The effect of benzocaine and ketoprofen gels on pain during fixed orthodontic appliance treatment : a randomised, double-blind, crossover trial

Aims: To compare the analgesic effect of topical benzocaine (5%) and ketoprofen (1.60 mg/ml) after 2 mm activation of 7 mm long delta loops used for maxillary en-masse orthodontic space closure. Subjects and methods: Twenty patients (seven males, 13 females, 15–25 years of age, mean age of 19.5 years) participated in a randomised crossover, double-blind trial. After appliance activation, participants were instructed to use analgesic gels and record pain perception at 2, 6, 24 hours and 2, 3 and 7 days (at 18.00 hrs), using a visual analogue scale ruler (VAS, 0–4). Each patient received all three gels (benzocaine, ketoprofen, and a control (placebo)) randomly, but at three different appliance activation visits following a wash-over gap of one month. After the first day, the patients were instructed to repeat gel application twice a day at 10:00 and 18:00 for three days. The recorded pain scores were subjected to non-parametric analysis. Results: The highest pain was recorded at 2 and 6 hours. Pain scores were significantly different between the three groups (Kruskal–Wallis test, p 0.05). Conclusion: A significant pain reduction was observed following the use of ketoprofen when tested against a control gel (placebo). The highest pain scores were experienced in patients administered the placebo and the lowest scores in patients who applied ketoprofen gel. Benzocaine had an effect mid-way between ketoprofen and the placebo. The highest pain scores were recorded 2 hours following force application, which decreased to the lowest scores at after 7 days