## 3 Results
### Main Outcomes of Individual Studies  
Two RCTs [20; 21] reported that there were no significant differences at any timepoint in the results regarding VAS scores between bite wafer and Ibuprofen groups. [PERSON] et al. [9] did not report statistical group comparisons regarding VAS scores between the bite wafer and Ibuprofen groups. [PERSON] et al. [2] reported that there were no significant differences at any timepoint in the results regarding VAS scores between the bite wafer and Acetaminophen (Paracetamol) groups. [PERSON] et al. [41] reported that there were no significant differences at any timepoint in the results regarding NRS scores between bite wafer and Acetaminophen (Paracetamol) groups. [PERSON] et al. [40] reported that there were significant differences at all timepoints in the results regarding VAS scores between the bite wafer and Acetaminophen (Paracetamol) groups, favoring the use of bite wafers. [PERSON] et al. [4] did not report statistically significant differences regarding VAS scores between the bite wafer and over-the-counter (OTC) groups (Table 4).  
\begin{table}
\begin{tabular}{c c c c c c c} \hline \hline \multirow{3}{*}{**Authors**} & \multicolumn{3}{c}{**Results Regarding Visual Analog Scale and Numeric Rating Scale**} & \multicolumn{3}{c}{**Statistical Group**} \\ \cline{2-7}  & \multicolumn{3}{c}{**Sale**} & \multicolumn{3}{c}{**Comparisons**} \\ \cline{2-7}  & \multicolumn{3}{c}{**Bite Wafer Group versus Ibuprofen Group**} & \multicolumn{3}{c}{**Conclusion**} \\ \cline{2-7}  & **Time** & **Bite Wafer Group** & **Ibuprofen Group** & **Period** & **\(p\)-Value** & \\  & **Period** & **(Mean \(\pm\) SD)** & **(Mean \(\pm\) SD)** & **Period** & **\(p\)-Value** & \\ \hline \multirow{5}{*}{[PERSON] et al. [20]} & 2 h & 3.53 \(\pm\) 1.35 & 3.88 \(\pm\) 1.52 & 2 h & NS & \multirow{5}{*}{Bite wafers were comparable to Ibuprofen in reducing pain following the initial activation of fixed orthodontic appliances. } \\  & 6 h & 4.08 \(\pm\) 1.34 & 4.50 \(\pm\) 1.73 & 6 h & NS & \\  & Bedtime & 4.93 \(\pm\) 1.01 & 5.08 \(\pm\) 1.73 & Bedtime & NS & \\  & 24 h & 4.36 \(\pm\) 1.18 & 5.08 \(\pm\) 1.61 & 24 h & NS & \\  & 2 d & 2.60 \(\pm\) 1.43 & 3.25 \(\pm\) 1.25 & 2 d & NS & \\  & 3 d & 1.65 \(\pm\) 1.31 & 2.10 \(\pm\) 1.17 & 3 d & NS & \\  & 7 d & 0.80 \(\pm\) 1.06 & 0.95 \(\pm\) 0.83 & 7 d & NS & \\ \hline \multirow{5}{*}{[PERSON] et al. [9]} & 2 h & & & 2 h & \multirow{5}{*}{NA} & \multirow{5}{*}{NA} & Chewing on the bite wafer was effective for orthodontic pain control and produced results that were comparable to the Ibuprofen. \\  & 6 h & & & 2 d & & \\  & 1 d & & & 3 d & \\  & 2 d & & & 7 d & \\ \hline \multirow{5}{*}{[PERSON] et al. [21]} & \multicolumn{3}{c}{Soft BW} & Hard BW & & & \\  & 2 h & 2.87 \(\pm\) 2.42 & 5.29 \(\pm\) 2.75 & 4.80 \(\pm\) 3.06 & 2 h & NS \\  & 6 h & 4.40 \(\pm\) 2.51 & 5.25 \(\pm\) 3.28 & 6.45 \(\pm\) 2.58 & 6 h & NS & \\ \cline{1-1}  & Bedtime & 5.23 \(\pm\) 2.78 & 4.85 \(\pm\) 3.24 & 6.96 \(\pm\) 2.13 & Bedtime & NS & \\ \cline{1-1}  & 24 h & 7.15 \(\pm\) 2.83 & 4.22 \(\pm\) 2.83 & 7.47 \(\pm\) 2.73 & 24 h & NS & \\ \cline{1-1}  & 2 d & 5.32 \(\pm\) 2.01 & 3.34 \(\pm\) 3.16 & 6.64 \(\pm\) 3.11 & 2 d & NS & orthodontic pain \\ \cline{1-1}  & 3 d & 3.18 \(\pm\) 1.84 & 2.50 \(\pm\) 2.90 & 5.04 \(\pm\) 3.07 & 3 d & NS & reduction. \\ \cline{1-1}  & 7 d & 1.55 \(\pm\) 1.72 & 1.14 \(\pm\) 1.75 & 4.02 \(\pm\) 2.77 & 7 d & NS & \\ \hline \hline \end{tabular}
\end{table}
Table 4: Main study outcomes.