Acta Scientific Dental Sciences (ISSN: 2581-4893)

Research Article Volume 4 Issue 9

Pharmacological Management of Orthodontic Pain: A Systematic Review and Meta-Analysis

Basel Mofti1*, Moataz ElShehaby1, Mona A Montasser2 and David Bearn3

1Postgraduate Student, Orthodontics, School of Dentistry, University of Dundee, Dundee, Scotland, UK
2Professor, Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
3Professor of Orthodontics, School of Dentistry, University of Dundee, Dundee, Scotland, UK

*Corresponding Author: Basel Mofti, Postgraduate Student, Orthodontics, School of Dentistry, University of Dundee, Dundee, Scotland, UK.

Received: July 14, 2020; Published: August 27, 2020

×

Abstract

Introduction: The objective of this systematic review and meta-analysis was to assess the effectiveness of various pharmacological interventions on pain experienced by patients undergoing orthodontic therapy.

Methods: PubMed, MEDLINE, Web of Science, and the Cochrane Library databases were searched to February 22, 2020 to identify relevant randomized controlled trials (RCTs) evaluating the effectiveness of any pharmacological interventions for pain relief following orthodontic activation. The Cochrane Collaboration tool for risk of bias evaluation was used. Meta-analysis was carried out using RevMan software with a random-effects' model applied.

Results: Seventeen RCTs were identified, but only ten RCTs with a total of 899 participants were included in the meta-analysis. Meta-analysis showed both ibuprofen and acetaminophen significantly reduced orthodontic pain at 2, 6, and 24 hours when compared to a placebo (P < 0.05). Acetaminophen was further found to reduce pain at 2 and 3 days when compared to a placebo (P < 0.05). Ibuprofen was found to reduce orthodontic pain more at 2 hours (P = 0.01) when compared to acetaminophen.

Conclusions: Both ibuprofen and acetaminophen are equally effective in reducing orthodontic pain at all time points within the first 24 hours. Further high quality research is required to improve the reliability of the evidence.

Keywords: Orthodontic Pain; Pharmacology; Analgesics; NSAID; Systematic Review

×

References

  1. Jones M and Chan C. “The pain and discomfort experienced during orthodontic treatment: a randomized controlled clinical trial of two initial aligning arch wires”. American Journal of Orthodontics and Dentofacial Orthopedics4 (1992): 373-381.
  2. Scheurer PA., et al. “Perception of pain as a result of orthodontic treatment with fixed appliances”. European Journal of Orthodontics4 (1996): 349-357.
  3. Krishnan V. “Orthodontic pain: from causes to management - a review”. European Journal of Orthodontics2 (2007): 170-179.
  4. Oliver RG and Knapman YM. “Attitudes to orthodontic treatment”. British Journal of Orthodontics4 (1985): 179-188.
  5. Angelopoulou MV., et al. “Pharmacological management of pain during orthodontic treatment: a meta-analysis”. Orthodontics Craniofacial Research2 (2012): 71-83.
  6. Brown D and Moerenhout R. “The Pain Experience and Psychological Adjustment to Orthodontic Treatment of Preadolescents, Adolescents, and Adults”. American Journal of Orthodontics and Dentofacial Orthopedics4 (1991): 349-356.
  7. Kluemper GT., et al. “Efficacy of a wax containing benzocaine in the relief of oral mucosal pain caused by orthodontic appliances”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2002): 359-365.
  8. Monk AB., et al. “Pharmacological interventions for pain relief during orthodontic treatment”. Cochrane Database of Systematic Reviews 11 (2017).
  9. Ngan P., et al. “Perception of discomfort by patients undergoing orthodontic treatment”. American Journal of Orthodontics and Dentofacial Orthopedics1 (1989): 47-53.
  10. Erdinç E M A and Dinçer B. “Perception of pain during orthodontic treatment with fixed appliances”. European Journal of Orthodontics1 (2004): 79-85.
  11. Needleman HL., et al. “Reports of pain by children undergoing rapid palatal expansion”. Pediatric Dentistry3 (2000): 221-226.
  12. Ngan P., et al. “The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment”. American Journal of Orthodontics and Dentofacial Orthopedics1 (1994): 88-95.
  13. Panda S., et al. “Perception of pain due to various orthodontic procedures”. Quintessence International 46.7 (2015): 603-609.
  14. Bondemark L., et al. “Separation effect and perception of pain and discomfort from two types of orthodontic separators”. World Journal of Orthodontics 2 (2004): 172-176.
  15. Jones ML. “An investigation into the initial discomfort caused by placement of an archwire”. European Journal of Orthodontics1 (1984): 48-54.
  16. Fernandes LM., et al. “Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire”. Journal of Orofacial Orthopedics 6 (1998): 331-339.
  17. Long H., et al. “Current advances in orthodontic pain”. International Journal of Oral Science 2 (2016): 67-75.
  18. Sacerdote P and Levrini L. “Peripheral mechanisms of dental pain: the role of substance P”. Mediators of Inflammation (2012).
  19. d’Apuzzo F., et al. “Biomarkers of periodontal tissue remodeling during orthodontic tooth movement in mice and men: overview and clinical relevance”. Science World Journal (2013).
  20. Gupta M., et al. “Controlling pain during orthodontic fixed appliance therapy with non-steroidal anti-inflammatory drugs (NSAID): a randomized, double-blinded, placebo-controlled study”. Journal of Orofacial Orthopedics6 (2014): 471-476.
  21. Xiaoting L., et al. “Interventions for pain during fixed orthodontic appliance therapy. A systematic review”. The Angle Orthodontist5 (2010): 925-932.
  22. Woodhouse NR., et al. “Supplemental vibrational force does not reduce pain experience during initial alignment with fixed orthodontic appliances: a multicenter randomized clinical trial”. Science Report 5 (2015): 17224.
  23. Nadeem M., et al. “Effect of Chewing Gum on Pain in Fixed Orthodontic Treatment”. Annals of Abbasi Shaheed Hospital and Karachi Medical and Dental College2 (2016): 94-99.
  24. Ireland AJ., et al. “Comparative assessment of chewing gum and ibuprofen in the management of orthodontic pain with fixed appliances: A pragmatic multicenter randomized controlled trial”. American Journal of Orthodontics and Dentofacial Orthopedics2 (2016): 220-227.
  25. Benson PE., et al. “The effect of chewing gum on the impact, pain and breakages associated with fixed orthodontic appliances: a randomized clinical trial”. Orthodontics Craniofacial Research3 (2012): 178-187.
  26. Youssef M., et al. “The effect of low-level laser therapy during orthodontic movement: a preliminary study”. Lasers in Medical Science 1 (2008): 27-33.
  27. Sousa MVS., et al. “Systematic Literature Review: Influence of Low-Level Laser on Orthodontic Movement and Pain Control in Humans”. Photomedicine, and Laser Surgery 11 (2014): 592-599.
  28. Shi Q., et al. “Does low level laser therapy relieve the pain caused by the placement of the orthodontic separators? - A meta-analysis”. Head and Face Medicine 11 (2015): 28.
  29. Ren C., et al. “The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis”. Lasers in Medical Science7 (2015): 1881-1893.
  30. Li FJ., et al. “Low-level laser therapy for orthodontic pain: a systematic review”. Lasers in Medical Science6 (2015): 1789-1803.
  31. Arias OR and Marquez-Orozco MC. “Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement”. American Journal of Orthodontics and Dentofacial Orthopedics3 (2006): 364-370.
  32. Karthi M., et al. “NSAIDs in orthodontic tooth movement”. Journal of Pharmacy and Bioallied Sciences 4 (2012): S304-306.
  33. Liberati A., et al. “The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration”. PLoS Medicine7 (2009): e1000100.
  34. Moher D., et al. “Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement”. PLoS Medicine7 (2009): e1000097.
  35. Higgins JP and Green S. “Cochrane handbook for systematic reviews of interventions”. John Wiley and Sons 4 (2011).
  36. Arantes GM., et al. “Tenoxicam controls pain without altering orthodontic movement of maxillary canines”. Orthodontics Craniofacial Research1 (2009): 14-19.
  37. Bernhardt MK., et al. “The effect of preemptive and/or postoperative ibuprofen therapy for orthodontic pain”. American Journal of Orthodontics and Dentofacial Orthopedics1 (2001): 20-27.
  38. Bruno MB., et al. “A double-blind, randomized clinical trial assessing the effects of a single dose of preemptive anti-inflammatory treatment in orthodontic pain”. Progress in Orthodontics1 (2011): 2-7.
  39. Young AN., et al. “Evaluation of preemptive valdecoxib therapy on initial archwire placement discomfort in adults”. The Angle Orthodontist2 (2006): 251-259.
  40. Polat O and Karaman AI. “Pain control during fixed orthodontic appliance therapy”. The Angle Orthodontist2 (2005): 214-219.
  41. Polat O., et al. “Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain”. The Angle Orthodontist5 (2005): 791-796.
  42. Bird SE., et al. “Preoperative acetaminophen vs ibuprofen for control of pain after orthodontic separator placement”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2007): 504-510.
  43. Bradley RL., et al. “A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2007): 511-517.
  44. Hosseinzadeh Nik T., et al. “Acetaminophen Versus Liquefied Ibuprofen for Control of Pain During Separation in Orthodontic Patients: A Randomized Triple Blinded Clinical Trial”. Acta Medica Iranica 7 (2016): 418-421.
  45. Kohli SS and Kohli VS. “Effectiveness of piroxicam and ibuprofen premedication on orthodontic patients’ pain experiences”. The Angle Orthodontist6 (2011): 1097-1102.
  46. Minor V., et al. “Effects of preoperative ibuprofen on pain after separator placement”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2009): 510-517.
  47. Patel S., et al. “Effects of analgesics on orthodontic pain”. American Journal of Orthodontics and Dentofacial Orthopedics1 (2011): e53-58.
  48. Salmassian R., et al. “Comparison of the efficacy of ibuprofen and acetaminophen in controlling pain after orthodontic tooth movement”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2009): 516-521.
  49. Steen Law SL., et al. “An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement”. American Journal of Orthodontics and Dentofacial Orthopedics6 (2000): 629-635.
  50. Zarif Najafi H., et al. “Comparison of the effects of preemptive acetaminophen, ibuprofen, and meloxicam on pain after separator placement: a randomized clinical trial”. Progress in Orthodontics 16 (2015): 34.
  51. Kehoe MJ., et al. “The effect of acetaminophen, ibuprofen, and misoprostol on prostaglandin E2 synthesis and the degree and rate of orthodontic tooth movement”. The Angle Orthodontist5 (1996): 339-349.
  52. Clarke R., et al. “Single dose oral etoricoxib for acute postoperative pain in adults”. Cochrane Database of Systematic Reviews2 (2009).
×

Citation

Citation: Basel Mofti., et al. “Pharmacological Management of Orthodontic Pain: A Systematic Review and Meta-Analysis”. Acta Scientific Dental Sciences 4.9 (2020): 125-135.



Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 10, 2020.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US