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Future Dental Journal

Abstract

Objectives: To investigate the efficacy of psychological interventions in the reduction of orthodontic pain at its peak of intensity.

Data sources: A search strategy was implemented using both manual hand search and electronic databases, including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ScienceDirect, Scopus and EBSCO.

Resources selection Randomized controlled trials involve 1) patients undergoing fixed orthodontic treatment 2) minimum age of 10 years old, 3) receiving a psychological intervention to control resulted pain and discomfort, 4) medically fit and 5) no previous orthodontic treatment, were included in the systematic review. All articles were checked against the inclusion and exclusion criteria independently and in duplicate by two authors. Risk of bias of the included trials was assessed using the Cochrane risk of bias tool.

Results: Only 7 RCTs met the inclusion criteria and were included in the final analysis. Meta-analysis showed a significant decrease in pain intensity in the cognitive behavioral therapy group, as compared to controls (mean difference [MD] -28.63 [95% confidence interval {CI} -34.24 to -23.02]), significant decrease in pain intensity in the structured phone calls group, when compared to controls (mean difference [MD] -7.55 [95% confidence interval {CI} -13.55 to -1.54]) and no difference in pain intensity between the text messages and control groups (mean difference [MD] -6.89 [95% confidence interval {CI} -17.08 to 3.31]).

Conclusions: Both 15 minutes self-practiced cognitive behavioral therapy and structured phone calls are effective non-pharmacological methods in the reduction of orthodontic pain after 24 hours of initial wire placement.

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