The Effect Of Meloxicam and Mefenamic Acid Premedication on Pain Experience In Orthodontic Patients

Asem A. M. Abdaljawwad, Zena Hekmat Al_Taee, Lamia Ibrahim Sood

Abstract


Background: One of the side effects of orthodontic treatment is pain this lead to discourage patients from treatment. The aim of this study to estimate and compare the effect of preoperative use of Meloxicam and Mefenamic acid drug on pain experienced after separator placement in orthodontic patients.
Materials and Methods: Thirty patients aged between 17 and 26 years who claimed to undergo orthodontic treatment with fixed appliance were participate in this double-blind, prospective study. They were randomly distributed into three experimental groups, 10 for each group as follow: group A; administration of starch capsules, group B; administration of 500 mg mefenamic acid, and group C; administration of 7.5 mg meloxicam; medications were administered 1 hour before separator placement. The pain was recorded by the patients on a linear and graded Visual Analogue Scale (VAS) at time intervals of 2 hours, 6 hours, nighttime on the day of appointment, 24 hours after the appointment, and 48 hours after the appointment during each of these four activities: (chewing, biting, fitting front teeth, and fitting back teeth).

Result: The results of ANOVA reveal high significant differences between the three experimental groups at all time intervals and during all four activities (P < .05). LSD comparisons reveal high significant differences between placebo, mefenamic acid, and meloxicam groups (P < .05) the lowest pain was reported by the meloxicam group, and the highest one in placebo group. Conclusion:

- The use of 7.5 mg meloxicam tab or drug as a single dose 1 hour preoperatively only is highly recommended for pain control after separator placement.
-The pain begins at the moment of separator placement and reaches its peak in 24 hours and then, gradually decreases until the 48 hours. 


Keywords


Orthodontic pain; Mefenamic acid; Meloxicam

Full Text:

PDF

References


Scheurer P, Firestone A, Burgin W.Perception of pain as a result of Orthodontic treatment with fixed appliances . Eu r J or t h o d .1996; 18:349-357.

Oliver R, Knapman YM. Attitudes to Orthodontic treatment. Br J Orthod.1985; 12:179-188.

Kapoor P., SinghH., Ghai G. and Ghai G.Perception Of Pain And Discomfort From Three Types Of Orthodontic Separators. Indian Journal of Dental Sciences.2013 ;( 5): 2231-2293

Krishnan V. Orthodontic pain: from cause to management—a review. Eur J Orthod. 2007; 29:170–79.

Furstman L, Bernik S. Clinical considerations of the periodontium. Am J Orthod. 1972; 61:138–55. 6. Najafi H., Oshagh M. , Salehi P., Babanouri N. and

Torkan S. Comparison of the effects of preemptive acetaminophen, ibuprofen, and meloxicam on pain after separator placement: a randomized clinical trial Progress in orthodontics. 2015; 16-34.

Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1989;96:47–53.

Brown DF, Moerenhout RG. The pain experience and psychological adjustment to orthodontic treatment of preadolescents, adolescents, and adults. Am J Orthod Dentofacial Orthop. 1991;100:394–56.

Jones ML, Chan C. Pain in the early stages of orthodontic treatment. J Clin Orthod 1992;26:311-3.

Dionne RA, Berthold CW. Therapeutic uses of non-steroidal anti-inflammatory drugs in dentistry. Crit Rev Oral Biol Med. 2001;12:315–30.

Jackson LM, Hawkey CJ. COX-2 selective nonsteroidal anti- inflammatory drugs, do they really offer any advantages? Drugs. 2000;59:1207–16.

Bruno MB, Bruno MA, Krymchantowski AV, da Motta AF, Mucha JN. A double-blind, randomized clinical trial assessing the effects of a single dose of preemptive anti- inflammatory treatment in orthodontic pain. Prog Orthod. 2011;12:2–7.

Euller-Ziegler L, Velicitat P, Bluhmki E, Turcy D, Scheuerer S, Combe B. Meloxicam: a review of its pharmacokinetics; efficacy and tolerability following intramuscular administration. Inflamm Res. 2001;50: 5–9.

Calvo AM, Sakai VT, Giglio FPM, Modensa KCS, Colombini BL, Benetello V, et al. Analgesic and anti- inflammatory dose-response relationship of 7.5 and 15 mg meloxicam after lower third molar removal: a double blind, randomized, crossover study. Int J Oral MaxillofacSurg. 2007;36:26–31.

Aoki A, Yamaguchi H, Naito H, Shiiki K, Izawa K, Ota Y, et al. Premedication with cyclooxygenase-2 inhibitor meloxicam reduced postoperative pain in patients after oral surgery. Int J Oral Maxillofac Surg. 2006;35:613–17.

Nekoofar MH, Sadeghipanah M, Dehpuor AR. Evaluation of meloxicam (a Cox-2 inhibitor) for management of postoperative endodontic pain: a double-blind placebo- controlled study. J Endod. 2003;29:634–37.

Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther. 1983; 34:234–239.)

Dionne RA, Cooper S. Evaluation of preoperative ibuprofen for postoperative pain after removal of third molars. Oral Surg Oral Med Oral Pathol 1978;45:851-6.

Dionne RA, Campbell RA, Cooper SA, Hall DL, Buckingham B. Suppression of postoperative pain by preoperative administration of ibuprofen in comparison to placebo,acetaminophen, and acetaminophen plus codeine. J Clin Pharmacol 1983;23:37-43.

Furst DE, Munster T. Nonsteroidal anti-inflammatory drugs, disease modifying anti rheumatic drugs, non-opioid analgesics and drugs used in gout. In: Katzung BG, editor. Basic and Clinical Pharmacology; 2001;8: 596-624.

Bergius M, Berggren U, Kiliaridis S. Experience of pain during an orthodontic procedure. Eur J Oral Sci. 2002;110: 92–98.

Steen Law SL, Southard KA, Law AS, Logan HL, Jakobsen JR. An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement. Am J Orthod Dentofacial Orthop. 2000;118:629–35.

Effectiveness of piroxicam and ibuprofen premedication on orthodontic patients’ pain experiences a randomized control trial. Angle Orthod. 2011; 81:1097-1102.

Bernhardt MK, Southard KA, Batterson KD, Logan HL, Baker KA, Jakobsen JR. The effect of preemptive and/or postoperative ibuprofen therapy for orthodontic pain. Am J Orthod Dentofacial Orthop. 2001;120:20–7.

Ngan P, Wilson S, Shanfeld J, Amini H. The effect of ibuprofen on the level of discomfort in patient undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1994;106:88–95.

Farzanegan F, Zebarjad SM, Alizadeh S, Ahrari F. Pain reduction after initial arch wire placement in orthodontic patients. Am J Orthod Dentofacial Orthop. 2012;141:169– 73.

Young AN, Taylor RW, Taylor SE, Linnebur SA, Buschang PH. Evaluation of preemptive valdecoxibthrapy on initial arch wire placement discomfort in adults. Angle Orthod. 2006;76:251–59.

Walker JB, Buring SM. NSAID impairment of orthodontic tooth movement. Ann Pharmacother. 2001;35:113–115.

Kehoe MJ, Cohen SM, Zarrinnia K, Cowan A. The effect of acetaminophen, ibuprofen, and misoprostol on prostaglandin E2 synthesis and the degree and rate of orthodontic tooth movement. Angle Orthod. 1996;66:339– 349.

Proffit WR. Contemporary Orthodontics, 3rd ed. St Louis, Mo: Mosby; 2000:280–281.

Fleischmann R, Iqbal I, Slobodin G. Meloxicam. Expert Opin Pharmacother. 2002;3:1–12.

Asghar W, Jamali F. The effect of COX-2 selective meloxicam on myocardial, vascular and renal risks: a systemic review. Inflammopharmacology. 2015;23:1–16.




DOI: http://dx.doi.org/10.26477/idj.v38i3.100

Refbacks

  • There are currently no refbacks.