Effect of preemptive ibuprofen analgesic compared to placebo on pain perception associated with the placement of temporary anchorage devices (TADs), A double blinded randomized clinical trial

Abstract

Introduction: It has been noted that placement of miniscrew in the alveolar bone of maxilla or mandible can cause immediate and/or delayed pain and discomfort in patients that need TAD placement for anchorage purposes, and most of the patients need to use analgesics to escape from the pain. This study was conducted to investigate whether the use of preemptive ibuprofen prior to the insertion of miniscrew will decrease or completely eliminate the pain and discomfort associated with the use of TADs. Methods: A total of 50 patients undergoing orthodontic treatment who required miniscrew placement in the posterior part of maxillary dental arches as part of their treatment plan were recruited as study participants. The method of the study was explained to the patients and a written consent was given if they agreed to participate in the study. The first group (25 patients) where given 400 mg of Ibuprofen (Advil ،Pfizer Inc.) 30 minutes before the TAD insertion and the second group (25 patients) where given placebo 30 minutes before the TAD insertion, the site of TAD insertion was anesthetized by injecting lidocaine. Then the patients were asked to fill the questionnaire form (translated SF-MPQ) at four different times: immediately after TAD placement (T1), 1 hour after TAD placement (T2), 12 hours after TAD placement (T3), 24 hours after TAD placement (T4). Results: At any of the follow-up intervals (immediate, 1 day, 12 days, and 24 hours) of the study, there were no statistically significant differences in the type or/and severity of pain between the ibuprofen and placebo groups. After follow-up intervals, there was no clear pattern in changes in pain intensity in either group. In other words, pain in one hour following surgery increased slightly versus immediately after surgery and then decreased between 12 and 24 hours. Conclusion: Ibuprofen had no significant effect on reducing pain intensity or on the type of pain associated with the placement of temporary anchorage devices (TADs).