Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

36 questions · 58 findings · 7 reviews · Orthodontics

No studies found 18 · 31%GRADE not reported 21 · 36.2%Very low 11 · 19%Low 5 · 8.6%Moderate 3 · 5.2%High 0 · 0%

Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment

Discomfort/pain · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances

Light vibrational forces (LVF) showed no clear difference in patient perception of pain and discomfort (VAS 0 to 100 mm),… compared with conventional orthodontic appliance treatment (placebo or no adjunct) (low certainty).

1 finding from 1 review

Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

It is very uncertain whether ibuprofen taken pre-emptively (about 1 hour before treatment) changes pain intensity (VAS 0-100 mm) compared with ibuprofen taken post-treatment (very low certainty).

3 findings from 1 review

Light-emitting diode (LED) photobiomodulation vs Conventional orthodontic appliance treatment

Discomfort/pain · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment

It is very uncertain whether light-emitting diode (LED) photobiomodulation changes patient perception of pain and discomfort (VAS 0 to 100 mm) compared with conventional orthodontic appliance treatment (very low certainty).

1 finding from 1 review

Low‐level laser therapy vs Conventional orthodontic appliance treatment

Discomfort/pain · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment

It is very uncertain whether low level laser therapy (LLLT) changes patient perception of pain and discomfort (VAS 0 to 100 mm) compared with conventional orthodontic appliance treatment (very low certainty).

1 finding from 1 review

Extraction of the primary (baby) canine (single primary tooth extraction) vs No extraction (non-intervention control)

Patient-reported outcomes (pain, discomfort and analgesic use) · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)
1 finding from 1 review

Orthodontic treatment with appliances inducing stable, permanent orthodontic tooth movement (splints worn 8 to 12 weeks and surgical interventions excluded) vs Control: no treatment, placebo, or reassurance

Overall symptoms, pain and headache (relief from symptoms assessed by global measures) · Adults aged 18 years or older with clinically diagnosed TMD (exhibiting two or more of the listed signs and/or symptoms)

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Adverse effects including pain, gingivitis, enamel decalcification and root resorption · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
1 finding from 1 review

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) probably leads to lower pain intensity (VAS 0-100 mm) compared with control (placebo or no treatment) (moderate certainty).

3 findings from 1 review

NSAID (systemic) vs paracetamol

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

NSAID (systemic) showed no clear difference in pain intensity (VAS 0-100 mm) compared with paracetamol (low certainty).

3 findings from 1 review

Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

It is very uncertain whether topical NSAID (ketoprofen chewing gum) changes pain intensity (VAS 0-100 mm) compared with local anaesthetic (benzocaine chewing gum) (very low certainty).

1 finding from 1 review

Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg)

Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

The review found no eligible studies for this question.

1 finding from 1 review