title: A randomized clinical trial comparing the efficacy of bite wafer and low level laser therapy in reducing pain following initial arch wire placement.
abstract: Background and aims:This study aimed to evaluate the efficacy of ibuprofen, bite wafer and low power red and infrared lasers in orthodontic pain management.Subjects and methods:One hundred subjects were randomly assigned to 5 groups of 20 each. The patients in each group received one of the following treatments after the placement of fixed orthodontic appliances: 1. placebo medication, 2. ibuprofen, 3. bite wafer, 4. irradiation from a low level red laser (LLRL; 660 nm, 200 mW, 1 J/point, 6 points), 5. irradiation from a low level infrared laser (LLIL; 810 nm, 200 mW, 1 J/point, 6 points). A Visual Analogue Scale (VAS) was used to record pain intensity while chewing, biting, fitting front teeth, and fitting back teeth at 2 hours, 6 hours, bedtime, 24 hours, 2 days, 3 days and 7 days following arch wire placement.Results:Significant between-group differences were found in pain at chewing, biting, fitting front teeth and fitting back teeth at all time points (p<0.001). Generally, VAS scores in the LLIL, ibuprofen and bite wafer groups were close to each other and significantly lower than those in the LLRL and control groups (p<0.05), which showed comparable pain level at most intervals. The infrared laser group (LLIL) showed significantly lower pain than all other groups at some points over the experiment (p<0.05).Conclusions:A single irradiation from a low level infrared laser proved to be the best strategy for orthodontic pain control. Alternatively, chewing on a bite wafer could be recommended. These methods should be considered as suitable alternatives for ibuprofen in orthodontic patients.
authors.affiliation: Department of Orthodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Bayani
authors.affiliation: Department of Orthodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Rostami
authors.affiliation: Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Ahrari
authors.affiliation: Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Iman
authors.initials: I
authors.lastname: Saeedipouya
keywords: Pain; arch wire; bite wafer; ibuprofen; laser; low level laser; low power laser; orthodontic treatment; therapy