Evaluating the efficacy of a single preemptive dose of ketorolac or paracetamol for managing orthodontic procedure pain in adolescents – A randomized controlled trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: ABSTRACT Background: Orthodontic pain is an expected consequence of orthodontic tooth movement and may affect patient compliance and quality of life. Preemptive analgesia has been proposed as a strategy to reduce procedure-related discomfort. Aim: The study aimed to evaluate the efficacy of a single preemptive oral dose of ketorolac or paracetamol in reducing pain associated with routine orthodontic archwire activation compared with placebo. Materials and Methods: This double-blind, crossover randomized controlled trial included 50 adolescents undergoing fixed orthodontic treatment. Participants received ketorolac (10 mg), paracetamol (500 mg), and placebo at three separate appointments in randomized order with a 1-month washout period. Pain was assessed using a Visual Analog Scale after activation at 0, 6, 24, and 48 h. Repeated measures analysis of variance was used for analysis. Results: Pain levels varied significantly over time ( P < 0.001), peaking at 24 h. No significant difference was observed among ketorolac, paracetamol, and placebo groups ( P > 0.05). The younger patients (14 and 15 years) experienced lower discomfort immediately after the procedure compared to older (16 and 17 years) age groups. Individuals with McLaughlin–Bennett–Trevisi (MBT) brackets experienced significantly more discomfort than those with self-ligating brackets. Conclusion: A single preemptive dose of ketorolac or paracetamol does not provide superior pain relief compared with placebo during orthodontic archwire activation. Hence, routine preemptive dosage of analgesia is not warranted.
Institution: Maharashtra Institute of Dental Science and Research
Language: English
Subfield: Orthodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213243578