Does long-term use of pain relievers have an impact on the rate of orthodontic tooth movement? A systematic review of animal studies

Abstract

Summary Background Pain relief drugs are used and misused widely and may theoretically affect the events leading to orthodontic tooth movement. Objective To systematically investigate and appraise the quality of the available evidence regarding the effect of pain relief medications on the rate of orthodontic tooth movement. Search methods Search without restrictions in eight databases (including grey literature) and hand searching until October 2018. Selection criteria Animal controlled studies investigating the effect of pain relievers on the rate of orthodontic tooth movement. Data collection and analysis Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE’s risk of bias tool. Results Fourteen studies were finally identified, most of which at unclear risk of bias. Ibuprofen and loxoprofen did not show any significant effects on the rate of orthodontic tooth movement, whereas indomethacin, ketorolac, morphine, and high doses of etoricoxib were found to decrease it. Inconsistent or conflicting effects were noted after the administration of acetaminophen, acetylsalicylic acid, celecoxib, meloxicam, and tramadol. The quality of the available evidence was considered at best as low. Conclusions Long-term consumption of pain relievers may affect the rate of orthodontic tooth movement. The orthodontist should be capable of identifying patients taking pain relievers independently of orthodontic treatment and consider the possible implications. Trial registration PROSPERO (CRD42017078208).

Do analgesics used for the pain experienced after orthodontic procedures affect tooth movement rate? A systematic review based on animal studies

“…Similar to analgesics consumption for extended periods, their short‐term use for pain relief following orthodontic procedures may also have an impact on the speed of tooth movement. Despite the fact that these results from animal studies should be seen cautiously, the clinician should not ignore the repercussions.…”

“…Recently, systematic reviews have elaborated on the potential effects of medication used for the relief of pain on orthodontic tooth movement and associated root resorption in experimental animals . Regarding the latter, root resorption was shown to decrease after administering ibuprofen and meloxicam in low doses.…”

“…According to the located studies, the rate of tooth movement was observed to decrease following the use of substances like ketorolac, indomethacin, morphine and etoricoxib in high doses. Non‐significant effects were found for loxoprofen and ibuprofen, whereas following the use of tramadol, celecoxib, aspirin, meloxicam and paracetamol, the results were conflicting or inconsistent …”

Pharmaka, Noxen und die Ernährung – welche anamnestische Relevanz haben sie für die kieferorthopädische Therapie?

“…Gängige Analgetika wie Aspirin und Ibuprofen, die als "Over-the-Counter"-Produkte rezeptfrei erhältlich sind und daher oft unkontrolliert eingenommen werden, können dabei die kieferorthopädische Therapie negativ beeinflussen. Zahlreiche tierexperimentelle und auch klinische Studien haben relativ übereinstimmend gezeigt, dass unselektive NSAID, zu denen Aspirin (ASS, Acetylsalicylsäure), Ibuprofen, Diclofenac und Indomethacin zählen, einen hemmenden Einfluss auf die kieferorthopädische Zahnbewegung haben [2,3], da sie durch Reduktion der Prostaglandinsynthese und des lokalen Entzündungsgeschehens im Par odont auch die Osteoklastogenese und damit die Knochenresorption beeinträchtigen, da der kieferorthopädischen Zahnbewegung auf molekular-zellulärer Ebene eine sterile pseudoinflammatorische Reaktion zugrunde liegt [4]. Zudem ist bekannt, dass unselektive NSAID bei regelmäßiger Einnahme mit zahlreichen unerwünschten Nebenwirkungen einhergehen, v. a. der Entwicklung einer Gastritis bis hin zu Magenulzera.…”

Could medications and biologic factors affect post‐orthodontic tooth movement changes? A systematic review of animal studies

“…As orthodontic tooth movement can be modulated by any substance administered that can have effects on the molecular pathways involved, 18,19 the potential impact of different medications on the rate of orthodontic tooth movement has been systematically reviewed previously, and various effects have been shown in animals 20‐23 . Effects in human subjects have also been documented 24,25 .…”