title: Controlling pain during orthodontic fixed appliance therapy with non-steroidal anti-inflammatory drugs (NSAID): a randomized, double-blinded, placebo-controlled study.
abstract: BACKGROUND
  Despite all the technological advances in orthodontics, orthodontic treatment still seems to involve some degree of discomfort and/or pain. Pain control during orthodontic therapy is of great concern to both orthodontists and patients. However, there has been limited research into controlling such pain.
  
  
  OBJECTIVE
  The purpose of this work was to assess patient-perceived pain following fixed orthodontic treatment and to evaluate the comparative analgesic efficacy of non-steroidal anti-inflammatory drugs for controlling pain.
  
  
  METHODS
  A total of 45 patients about to undergo fixed appliance orthodontic treatment were enrolled in this double-blind prospective study. Patients were evenly and randomly distributed in a blinded manner to one of three groups as follows: paracetamol/acetaminophen 500 mg thrice daily; placebo in the form of empty capsules; and etoricoxib 60 mg once daily. Drug administration began 1 h before initiating the bonding procedure and archwire placement, and given until the day 3. The pain perceived was recorded by the patients on a linear and graded Visual Analogue Scale at time intervals of 2 h after insertion of the appliance; 6 h thereafter and again at nighttime of the same day of the appointment; 24 h later and on the 2nd day at nighttime; 48 h after the appointment and on day 3 at nighttime.
  
  
  RESULTS
  Our results revealed that moderately intense pain is associated with routine orthodontic treatment, and that the amount of pain individuals perceive varies widely. We observed statistically significant differences in the pain control among the three groups, and that etoricoxib 60 mg proved most efficient.
  
  
  CONCLUSIONS
  Etoricoxib 60 mg is highly efficacious for controlling pain during fixed orthodontic appliance therapy.
authors.affiliation: Department of Oral Medicine and Radiology, Uttaranchal Dental and Medical Research Institute, Dehraduun, Uttarakhand, India, mudit_dentist@rediffmail.com.
authors.forename: Mudit
authors.initials: M
authors.lastname: Gupta
authors.forename: Srinivas
authors.initials: S
authors.lastname: Kandula
authors.forename: Sarala M
authors.initials: SM
authors.lastname: Laxmikanth
authors.forename: Shreyas S
authors.initials: SS
authors.lastname: Vyavahare
authors.forename: Satheesha B H
authors.initials: SB
authors.lastname: Reddy
authors.forename: Chanila S
authors.initials: CS
authors.lastname: Ramachandra
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005157:Facial Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D009967:Orthodontic Appliances / Q000009:adverse effects*; D009971:Orthodontics, Corrective / Q000009:adverse effects* / Q000295:instrumentation*; D010147:Pain Measurement / Q000187:drug effects; D015990:Placebo Effect; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal