The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review

CORRÊA, ADRIANO S.; ALMEIDA, VINÍCIUS L. DE; LOPES, BEATRIZ M.V.; FRANCO, ADEMIR; MATOS, FELIPE R. DE; QUINTANS-JÚNIOR, LUCINDO J.; RODE, SIGMAR M.; PARANHOS, LUIZ R.

doi:10.1590/0001-3765201720160865

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Health Sciences • An. Acad. Bras. Ciênc. 89 (04) • Oct-Dec 2017 • https://doi.org/10.1590/0001-3765201720160865 copy

The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The present study aimed to perform a systematic literature review to determine if there is a non-steroidal anti-inflammatory drug (NSAID) that interferes less within tooth movement. This research was performed according to the PRISMA statement. Articles were searched in eight electronic databases (PubMed, Scopus, Embase, Web of Science, LILACS, SciELO, Google Scholar, and Open Grey). Only experimental studies on male Wistar rats were selected, which included experiments related to the influence of NSAIDs on orthodontic movement. Studies in animals with pathological conditions, literature review articles, letters to the editor and/or editorials, case reports, abstracts, books, and book chapters were excluded. Each of the steps of this systematic literature review was performed by two examiners independently. Results: the total sample consisted of 505 articles, from which 6 studies were eligible after a qualitative analysis. From the drugs assessed, paracetamol was unanimous for not interfering within orthodontic movement when compared to the control group. However, drugs such as aspirin, ibuprofen, sodium diclofenac, and selective cyclooxygenase-2 inhibitors caused a reduction in tooth movement when compared to the control group. Conclusion: paracetamol could be considered the drug of choice for pain relief because it interferes less within tooth movement.

Key words:
Anti-inflammatory; drug; orthodontics; non-steroidal; tooth movement

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[1] Correspondence to: Luiz Renato Paranhos E-mail: paranhos.lrp@gmail.com

Studies	P	I			C	O
Studies	Animals	Orthodontic Mechanotherapy	TT	Dose
De Carlos et al. 2006	42 male Wistar rats	Through closed unilateral helical spring, connected between the first left maxillary molar and the central incisor, orthodontic force of 50g was used for the first half of the sample, and orthodontic force of 100g was used for the other half. Drugs used: rofecoxib and diclofenac. Control group: saline solution.	10 days	Rofecoxib - 2mg/Kg Diclofenac - 10mg/Kg 0.9% saline solution	√	√
Arias and Marquez-Orozco 2006ARIAS OR AND MARQUEZ-OROZCO MC. 2006. Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement. Am J Orthod Dentofacial Orthop 130: 364-370.	36 male Wistar rats	Orthodontic appliance 3-pin loop, 2-mm diameter, 12-mm long arms, “V” folds, placed at 9 mm from the coil region, made from 0.016 beta-titanium alloy wire, imposing force of 35g between lower incisors. Drugs used: aspirin, ibuprofen, and paracetamol. Control group: water filtered by reverse osmosis.	10 days	Aspirin - 100mg/Kg Ibuprofen - 30mg/Kg Paracetamol - 200mg/Kg	√	√
De Carlos et al. 2007	28 male Wistar rats	Through closed unilateral helical spring, connected between the first left maxillary molar and the central incisor, orthodontic force of 50g was used. Drugs used: rofecoxib, celecoxib, and parecoxib. Control group: saline solution.	10 days	Rofecoxib - 0.5mg/Kg Celecoxib - 8mg/Kg Parecoxib - 25mg/Kg 0.9% saline solution	√	√
Hauber Gameiro et al. 2008	32 male Wistar rats	Through closed Nickel-Titanium helical spring, connected between the first maxillary molar and the central incisor, orthodontic force of 50g was used. Drugs used: celecoxib. Control group: saline solution.	14 days	Celecoxib - 10mg/Kg saline solution	√	√
Stabile et al. 2009STABILE AC, STUANI MB, LEITE-PANISSI CR AND ROCHA MJ. 2009. Effects of short-term acetaminophen and celecoxib treatment on orthodontic tooth movement and neuronal activation in rat. Brain Res Bull 79: 396-401.	15 male Wistar rats	Fixed orthodontic appliance made of a 0.016 stainless steel torsion spring, with each edge welded to 0.004” x 0.06” stainless steel rings (bands), imposing force of 30g between upper incisors. Drugs used: celecoxib, paracetamol. Control Group: 0.4% carboxymethylcellulose solution.	2 days	Celecoxib - 50mg/Kg Paracetamol - 200mg/Kg 0.4% carboxymethylcellulose	√	√
Gonzales et al. 2009GONZALES C, HOTOKEZAKA H, MATSUO K, SHIBAZAKI T, YOZGATIAN JH, DARENDELILER MA AND YOSHIDA M. 2009. Effects of steroidal and nonsteroidal drugs on tooth movement and root resorption in the rat molar. Angle Orthod 79: 715-726.	45 male Wistar rats	Through closed Nickel-Titanium helical spring, connected between the first left maxillary molar and the central incisor, an orthodontic force of 50g was used. Drugs used: aspirin, paracetamol, meloxicam, and celecoxib. Control group: no drugs.	14 days	Aspirin - 300mg/Kg and 60mg/Kg Paracetamol - 100mg/Kg and 20mg/Kg Celecoxib - 16mg/Kg and 3.2mg/Kg Meloxicam - 13mg/Kg and 67mg/Kg	√	√

Authors	Q.1 (1 point)	Q.2 (1 point)	Q.3 (3 points)	Q.4 (1 point)	Q.5 (2 points)	Q.6 (2 points)	Q.7 (1 point)	Q.8 (1 point)	Total	General quality
De Carlos et al. 2006	√	√	√ (1 point)	√	--	√	√	√	8 points	++
Arias and Marquez-Orozco 2006ARIAS OR AND MARQUEZ-OROZCO MC. 2006. Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement. Am J Orthod Dentofacial Orthop 130: 364-370.	√	√	√ (2 points)	√	--	√	√	√	9 points	++
De Carlos et al. 2007	√	√	√ (2 points)	√	--	√	√	√	9 points	++
Hauber Gameiro et al. 2008	√	√	√ (2 points)	√	--	√	√	√	9 points	++
Stabile et al. 2009STABILE AC, STUANI MB, LEITE-PANISSI CR AND ROCHA MJ. 2009. Effects of short-term acetaminophen and celecoxib treatment on orthodontic tooth movement and neuronal activation in rat. Brain Res Bull 79: 396-401.	√	√	√ (2 points)	√	√	√	√	√	11 points	+++
Gonzales et al. 2009GONZALES C, HOTOKEZAKA H, MATSUO K, SHIBAZAKI T, YOZGATIAN JH, DARENDELILER MA AND YOSHIDA M. 2009. Effects of steroidal and nonsteroidal drugs on tooth movement and root resorption in the rat molar. Angle Orthod 79: 715-726.	√	√	√ (2 points)	√	--	√	√	√	9 points	++

Drugs Used	Studies	Sample division by drugs and concentrations used	Measurement of tooth movement (mm)
aspirin	Arias and Marquez-Orozco 2006ARIAS OR AND MARQUEZ-OROZCO MC. 2006. Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement. Am J Orthod Dentofacial Orthop 130: 364-370.	E.G.: 9 rats - 100mg/Kg	1.77 ± 0.44
aspirin		C.G.: 9 rats - 0.6ml of water filtered by reverse osmosis	2.89 ± 0.99
ibuprofen	Arias and Marquez-Orozco 2006ARIAS OR AND MARQUEZ-OROZCO MC. 2006. Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement. Am J Orthod Dentofacial Orthop 130: 364-370.	E.G.: 9 rats - 30mg/Kg	1.69 ± 0.33
ibuprofen		C.G.: 9 rats - 0.6ml of water filtered by reverse osmosis	2.89 ± 0.99
paracetamol	Arias and Marquez-Orozco 2006ARIAS OR AND MARQUEZ-OROZCO MC. 2006. Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement. Am J Orthod Dentofacial Orthop 130: 364-370.	E.G.: 9 rats - 200mg/Kg	2.49 ± 0.39
		C.G.: 9 rats - 0.6ml of water filtered by reverse osmosis	2.89 ± 0.99
	Stabile et al. 2009STABILE AC, STUANI MB, LEITE-PANISSI CR AND ROCHA MJ. 2009. Effects of short-term acetaminophen and celecoxib treatment on orthodontic tooth movement and neuronal activation in rat. Brain Res Bull 79: 396-401.	E.G.: 5 rats - 200mg/Kg	1.22 ± 0.04
		C.G.: 5 rats - 1ml of 0.4% carboxymethylcellulose solution	1.11 ± 0.03
celecoxib	Stabile et al. 2009STABILE AC, STUANI MB, LEITE-PANISSI CR AND ROCHA MJ. 2009. Effects of short-term acetaminophen and celecoxib treatment on orthodontic tooth movement and neuronal activation in rat. Brain Res Bull 79: 396-401.	E.G.: 5 rats - 50mg/Kg	1.11 ± 0.05
celecoxib		C.G.: 5 rats - 1ml of 0.4% carboxymethylcellulose solution	1.11 ± 0.03

Drugs Used	Studies	Sample division by drugs and concentrations used	Measurement of tooth movement (mm)
Aspirin	Gonzales et al. 2009GONZALES C, HOTOKEZAKA H, MATSUO K, SHIBAZAKI T, YOZGATIAN JH, DARENDELILER MA AND YOSHIDA M. 2009. Effects of steroidal and nonsteroidal drugs on tooth movement and root resorption in the rat molar. Angle Orthod 79: 715-726.	E.G.1: 5 rats - 300mg/Kg	0.24 ± 0.02
		E.G.2: 5 rats - 60mg/Kg	0.28 ± 0.03
		C.G.: 5 rats - no drugs	0.28 ± 0.02
Meloxicam	Gonzales et al. 2009GONZALES C, HOTOKEZAKA H, MATSUO K, SHIBAZAKI T, YOZGATIAN JH, DARENDELILER MA AND YOSHIDA M. 2009. Effects of steroidal and nonsteroidal drugs on tooth movement and root resorption in the rat molar. Angle Orthod 79: 715-726.	E.G.1: 5 rats - 67mg/Kg	0.25 ± 0.01
		E.G.2: 5 rats - 13mg/Kg	0.26 ± 0.01
		C.G.: 5 rats - no drugs	0.28 ± 0.02
Paracetamol	Gonzales et al. 2009GONZALES C, HOTOKEZAKA H, MATSUO K, SHIBAZAKI T, YOZGATIAN JH, DARENDELILER MA AND YOSHIDA M. 2009. Effects of steroidal and nonsteroidal drugs on tooth movement and root resorption in the rat molar. Angle Orthod 79: 715-726.	E.G.1: 5 rats - 100mg/Kg	0.25 ± 0.04
		E.G.2: 5 rats - 20mg/Kg	0.27 ± 0.01
		C.G.: 5 rats - no drugs	0.28 ± 0.02
Celecoxib	De Carlos et al. 2007	E.G.: 6 rats - 8mg/Kg	0.22 ± 0.04
	De Carlos et al. 2007	C.G.: 12 rats - saline solution	0.33 ± 0.07
	Hauber Gameiro et al. 2008	E.G.1: 9 rats - 10mg/Kg for 3 days	0.15 ± 0.06
		C.G.1: 9 rats - saline solution for 3 days	0.28 ± 0.05
		E.G.2: 7 rats - 10mg/Kg for 14 days	0.23 ± 0.07
		C.G.2: 7 rats - saline solution for 14 days	0.33 ± 0.12
	Gonzales et al. 2009GONZALES C, HOTOKEZAKA H, MATSUO K, SHIBAZAKI T, YOZGATIAN JH, DARENDELILER MA AND YOSHIDA M. 2009. Effects of steroidal and nonsteroidal drugs on tooth movement and root resorption in the rat molar. Angle Orthod 79: 715-726.	E.G.1: 5 rats - 16mg/Kg	0.16 ± 0.02
		E.G.2: 5 rats - 3.2mg/Kg	0.20 ± 0.02
		C.G.: 5 rats - no drugs	0.28 ± 0.02
Rofecoxib	De Carlos et al. 2006	E.G.1: 7 rats - 2mg/Kg (group under orthodontic force of 50 g)	No movement
		C.G.1: 7 rats - 0.9% saline solution (group under orthodontic force of 50g)	0.43 ± 0.13
		E.G.2: 7 rats - 2 mg/Kg (group under orthodontic force of 100g)	0.19 ± 0.13
		C.G.2: 7 rats - saline solution (group under orthodontic force of 100g)	0.72 ± 0.14
	De Carlos et al. 2007	E.G.: 5 rats - 0.5mg/Kg	No movement
	De Carlos et al. 2007	C.G.: 12 rats - saline solution	0.33 ± 0.07
Parecoxib	De Carlos et al. 2007	E.G.: 5 rats - 25mg/Kg	0.42 ± 0.09
Parecoxib	De Carlos et al. 2007	C.G.: 12 rats - saline solution	0.33 ± 0.07
Sodium diclofenac	De Carlos et al. 2006	E.G.1: 7 rats - 10mg/Kg (group under orthodontic force of 50g)	No movement
		C.G.1: 7 rats - saline solution (group under orthodontic force of 50g)	0.43 ± 0.13
		E.G.2: 7 rats - 10mg/Kg (group under orthodontic force of 100g)	No movement
		C.G.2: 7 rats - saline solution (group under orthodontic force of 100g)	0.72 ± 0.14