Int J Stomatol

Int J Stomatol ›› 2020, Vol. 47 ›› Issue (4): 424-430.doi: 10.7518/gjkq.2020081

• Original Articles • Previous Articles     Next Articles

Randomized cross-control trial of placebo in the regulation of orthodontic tooth movement pain

Yang Hong,Jin Yu,Lai Wenli()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-07-05 Revised:2019-12-10 Online:2020-07-01 Published:2020-07-10
  • Contact: Wenli Lai E-mail:wenlilai@scu.edu.cn
  • Supported by:
    This study was supported by The National Natural Science Foundation of China(81571004);This study was supported by The National Natural Science Foundation of China(81500884)

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Abstract:

Objective This study aims to explore the therapeutic effect of placebo on orthodontic pain and its mechanism. Methods Sixty volunteers were recruited and randomly divided into two groups. Vitamin B tablets were used as placebo. At baseline, orthodontic separators were placed between the left lower molars, and subjects in the placebo group took pla-cebos after half an hour. Only orthodontic separators were placed in the non-placebo group. Pain level (visual analogue scales), anxiety level, and salivary alpha-amylase (sAA) and saliva cortisol of the subjects were measured at baseline and 24 hours after separation. After 1 month of wash-out period, the orthodontic separators were placed between the left lower molars again, and subjects in the two groups were cross-experimented. Results The pain and anxiety levels in the placebo and non-placebo groups increased after placement of orthodontic separators. The pain and anxiety levels in the placebo group were significantly lower than those in the non-placebo group (P<0.05). The levels of cortisol and sAA increased in varying degrees, and the expression of cortisol in the placebo group was lower than that in the non-placebo group (P<0.05). No significant difference was observed in the level of sAA expression between two groups (P>0.05). Conclusion The placement of orthodontic separators can stimulate orthodontic pain. The levels of pain and anxiety increased similar to the levels of cortisol and salivary amylase. Cortisol and sAA can be used as objective biological indicators to evaluate pain intensity and anxiety level, respectively. Placebo can effectively reduce the pain and anxiety caused by orthodontic pain.

Key words: orthodontics, placebo, pain, anxiety, cortisol, salivary alpha-amylase

CLC Number: 

  • R783.5

TrendMD: 

Fig 1

Schematic representation of the experimental design"

Tab 1

VAS and anxiety measurements before and after placement of orthodontic separators in the pla-cebo and non-placebo groups"

测量项目 干预措施 非安慰剂组 安慰剂组
VAS值 放置前 1.138±1.198 1.581±1.654
放置后 2.641±2.046 2.407±2.016
放置后-放置前 1.432±1.970 0.716±1.854
S值 放置前 25.900±9.432 26.780±11.370
放置后 28.820±10.170 27.120±10.950
放置后-放置前 2.918±6.763 0.3469±4.437

Fig 2

Scatter diagram of correlation between VAS difference and anxiety score difference before and after separator placement"

Tab 2

The expression of sAA and cortisol in the placebo group and the non-placebo group before and after the placement of orthodontic separators nmol·L-"

测量项目 干预措施 非安慰剂组 安慰剂组
sAA 放置前 0.356±2.022 0.3581±1.998
放置后 0.374±2.021 0.3662±1.865
放置后-放置前 0.031±2.176 0.027±2.177
皮质醇 放置前 4.672±5.299 4.565±5.413
放置后 5.130±5.757 4.778±5.355
放置后-放置前 1.159±3.149 0.031±3.075

Fig 3

Scatter diagram of correlation between sAA secretion level dif-ference and VAS value change (top), cortisol secretion level difference and anxiety score change (bottom) before and after separator placement"

Tab 3

The difference of VAS, anxiety score, cortisol and sAA expression between male and femal subjects before and after placement of orthodontic se-parators"

测量项目 男性 女性
年龄/岁 21.00±0.70 20.87±1.01
VAS值差值 1.0±1.9 0.7±1.5
S值差值 1.21±6.57 3.63±12.26
SAA差值/（nmol·L-1） -0.006 2±0.087 0 0.007 4±0.082 0
皮质醇差值/（nmol·L-1） 0.24±2.56 0.60±3.56
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