Comparison of the effects of preemptive acetaminophen, ibuprofen, and meloxicam on pain after separator placement: a randomized clinical trial

BACKGROUND: This study aims to evaluate and compare the effect of pre-procedural administration of acetaminophen, ibuprofen, and meloxicam in reducing pain after separator placement. METHODS: Three hundred twenty-one patients who needed orthodontic treatment and aged above 15 were randomly assigned to one of the three study groups: group A: 650 mg acetaminophen, group B: 400 mg ibuprofen, and group C: 7.5 mg meloxicam. All subjects received a single dose of medication 1 h prior to separator placement. Using visual analog scale, patients recorded their pain perception during rest, fitting posterior teeth together, and chewing at time intervals of immediately, 2, 6, 24, and 48 h after separator placement. RESULTS: There was no significant difference between acetaminophen, ibuprofen, and meloxicam in post-separator placement pain control when administered 1 h before the procedure. In all the groups, at rest, pain level elevated after separator placement and reached its peak at 24 h and then subsided until 48 h. But during chewing and fitting of the posterior teeth, some of the groups reached a peak in pain at 48 h. No significant difference was found in pain experience between males and females. CONCLUSIONS: Meloxicam can be used as an effective analgesic in orthodontic pain control considering it has less gastric side effects compared to the conventional nonsteroidal anti-inflammatory drugs. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2015041821828N1