***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: INTRODUCTION Some patients undergoing orthodontic treatment report enough discomfort to affect their compliance or request treatment termination . The purpose of this preliminary study was to test the effectiveness of ibuprofen vs acetaminophen in controlling discomfort after initial orthodontic appliance and archwire placement . METHODS A total of 60 patients ( ages , 12 - 18 years ) undergoing fixed comprehensive orthodontic treatment were r and omly assigned to 1 of 3 experimental groups : 600 mg of acetaminophen , 400 mg of ibuprofen , or a placebo . All subjects were instructed to take the medications orally at prescribed times after initial appliance and archwire placement . Each patient 's level of discomfort was assessed with a 100-mm visual analog scale immediately after placement ; at 3 , 7 , 19 , 24 , 31 , and 48 hours ; and at 3 , 4 , and 7 days . RESULTS The results indicated that the peak level of pain was at 19 hours after placement , and the differences in scores among the 3 groups were not statistically significant . CONCLUSIONS Acetaminophen , ibuprofen , and placebo are equally effective in reducing discomfort after initial orthodontic appliance placement patients undergoing any form of dental treatment , to the extent that 77 % of a patient population reported some degree of pain from a visit to the dentist.1 Pain following orthodontic adjustments appears to be equally prevalent.2 - 10 Jones and Chan showed that compliance with orthodontic treatment may be predicated on the amount of initial pain and discomfort experienced.5 Other studies indicate that plaque control may suffer as a result of the pain associated with orthodontics.7,11 Although analgesics have been found to reduce such discomfort , in most cases they do not totally eliminate it.12 - 15 Moreover , some patients may be allergic to these agents , and one report suggested that nonsteroidal anti-inflammatory drugs may adversely affect the rate of tooth movement.14 Patients who do not respond to or elect not to use pharmacological therapy have had few practical alternatives . Some orthodontists recommend chewing on gum or a plastic wafer immediately after adjustments.16 Proffit suggested that lower force levels could reduce pain,17 but Lim and colleagues showed that pain or discomfort was still experienced by most patients even when “ physiologic and light forces ” were used.18 Recently , there have been major developments in the underst and ing of pain mechanisms and of new approaches to the management of pain.19 Low-level laser therapy has been shown to produce analgesic effects in many clinical applications , including orthodontics.18 Transcutaneous electrical nerve stimulation ( TENS ) is another non-pharmacological , non-invasive method of reducing post-orthodontic adjustment pain.20,21 Vibratory stimulation , a classic noninvasive and non-medicinal method of reducing pain , could also be effective in orthodontic patients .21 - 26 The orthodontic application of this method was first investigated by Dr. Powers on a patient with a history of painful post-adjustment episodes during closure of a wide maxillary midline diastema with elastic chain . After placing a new elastic chain , Dr. Powers observed that gentle vibration of the maxillary central incisors produced two effects : the blanching of the tissue between and above the incisors was quickly reversed , and the previous level of pain did not occur INTRODUCTION The purpose of this study was to clinical ly evaluate the effect of low-level laser therapy ( LLLT ) as a method of reducing pain reported by patients after placement of their first orthodontic archwires . METHODS The sample comprised 60 orthodontic patients ( ages , 12 - 18 years ; mean , 15.9 years ) . All patients had fixed orthodontic appliances placed in 1 dental arch ( maxillary or m and ibular ) , received the first archwire , and were then r and omly assigned to the experimental ( laser ) , placebo , or control group . This was a double-blind study . LLLT was started in the experimental group immediately after placement of the first archwire . Each tooth received a dose of 2.5 J per square centimeter on each side ( buccal and lingual ) . The placebo group had the laser probe positioned into the mouth at the same areas overlying the dental root and could hear a sound every 10 seconds . The control group had no laser intervention . All patients received a survey to be filled out at home describing their pain during the next 7 days . RESULTS The patients in the LLLT group had lower mean scores for oral pain and intensity of pain on the most painful day . Also , their pain ended sooner . LLLT did not affect the start of pain perception or alter the most painful day . There was no significant difference in pain symptomatology in the maxillary or m and ibular arches in an evaluated parameter . CONCLUSIONS Based on these findings , we concluded that LLLT efficiently controls pain caused by the first archwire The control of pain during orthodontic treatment is of great interest to both clinicians and patients . However , there has been limited research into the control of this pain , and there is no st and ard of care for controlling this discomfort . This prospect i ve study determines the pain sequelae in fixed orthodontic treatment and evaluates comparatively the analgesic effects of nonsteroidal anti-inflammatory drugs for the control of this pain . One hundred and fifty orthodontic patients who were to have teeth bonded in at least one arch were r and omly assigned to one of six groups : ( 1 ) placebo/placebo , ( 2 ) ibuprofen/ibuprofen , ( 3 ) flurbiprofen/flurbiprofen , ( 4 ) acetaminophen/acetaminophen , ( 5 ) naproxen sodium/naproxen sodium , and ( 6 ) aspirin/aspirin . The pain evaluations were made during chewing , biting , fitting the front teeth , and fitting the back teeth using a 100-mm visual analogue scale ( VAS ) for seven days . All the analgesics succeeded in decreasing the pain levels compared with the placebo group . However , naproxen sodium and aspirin groups showed the lowest pain values , and the acetaminophen group showed VAS results similar to those of the two analgesics INTRODUCTION This purpose of this study was to examine the effects of a structured telephone call after  orthodontic appliance placement on self-reported pain and anxiety . METHODS One hundred-fifty orthodontic patients were r and omly assigned to 1 of 3 groups and matched for age , sex , and ethnicity . The subjects completed baseline question naires to assess their levels of pain ( on a 100-mm visual analog scale ) and anxiety ( Spielberger 's State-Trait Anxiety Inventory ) before orthodontic treatment . After the initial archwires were placed , all subjects completed the  pain question naire and  state-anxiety inventory  at the same time daily for 1 week . One group also received a structured telephone call demonstrating care and reassurance ; the second group received an attention-only telephone call , thanking them for participating in the study ; the third group served as a control . RESULTS Although both telephone groups reported significantly less pain ( P = .005 ) and state-anxiety ( P = .033 ) than the control group , there was no difference between the 2 telephone groups ( P > .12 for pain ; P > .81 for state-anxiety ) . CONCLUSIONS A telephone call from a health-care provider reduced patients ' self-reported pain and anxiety ; the content of the telephone call was not important The purpose of this r and omized , double-blinded , placebo-controlled prospect i ve clinical trial was to compare the efficacy of preemptive and postoperative administration of valdecoxib in reducing  discomfort caused by initial archwire placement in adults . A total of 56 orthodontic patients aged 18 - 54 years who were to begin treatment were r and omly assigned to one of three groups : ( 1 ) placebo , ( 2 ) those who received preemptive valdecoxib 40 mg at least 30 minutes before initial archwire placement , or ( 3 ) those who received postoperative valdecoxib 40 mg two hours after initial archwire placement . Patients in the active treatment groups also received continuous valdecoxib therapy for an additional 48 hours . Discomfort levels were recorded on a visual analog scale at zero , two , six , 24 , and 48 hours after initial archwire placement . At baseline , no significant differences were detected between the three groups . In the preemptive valdecoxib group , there was no significant increase ( P > .05 ) in discomfort from baseline at any time point . The placebo and postoperative valdecoxib groups showed significant ( P < .05 ) increases in discomfort after six hours , with the peak discomfort at 24 hours . The postoperative group showed a tendency toward decreased discomfort over time , but the changes were not significantly different from the placebo or the preemptive group . Preemptive analgesia with nonsteroidal anti-inflammatory drugs may be an approach to prevent discomfort associated with initial archwire placement in healthy adults Three experimental groups of 20 patients each , all of whom were to undergo fixed orthodontic treatment , were enrolled in this prospect i ve study . Group 1 was given a placebo , group 2 was given 400 mg ibuprofen , and group 3 was given 550 mg naproxen sodium . All the patients received only one dose that was given one hour before archwire placement . All patients were asked to complete a question naire concerning the pain perceived after archwire placement . The question naire was in the form of a seven-page booklet that contained 100-mm horizontal Visual Analogue Scale on which the patient marked the degree of discomfort at the indicated time periods . The patients were instructed to make a check on the scale at each time interval to represent the perceived severity of pain during each of four activities , ie , chewing , biting , fitting back teeth together , and fitting front teeth together . Incidence and severity of pain were recorded by the patient at two hours , six hours , nighttime on the day of appointment , 24 hours after the appointment , and two days , three days , and seven days after bonding . The results revealed that patients taking 550 mg naproxen sodium one hour before archwire placement had significantly lower levels of pain at two hours , six hours , and nighttime after adjustment than patients taking placebo or ibuprofen . However , the use of additional postoperative doses was recommended to control orthodontic pain completely The present study compared the effect of acetaminophen , ibuprofen and misoprostol on PGE2 synthesis and  orthodontic tooth movement . Guinea pigs were r and omly assigned into one of three test groups or a control group . Each group received study treatments every 12 hours as an orthodontic force was applied to the maxillary incisors . Direct linear measurements of tooth separation were recorded at days 2 , 4 , 6 , 10 , and 11 , and inflammatory exu date from the periodontal ligament ( PDL ) space was extracted and quantitatively analyzed radioimmunologically for the presence of PGE2 at days 4 and 9 . Comparing the concentration of PGE2 in sample extracts , a significant difference ( P = 0.001 ) was found among drug groups . A highly significant difference was found between the mean tooth separation among the various drug groups ( P < 0.001 ) . At day 11 the misoprostol group exhibited 4.49 + /- 0.49 mm of separation ;  ibuprofen 2.56 + /- 0.11 mm , and the control and acetaminophen groups exhibited similar degrees of tooth separation : 3.31 + /- 0.07 mm and 3.31 + /- 0.08 mm , respectively . A highly significant difference occurred between the mean rates of tooth separation among the various drug groups after day 8 ( P < 0.001 ) . Results of this study suggest that acetaminophen is the analgesic of choice for the relief of minor discomfort associated with orthodontic treatment OBJECTIVES To test the hypothesis that mechanical forces combined with low-level laser therapy stimulate the rate of orthodontic tooth movement . STUDY DESIGN This study was a double blind , r and omized placebo/control matched pairs clinical trial to test the efficacy of GaAlAs low-level laser therapy ( LLLT ) on 12 young adult patients who required retraction of maxillary canines into first premolar extraction spaces using tension coil springs with fixed edgewise appliance . LLLT was applied on the mucosa buccally , distally and palatally to the canine on the test side and using a pseudo-application on the placebo side . Dental impressions and casts were made at the commencement of the trial and at the end of the first , second and third months after starting the trial . Measurement of tooth movements was made on each stage model using a stereo microscope . RESULTS There was no significant difference of means of the canine distal movement between the LLLT side and the placebo side for any time periods ( p-value = 0.77 ) . CONCLUSION The energy density of LLLT ( GaAlAs ) at the surface level in this study ( 25 J/cm(2 ) ) was probably too low to express either stimulatory effect or inhibitory effect on the rate of orthodontic tooth movement The aims of this study were to investigate the initial time at which pain occurs after insertion of two initial wires of different sizes , the duration of the pain , the areas affected within the mouth , the level of self-medication , the effect of this pain on daily life , and whether gender is important in the perception of pain . The study group consisted of 109 patients ( 52 boys , 57 girls ) with a mean chronological age of 13.6 years for boys and 14.7 years for girls .  Insertion of either a 0.014 or 0.016 inch wire was by r and om selection . Following insertion of the 
    Output:
    
Other analgesics such as tenoxicam and valdecoxib had relatively lower visual analog scale ( VAS ) scores in pain perception .
Analgesics are still the main treatment modality to reduce orthodontic pain despite their side effects .