title: Effectiveness of piroxicam and ibuprofen premedication on orthodontic patients' pain experiences.
abstract: OBJECTIVE
  To compare the effectiveness of preoperative administration of ibuprofen and piroxicam on orthodontic pain experienced after separator placement.
  
  
  METHODS
  Ninety patients aged between 13 years 9 months and 18 years 2 months who were to undergo fixed appliance orthodontic treatment were enrolled in this double-blind, parallel-arm, prospective study. Patients were evenly and randomly distributed to any of three experimental groups, as follows: (1) administration of placebo, (2) administration of 400 mg ibuprofen, and (3) administration of 20 mg piroxicam; medications were administered 1 hour before separator placement. The pain perceived was recorded by the patients on a linear and graded Visual Analogue Scale at time intervals of 2 hours; 6 hours; nighttime on the day of appointment; 24 hours after the appointment; and 2 days, 3 days, and 7 days after separator placement during each of the four activities (viz, chewing, biting, fitting front teeth, and fitting back teeth).
  
  
  RESULTS
  The results revealed that preoperative administration of 20 mg of piroxicam 1 hour prior to separator placement resulted in a significant decrease in pain levels at 2 hours, 6 hours, nighttime, and 24 hours and on the second and third days after separator placement, compared to patients on a placebo or ibuprofen.
  
  
  CONCLUSIONS
  Premedication with 20 mg of piroxicam results in significantly decreased pain experienced, compared to premedication with 400 mg of ibuprofen or placebo. Usage of 20 mg of piroxicam 1 hour prior to separator placement is recommended.
authors.affiliation: Department of Orthodontics & Dentofacial Orthopaedics, Hitkarini Dental College & Hospital, Jabalpur, India. sarvraj.kohli@gmail.com
authors.forename: Sarvraj Singh
authors.initials: SS
authors.lastname: Kohli
authors.forename: Virinder Singh
authors.initials: VS
authors.lastname: Kohli
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004311:Double-Blind Method; D005157:Facial Pain / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008297:Male; D009967:Orthodontic Appliances / Q000009:adverse effects*; D010147:Pain Measurement; D010894:Piroxicam / Q000627:therapeutic use*; D011292:Premedication; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D007052:Ibuprofen