A randomized controlled trial on the effectiveness of low-level laser therapy versus paracetamol-caffeine for pain control during overall orthodontic treatment.

This study aimed to evaluate the analgesic effects of low-level laser therapy (LLLT) and paracetamol-caffeine in controlling orthodontic pain induced during different stages of leveling and alignment orthodontic treatment. Fifty-four patients with mild to moderate crowded arches were enrolled. Elastomeric separators were placed, followed by fixed appliance bonding one week later. Archwires were replaced according to a predefined sequence until reaching the final 0.019 × 0.025-inch stainless steel wires. The first group received a beam of GaAlAs-Laser before separator placement or any archwire replacement, whereas the second group received paracetamol-caffeine tablets (the drug). Patients in the control group did not receive any procedure. A numeric rating scale (NRS) was used to assess spontaneous and chewing pain immediately, after 1, 24, 48 h, one week, and on the next visit of any replacement. The pain perception reached its peak after 24 h of any replacement. The intensity of pain after 24 and 48 h of separators' placement and initial archwires' engagement was significantly greater than pain induced by 0.016, 0.016 × 0.022, 0.017 × 0.025, and 0.019 × 0.025 NiTi and 0.019 × 0.025 SS archwires in all groups for spontaneous and chewing pain scores. Pain scores in the LLLT group were significantly smaller than those of the control group after 48 h of separation and after 24 and 48 h of rectangular archwire insertion. No significant differences were observed between the drug and control groups. The highest pain levels were induced during the initial stages (separation and initial archwire) of orthodontic treatment. LLLT was able to reduce the peak of high-level pain just during separation and was not highly effective throughout the treatment course. On the other hand, the paracetamol-caffeine combination was not very effective in reducing pain perception throughout the treatment course.This trial was registered at Clinical Trials.gov (Identifier NCT03400111), registered on 17/01/2018.