Evaluating the efficacy of a single preemptive dose of ketorolac or paracetamol for managing orthodontic procedure pain in adolescents – A randomized controlled trial
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.
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BibTeX
@article{joshi2026evaluating,
title = {{Evaluating the efficacy of a single preemptive dose of ketorolac or paracetamol for managing orthodontic procedure pain in adolescents – A randomized controlled trial}},
author = {Yatishkumar S. Joshi and Disha Limbraj Khandade and Suresh K. Kangane and Pravinkumar S. Maroore and Ganesh Dange and Arsalan Shaikh and Swathilekshmi Nair},
journal = {SRM Journal of Research in Dental Sciences},
year = {2026},
month = jul,
doi = {10.4103/srmjrds.srmjrds_18_26},
url = {https://doi.org/10.4103/srmjrds.srmjrds_18_26},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Evaluating the efficacy of a single preemptive dose of ketorolac or paracetamol for managing orthodontic procedure pain in adolescents – A randomized controlled trial
AU - Yatishkumar S. Joshi
AU - Disha Limbraj Khandade
AU - Suresh K. Kangane
AU - Pravinkumar S. Maroore
AU - Ganesh Dange
AU - Arsalan Shaikh
AU - Swathilekshmi Nair
PY - 2026
DA - 2026/07/01
JO - SRM Journal of Research in Dental Sciences
DO - 10.4103/srmjrds.srmjrds_18_26
UR - https://doi.org/10.4103/srmjrds.srmjrds_18_26
AB - 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.
SN - 2772-5243
SN - 2772-5251
ER -