcomes. A plethora of research has been conducted on the mechanisms of placebo hypoalgesia and nocebo hyperalgesia in experimental and clinical settings. However, its implications in particular clinical settings such as orthodontic pain management remain underexplored. We conducted a search of the literature regarding placebo analgesia, orthodontic pain management, and orofacial and dental pain. Articles were qualitatively assessed and selected based on the scope of this narrative review. Although no studies investigating the extent of the implications of the placebo and nocebo phenomena in the orthodontic clinical setting were found, we herein present a comprehensive review on the influences of placebo and nocebo effects in experimental and clinical pain management, as well as on the potential for engaging placebo-related endogenous pain modulation for orthodontic pain management. Ethical considerations for the clinical application of placebos are discussed, and future research directions are presented.
安慰剂效应和反安慰剂效应存在于每一种治疗和干预中，并且可以分别通过有目的地增强和减弱来改善患者的临床结局。在实验和临床环境中，已经对安慰剂性痛觉减退和反安慰剂性痛觉过敏的机制进行了大量研究。然而，其在诸如正畸疼痛管理等特定临床环境中的意义仍未得到充分探索。我们检索了有关安慰剂镇痛、正畸疼痛管理以及口腔颌面和牙齿疼痛的文献。根据本叙述性综述的范围对文章进行了定性评估和筛选。尽管未找到研究安慰剂和反安慰剂现象在正畸临床环境中影响程度的研究，但我们在此对安慰剂和反安慰剂效应在实验性和临床疼痛管理中的影响以及利用与安慰剂相关的内源性疼痛调节进行正畸疼痛管理的潜力进行全面综述。讨论了安慰剂临床应用的伦理考量，并提出了未来的研究方向。
