{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:57:19Z","timestamp":1791295039902,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp; Exp Dental Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Orthodontic treatment can be associated with pain, particularly during separator placement, appliance insertion, or activation. Topical anesthetics may offer a simple, locally applied alternative to systemic analgesics, but their effectiveness remains uncertain. The objective of this review was to evaluate the efficacy of topical anesthetics, compared to other treatments or no treatment, in reducing orthodontic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Eligible studies were randomized controlled trials (RCTs) comparing topical anesthetics (gels or patches) with placebo, no treatment, or other active pain\u2010control interventions in orthodontic patients. Five databases (PubMed, Scopus, Cochrane CENTRAL, Embase, Web of Science) were searched up to 14th March 2026, with no language or date restrictions. Data were extracted in duplicate, and the risk of bias was assessed using the ROB\u20102 tool. Due to heterogeneity, only a qualitative synthesis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine RCTs (456 participants, mean age 14\u201335 years; 36.3% male) conducted in four countries were included. Benzocaine was the most investigated, followed by lidocaine, prilocaine\/lidocaine, and menthol. Most studies examined separator\u2010induced pain. Eight of nine trials reported significant reductions in pain intensity with topical anesthetics at one or more time points, particularly within the first 24 to 72\u2009h. Benzocaine consistently showed superior outcomes compared with placebo. Lidocaine and prilocaine\/lidocaine provided rapid analgesia, especially in patients with high anxiety or low pain thresholds. Menthol patches also showed significant short\u2010term pain reduction in two studies. Risk of bias was moderate in most trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Topical anesthetics can be effective in reducing short\u2010term orthodontic pain. Their use may reduce reliance on systemic analgesics and improve patient comfort during the initial stages of treatment. However, evidence quality remains limited, and further high\u2010quality RCTs with standardized protocols are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cre2.70473","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:18:17Z","timestamp":1791292697000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Topical Anesthetics Effectiveness in Management of Orthodontic Pain: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3877-1925","authenticated-orcid":false,"given":"Qasim","family":"Khalid","sequence":"first","affiliation":[{"name":"Orofacial Pain and TMD, Eastman Institute for Oral Health University of Rochester Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Naseem","sequence":"additional","affiliation":[{"name":"Department of Orthodontics Niazi Medical and Dental College Sargodha Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4556-1995","authenticated-orcid":false,"given":"Waqas","family":"Naseem","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Debrecen Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6819-4688","authenticated-orcid":false,"given":"Adnan","family":"Jehangir","sequence":"additional","affiliation":[{"name":"BioMedical Sciences Department, College of Medicine King Faisal University Hofuf Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8100-561X","authenticated-orcid":false,"given":"Umar","family":"Hussain","sequence":"additional","affiliation":[{"name":"Saidu College of Dentistry Saidu Sharif Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7025-5728","authenticated-orcid":false,"given":"Maryam","family":"Altuhafy","sequence":"additional","affiliation":[{"name":"Orofacial Pain and TMD, Eastman Institute for Oral Health University of Rochester Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3107-6118","authenticated-orcid":false,"given":"Junad","family":"Khan","sequence":"additional","affiliation":[{"name":"Orofacial Pain and TMD, Eastman Institute for Oral Health University of Rochester Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"issue":"1","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40510-016-0156-7","article-title":"The Effect of a Lidocaine\/Prilocaine Topical Anesthetic on Pain and Discomfort Associated With Orthodontic Elastomeric Separator Placement","volume":"18","author":"Al\u2010Melh M. 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