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Comparison between Acetaminophen, Ibuprofen, and Ketorolac as an Efficient Single-Dose Preoperative Medication for Control of Pain Associated with Initial Aligning Archwire: A Double-Blind Randomized Control Trial

Background: Pain regulation is an issue of utmost importance for an orthodontist and a patient that undergoes orthodontic treatment. This is mainly because there is no set standard for controlling pain during orthodontic treatment. Objectives: The aim of the present study is to compare the efficacy of commonly prescribed drugs, acetaminophen, ibuprofen, and ketorolac on relieving orthodontic pain. Materials and Methods: A sample of 80 orthodontic patients scheduled to undergo fixed orthodontic treatment were selected and allocated (block randomized) into four experimental groups of 20 patients each, of which Group 1 was prescribed acetaminophen (500 mg), while Groups 2–4 were prescribed ibuprofen (400 mg), ketorolac (10 mg), and placebo (lactose capsule), respectively. All the prescriptions were given as a single-dose preoperatively. Each patient was thereafter asked to note the degree of pain perceived at specific intervals of time with reference to a questionnaire and a 100-mm visual analog scale. Statistical Analysis: Data comparison was done by applying the analysis of variance test to compare each group for every experimental parameter. To further elucidate the individual comparisons between each time point, the Tukey's test was used as post hoc analysis. Results: There were significant relationships between the four drug groups for each parameter, namely chewing, biting, occluding on anterior teeth together, and occluding on posterior teeth together (P < 0.05). Conclusion: The present study concluded that, when compared with the placebo group, the use of (nonsteroidal anti-inflammatory drugs) ketorolac, ibuprofen, and acetaminophen preoperatively reduced the pain perceived at 2 hours and 6 hours after archwire placement. However, the results were much significant for the ketorolac group as compared with the ibuprofen and acetaminophen groups. Trial Registration: Clinical Trials Registry-India CTRI/2017/03/007995.