State Key Laboratory of Oral Diseases, Department of Orthodontics, West China College of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin South Road, Chengdu, 610041, China.
Department of Stomatology, the First Affiliated Hospital of Shenzhen University, The Shenzhen Second People's Hospital, Shenzhen, China.
BMC Oral Health. 2020 Sep 18;20(1):259. doi: 10.1186/s12903-020-01245-w.
Patients who had gone through orthodontic treatment experienced pain and discomfort which could be the highest-ranking reason for treatment disturbance or early termination. Thus, this review aimed to assess the efficacy of analgesics on the relief of pain in orthodontic treatment.
A computerized literature search was conducted in the databases of EMBASE (via OVID, 1974 to 2019 Week 50), MEDLINE (via OVID, 1946 to Dec 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (December 2019). The Cochrane Collaboration's Review Manager 5.3 software was applied in the present study. And methodological quality was evaluated by the Cochrane Risk of Bias Tool.
We identified twelve publications including 587 patients in 19 randomized controlled trials. The results showed that the mean difference of naproxen in visual analogue scale (VAS) were - 1.45 (95% CI -2.72, - 0.19; P = .02), - 2.11 (95% CI -3.96, - 0.26; P = .03) and - 1.90 (95% CI -3.33, - 0.47; P = .009) in 2 h, 6 h and 24 h respectively. As for ibuprofen, the standard mean differences were - 1.10 (95% CI -1.49, - 0.71), - 1.63(95% CI -2.32, - 0.95) and - 1.34 (95% CI -2.12, - 0.55) at 2 h, 6 h, and 24 h, with the overall P values all < 0.001. The mean difference of acetaminophen is - 0.68, - 1.34, - 1.91 at three time points and the overall P values all < 0.01.
This meta-analysis suggests that the use of analgesics is effective for patients in controlling orthodontic pain. Ibuprofen and naproxen are both of stable analgesic effects which could peak at 6 h, while the analgesic effect of acetaminophen increases steadily from 2 h through 24 h. Compared with ibuprofen and acetaminophen, naproxen shows a stronger analgesic effect either at 2 h or 6 h, and its effect lasts to 24 h.
接受正畸治疗的患者会经历疼痛和不适，这可能是治疗干扰或早期终止的最主要原因。因此，本综述旨在评估镇痛药在缓解正畸治疗疼痛方面的疗效。
计算机检索 EMBASE（通过 OVID，1974 年至 2019 年第 50 周）、MEDLINE（通过 OVID，1946 年至 2019 年 12 月）和 Cochrane 对照试验中心注册库（CENTRAL）（2019 年 12 月）中的文献。本研究采用 Cochrane 协作网的 Review Manager 5.3 软件进行分析。并采用 Cochrane 偏倚风险工具评估方法学质量。
我们共纳入 19 项随机对照试验的 12 项研究，共 587 名患者。结果显示，在 2 小时、6 小时和 24 小时时，萘普生的视觉模拟评分（VAS）的均数差值分别为-1.45（95%CI-2.72，-0.19；P=0.02）、-2.11（95%CI-3.96，-0.26；P=0.03）和-1.90（95%CI-3.33，-0.47；P=0.009）。布洛芬的标准均数差值分别为-1.10（95%CI-1.49，-0.71）、-1.63（95%CI-2.32，-0.95）和-1.34（95%CI-2.12，-0.55），在 2 小时、6 小时和 24 小时时，总体 P 值均<0.001。扑热息痛的均数差值分别为-0.68、-1.34、-1.91，在三个时间点的总体 P 值均<0.01。
本荟萃分析表明，使用镇痛药对控制正畸疼痛有效。布洛芬和萘普生均具有稳定的镇痛效果，镇痛效果在 6 小时时达到峰值，而扑热息痛的镇痛效果从 2 小时开始逐渐增加，持续至 24 小时。与布洛芬和扑热息痛相比，萘普生在 2 小时或 6 小时时的镇痛效果更强，其作用可持续至 24 小时。
