title: The effect of benzocaine and ketoprofen gels on pain during fixed orthodontic appliance treatment: a randomised, double-blind, crossover trial.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.forename: Ladan
authors.initials: L
authors.lastname: Eslamian
authors.forename: Ali
authors.initials: A
authors.lastname: Borzabadi-Farahani
authors.forename: Hadi
authors.initials: H
authors.lastname: Gholami
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001566:Benzocaine / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003722:Dental Alloys / Q000737:chemistry; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D007660:Ketoprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D016382:Orthodontic Appliance Design; D019516:Orthodontic Space Closure / Q000295:instrumentation; D009969:Orthodontic Wires; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D058748:Pain Perception / Q000187:drug effects; D010919:Placebos; D011446:Prospective Studies; D013193:Stainless Steel / Q000737:chemistry; D014087:Tooth Movement Techniques / Q000295:instrumentation; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003722:Dental Alloys; D005782:Gels; D010919:Placebos; D013193:Stainless Steel; D007660:Ketoprofen; D001566:Benzocaine