Comparative Analgesic Efficacy of Diclofenac and Ketoprofen Transdermal Patches Versus Ibuprofen Tablets for Pain Control After Initial Archwire Placement in Orthodontic Patients: A Randomized Clinical Trial
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Objectives This study compared the analgesic efficacy of diclofenac and ketoprofen transdermal patches versus ibuprofen tablets for pain control following initial archwire placement in orthodontic patients. sec-0001 Materials and Methods In this randomized clinical trial, 60 patients (aged 15–30 years) undergoing fixed orthodontic treatment (0.022‐inch MBT brackets and 0.014‐inch nickel–titanium archwires on both arches) were assigned via stratified permuted block randomization (1:1:1 ratio) to three groups (= 20 each): 30‐mg ketoprofen transdermal patches every 12 h, 15‐mg diclofenac transdermal patches every 12 h, or 400‐mg ibuprofen tablets every 8 h for 1 day. Pain severity was assessed using the numeric rating scale (NRS; 0–10) at baseline (immediately postplacement), 2 and 6 h, bedtime, 24 and 48 h, and 3 and 7 days. Data were analyzed by the generalized estimating equation (GEE) and the Kruskal–Wallis, Bonferroni, chi‐square, and Fisher’s exact tests (= 0.05). sec-0002 Results The pain score was the lowest in the ketoprofen group, followed by the ibuprofen group, and then the diclofenac group, but the difference was not significant (> 0.05). The pain score initially increased after archwire placement to 6 h (from 0 pain in all groups to 2.50 ± 1.64, 3.90 ± 1.25, and 3.45 ± 1.82, respectively, in ketoprofen, diclofenac, and ibuprofen groups). It subsequently decreased until bedtime, increased again at 24 h, and then followed a descending trend from 48 h to 7 days. The t
Abstract
Objectives This study compared the analgesic efficacy of diclofenac and ketoprofen transdermal patches versus ibuprofen tablets for pain control following initial archwire placement in orthodontic patients. sec-0001 Materials and Methods In this randomized clinical trial, 60 patients (aged 15–30 years) undergoing fixed orthodontic treatment (0.022‐inch MBT brackets and 0.014‐inch nickel–titanium archwires on both arches) were assigned via stratified permuted block randomization (1:1:1 ratio) to three groups (= 20 each): 30‐mg ketoprofen transdermal patches every 12 h, 15‐mg diclofenac transdermal patches every 12 h, or 400‐mg ibuprofen tablets every 8 h for 1 day. Pain severity was assessed using the numeric rating scale (NRS; 0–10) at baseline (immediately postplacement), 2 and 6 h, bedtime, 24 and 48 h, and 3 and 7 days. Data were analyzed by the generalized estimating equation (GEE) and the Kruskal–Wallis, Bonferroni, chi‐square, and Fisher’s exact tests (= 0.05). sec-0002 Results The pain score was the lowest in the ketoprofen group, followed by the ibuprofen group, and then the diclofenac group, but the difference was not significant (> 0.05). The pain score initially increased after archwire placement to 6 h (from 0 pain in all groups to 2.50 ± 1.64, 3.90 ± 1.25, and 3.45 ± 1.82, respectively, in ketoprofen, diclofenac, and ibuprofen groups). It subsequently decreased until bedtime, increased again at 24 h, and then followed a descending trend from 48 h to 7 days. The trend of change in the pain score over time was not significantly different among the three groups (= 0.657). Age (= 0.757) and gender (= 0.153) of patients did not affect their perceived pain. sec-0003 Conclusion Considering the comparable analgesic efficacy of ibuprofen and the tested transdermal patches, diclofenac and ketoprofen patches may be used as an alternative to ibuprofen tablets for efficient pain control after initial archwire placement. Iranian Registry of Clinical Trials: IRCT20190915044771N2 sec-0004