Fang Jie, Li Yifei, Zhang Keke, Zhao Zhihe, Mei Li
From the State Key Laboratory of Oral Diseases (JF, KZ, ZZ, LM), West China Hospital of Stomatology; Department of Pediatric Cardiology (YL), West China Second University Hospital, Sichuan University, Chengdu, China; and Discipline of Orthodontics (LM), Department of Oral Sciences, Faculty of Dentistry, University of Otago, Otago, New Zealand.
Medicine (Baltimore). 2016 Apr;95(16):e3256. doi: 10.1097/MD.0000000000003256.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain during orthodontic treatments; however, the possible inhibition of orthodontic tooth movement (OTM) by NSAIDs has been debated. The aim of this study was to evaluate the influence of some commonly used NSAIDs on OTM during orthodontic treatments. A review of the literature identified relevant studies up to August 2014. A meta-analysis was performed following the guidelines of the Cochrane review group and the PRISMA statement. Studies were identified by searching PUBMED, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and the WHO Clinical Trials Registry Platform. Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1.Five studies, including 128 subjects and 3 main NSAIDs (celecoxib, acetaminophen, and aspirin), were included for quantitative synthesis and analysis. Celecoxib did not inhibit OTM except with middle-term use (2-3 weeks) (95% CI [-6.47 to -0.43], P = 0.03). Acetaminophen did not inhibit OTM except with long-term use (>1 month) and low-dose use (∼100 mg/kg per day), (95% CI [-2.96 to -0.78], P = 0.0008; 95%CI [-2.42, -0.46], P = 0.004; respectively). Aspirin was found to inhibit OTM (95%CI [-2.40 to -0.64], P = 0.0008). Our systematic review with meta-analysis suggests that aspirin might inhibit OTM in rat models, whereas the short-term (<1 week) use of celecoxib and acetaminophen for relieving orthodontic pain would not inhibit OTM. Well-designed human research should be completed before a solid conclusion can be reached.
非甾体抗炎药（NSAIDs）常用于缓解正畸治疗期间的疼痛；然而，NSAIDs对正畸牙齿移动（OTM）的潜在抑制作用一直存在争议。本研究的目的是评估正畸治疗期间一些常用NSAIDs对OTM的影响。检索截至2014年8月的文献以确定相关研究。按照Cochrane综述小组的指南和PRISMA声明进行荟萃分析。通过检索PUBMED、EMBASE、科学网、Cochrane对照试验中央注册库和世界卫生组织临床试验注册平台来识别研究。使用Revman 5.1.1在固定/随机效应模型中进行荟萃分析。纳入五项研究，包括128名受试者和3种主要NSAIDs（塞来昔布、对乙酰氨基酚和阿司匹林）进行定量合成和分析。除中期使用（2 - 3周）外，塞来昔布不抑制OTM（95%可信区间[-6.47至-0.43]，P = 0.03）。除长期使用（>1个月）和低剂量使用（约100 mg/kg/天）外，对乙酰氨基酚不抑制OTM（95%可信区间[-2.96至-0.78]，P = 0.0008；95%可信区间[-2.42，-0.46]，P = 0.004；分别）。发现阿司匹林抑制OTM（95%可信区间[-2.40至-0.64]，P = 0.0008）。我们的系统评价和荟萃分析表明，在大鼠模型中阿司匹林可能抑制OTM，而短期（<1周）使用塞来昔布和对乙酰氨基酚缓解正畸疼痛不会抑制OTM。在得出确凿结论之前，应完成精心设计的人体研究。
