Journal Article

The effect of physical interventions on pain control after orthodontic treatment: A systematic review and network meta-analysis

Chen, Hongjun, Qiu, Ya, Li, Siyu, Li, Junxiong, Feng, Jingzhe, Li, Lihua

2024

Overview

Pain is a frequent adverse reaction during orthodontic treatment, which can significantly reduce treatment compliance and compromise the expected treatment effect. Physical interventions have been used to alleviate pain after orthodontic treatment, but their effectiveness is controversial. This study used a network meta-analysis to assess the efficacy of various physical interventions typically used in managing pain after orthodontic treatment, with a view to provide evidence-based recommendations for representative interventions for orthodontic pain relief during peak pain intensity. A systematic search of six electronic databases, from their respective inception dates, was conducted to identify relevant literature on the efficacy of various typical physical interventions for managing pain after orthodontic treatment. Literature screening was performed according to the Cochrane System Evaluator's Manual. Stata 16.0 was used to assess heterogeneity, inconsistency, publication bias, and sensitivity to generate an evidence network diagram and conduct a network meta-analysis. In total, 771 articles were reviewed to collect literature on interventions, including low-level laser therapy (LLLT), vibration, acupuncture, and chewing. Of these, 28 studies using a visual analog scale (VAS) as an outcome indicator were included. The results showed that LLLT, vibration, acupuncture, and chewing effectively relieved the pain symptoms in patients after orthodontic treatment. At 24 h post-treatment, LLLT (surface under the cumulative ranking curve [SUCRA] = 80.8) and vibration (SUCRA = 71.1) were the most effective interventions. After 48 h of treatment, acupuncture (SUCRA = 89.6) showed a definite advantage as the best intervention. LLLT, vibration, acupuncture, and chewing can alleviate pain associated with orthodontic treatment. Among these interventions, acupuncture was found to be the most effective at 48 h after orthodontic treatment. In addition, acupuncture demonstrated long-lasting and stable pain-relieving effects. However, further studies are needed to determine the most suitable equipment-specific parameters for acupuncture in relieving pain associated with orthodontic treatment.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acupuncture / Acupuncture Therapy - methods / Analysis / Biology and Life Sciences / Care and treatment / Engineering and Technology / Evaluation / Evidence-based medicine / Health aspects / Humans / Lasers in medicine / Lasers in surgery / Low-Level Light Therapy - methods / Medicine and Health Sciences / Oral health / Orthodontics / Orthodontics - methods / Orthodontics, Corrective - adverse effects / Pain / Pain - etiology / Pain - prevention & control / Pain Management - methods / Pain Measurement / Patient compliance / Physical Sciences / Rankings / Research and Analysis Methods / Vibration - therapeutic use