Abstract
BackgroundPain is among the most cited negative effects of orthodontic treatment. Non-steroidal anti-inflammatory drugs seem to be an effective option for minimizing this but can have adverse effects on tooth movement owing to their ability to block prostaglandin synthesis. Acetaminophen has been suggested as the analgesic of choice during orthodontic treatment as it showed no effect on orthodontic tooth movement in previous animal studies. The purpose of this study was to compare the effects of ibuprofen and acetaminophen on the prostaglandin E2 (PGE2) levels of the gingival crevicular fluid (GCF) during orthodontic tooth movement in human subjects.MethodsA total of 42 patients (mean age 18 ± 4.5 years) were randomly divided into three equal groups: ibuprofen, acetaminophen, and control groups. Maxillary canines were distalized with 150 g of force delivered by NiTi coil springs. GCF samples were obtained before (baseline) and after spring activation at 24, 48, and 168 h. The PGE2 content of the GCF was determined using enzyme-linked immunosorbent assay.ResultsPGE2 levels in all groups increased significantly by 24 and 48 h of force application and decreased to baseline levels by 168 h. No significant difference was found between the acetaminophen and control groups at any time point. There was a significant decrease in PGE2 levels in the ibuprofen group at 24 and 48 h when compared to the other two groups.ConclusionsAcetaminophen showed no significant effect on prostaglandin synthesis and may be the safe choice compared to ibuprofen for relieving pain associated with orthodontic tooth movement.
Highlights
Pain is among the most cited negative effects of orthodontic treatment
Prostaglandin E2 levels in the gingival crevicular fluid (GCF) significantly increased in all groups by 24 h when compared to baseline values (p = 0.001)
No significant differences in prostaglandin E2 (PGE2) levels were found between the acetaminophen and control groups at any time measured (Table 1)
Summary
Pain is among the most cited negative effects of orthodontic treatment. Non-steroidal anti-inflammatory drugs seem to be an effective option for minimizing this but can have adverse effects on tooth movement owing to their ability to block prostaglandin synthesis. Acetaminophen has been suggested as the analgesic of choice during orthodontic treatment as it showed no effect on orthodontic tooth movement in previous animal studies. Orthodontic tooth movement is known to cause inflammatory reactions in the periodontium and dental pulp, which stimulate release of various biochemical mediators. This is often associated with painful reactions, which have been rated as the greatest dislike during and fourth among major fears prior to orthodontic treatment [1]. Acetaminophen, a non-steroidal anti-inflammatory drug in the family of para-aminophenols, said to have a central analgesic effect, showed no effect on orthodontic tooth movement in previous animal studies [12,13,14]. It is known to reduce the levels of prostacyclins after systemic administration in humans [18]
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