Colceriu-Șimon Ioana-Maria, Feștilă Dana, Emoke Hanțig, Pancsur Amelia, Șimon Mara Ștefania, Olteanu Cristian Doru, Păstrav Mihaela, Bunta Olimpia, Ghergie Mircea
Department of Orthodontics, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Department of Dental Propaedeutics and Aesthetics, Faculty of Dental Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
J Clin Med. 2025 Apr 23;14(9):2920. doi: 10.3390/jcm14092920.
Orthodontic treatment is commonly associated with pain, leading to reduced patient compliance and treatment adherence. Non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing this pain by inhibiting prostaglandin synthesis. However, this mechanism may also interfere with orthodontic tooth movement (OTM) by affecting bone remodeling. This narrative review investigates the existing literature published between 2004 and 2024 to assess the impact of various NSAIDs on OTM and identify those that balance pain relief with minimal impact on tooth movement. Evidence shows that NSAIDs such as aspirin, ketorolac, diclofenac, and nimesulide significantly reduce OTM. The results for ibuprofen, meloxicam, and celecoxib were inconsistent with both no influence or a reduction in OTM, depending on dosage, mode, and duration of administration. Conversely, tenoxicam, nabumetone, etoricoxib, and parecoxib appear to have no effect on OTM. Among these, etoricoxib appears particularly promising due to its favorable gastrointestinal profile, high COX-2 selectivity, and negligible influence on OTM in clinical doses. However, the limited number of human trials highlights the need for further research to develop evidence-based guidelines for pain management that preserve treatment efficiency in orthodontics.
正畸治疗通常与疼痛相关，导致患者的依从性和治疗坚持性降低。非甾体抗炎药（NSAIDs）通过抑制前列腺素合成有效减轻这种疼痛。然而，这种机制也可能通过影响骨重塑而干扰正畸牙齿移动（OTM）。本叙述性综述调查了2004年至2024年间发表的现有文献，以评估各种NSAIDs对OTM的影响，并确定那些在缓解疼痛与对牙齿移动影响最小之间取得平衡的药物。证据表明，阿司匹林、酮咯酸、双氯芬酸和尼美舒利等NSAIDs会显著减少OTM。布洛芬、美洛昔康和塞来昔布的结果不一致，根据给药剂量、方式和持续时间，对OTM既无影响，也有减少的情况。相反，替诺昔康、萘丁美酮、依托考昔和帕瑞昔布似乎对OTM没有影响。其中，依托考昔因其良好的胃肠道特性、高COX - 2选择性以及临床剂量下对OTM的影响可忽略不计而显得特别有前景。然而，人体试验数量有限，这突出表明需要进一步研究，以制定基于证据的疼痛管理指南，从而在正畸治疗中保持治疗效果。
