Non-Cochrane · intervention · PM42010949
Effectiveness of acetaminophen in comparison with ibuprofen for pain control in orthodontic patients: A systematic review and meta-analysis.
Neves Nycole Mariana, Rodrigues Ádelin Olívia Lopes Joly, Bordin Giuliana Martina, et al. · Korean journal of orthodontics · 2026 · PubMed · doi:10.4041/kjod25.273
Findings
Population Patients undergoing orthodontic tooth movement (fixed appliances or separators; ages 9 to 30 years)
11 findings
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain at rest (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients | MD 0.11 [-0.38, 0.6] 0.11 [-0.38, 0.6] VAS points (0 to 10) Moderate Downgraded: risk of bias 3 studies · 206 participants |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 6 hours · University, hospital and private clinic orthodontic patients | MD -0.25 [-1.09, 0.59] -0.25 [-1.09, 0.59] VAS points (0 to 10) Moderate Downgraded: risk of bias 3 studies · 207 participants |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients · Leave-one-out sensitivity analysis: excluding Polat and Karaman (2005) | MD 0.36 [-1.25, 1.98] GRADE not reported 3 studies |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients · Leave-one-out sensitivity analysis: excluding Zarif Najafi et al. (2015) | MD 0.23 [-1.68, 2.15] GRADE not reported 3 studies |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients | MD 0.01 [-1.36, 1.38] 0.01 [-1.36, 1.38] VAS points (0 to 10) Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 237 participants |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients · Medication protocol: before and after the procedure | MD 0.35 [-2.42, 3.12] GRADE not reported 2 studies · 70 participants |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients · Leave-one-out sensitivity analysis: excluding Tunçer et al. (2014) | MD -0.66 [-1.49, 0.17] GRADE not reported 3 studies |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 48 hours · University, hospital and private clinic orthodontic patients | MD -0.69 [-1.44, 0.06] -0.69 [-1.44, 0.06] VAS points (0 to 10) Moderate Downgraded: risk of bias 4 studies · 237 participants |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients · Medication protocol: before the procedure | MD -0.53 [-1.46, 0.41] GRADE not reported 2 studies · 167 participants |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain during chewing (VAS 0 to 10) 24 hours · University, hospital and private clinic orthodontic patients · Leave-one-out sensitivity analysis: excluding Keith and Bollen (2019) | MD 0.05 [-1.62, 1.72] GRADE not reported 3 studies |
| Acetaminophen (paracetamol) for pain control | Ibuprofen for pain control | Pain at rest (VAS 0 to 10) 48 hours · University, hospital and private clinic orthodontic patients | MD -0.48 [-1.12, 0.17] -0.48 [-1.12, 0.17] VAS points (0 to 10) Moderate Downgraded: risk of bias 3 studies · 206 participants |
Included primary studies 13
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Hosseinzadeh Nik 2016 Acetaminophen Versus Liquefied Ibuprofen for Control of Pain During Separation in Orthodontic Patients: A Randomized Triple Blinded… PMID:27424011 | 2016 | 1 other review | not stated | not extracted yet |
| Polat 2005 Pain control during fixed orthodontic appliance therapy. PMID:15825785 | 2005 | 1 other review | Pain during chewing (VAS 0 to 10) | not extracted yet |
| Salmassian 2009 Comparison of the efficacy of ibuprofen and acetaminophen in controlling pain after orthodontic tooth movement. PMID:19361739 | 2009 | 1 other review | not stated | not extracted yet |
| Zarif Najafi 2015 Comparison of the effects of preemptive acetaminophen, ibuprofen, and meloxicam on pain after separator placement: a randomized clinical… PMID:26467790 | 2015 | 1 other review | Pain at rest (VAS 0 to 10); Pain during chewing (VAS 0 to 10) | not extracted yet |
| Abdaljawwad 2022 Effects of various analgesics on pain perception and rate of tooth movement: a randomized controlled clinical study DOI:10.26477/jbcd.v34i2.3144 | 2022 | this review only | not stated | not extracted yet |
| Bird 2007 Preoperative acetaminophen vs ibuprofen for control of pain after orthodontic separator placement. PMID:17920504 | 2007 | this review only | not stated | not extracted yet |
| Bradley 2007 A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain. PMID:17920505 | 2007 | this review only | not stated | not extracted yet |
| da Silva Santos 2021 Chewing gum as a non-pharmacological alternative for orthodontic pain relief: A randomized clinical trial using an intention-to-treat… PMID:34556589 | 2021 | this review only | Pain at rest (VAS 0 to 10) | not extracted yet |
| Keith 2019 NCT:03523988 | NR | this review only | Pain at rest (VAS 0 to 10); Pain during chewing (VAS 0 to 10) | not extracted yet |
| Ousehal 2009 [Comparison of the effect of paracetamol and ibuprofen on orthodontic pain]. PMID:20303910 | 2009 | this review only | not stated | not extracted yet |
| Patel 2011 Effects of analgesics on orthodontic pain. PMID:21195257 | 2011 | this review only | not stated | not extracted yet |
| Sudhakar 2014 The efficacy of different pre- and post-operative analgesics in the management of pain after orthodontic separator placement: A randomized… PMID:25210391 | 2014 | this review only | not stated | not extracted yet |
| Tunçer 2014 Effects of various analgesics on the level of prostaglandin E2 during orthodontic tooth movement. PMID:23882088 | 2014 | this review only | Pain during chewing (VAS 0 to 10) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| The effect of pharmacological and non-pharmacological interventions on pain control after orthodontic treatment: a systematic review and… (2026) | 4 | 0.05 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients of any sex or age undergoing orthodontic tooth movement (separators, coil springs, fixed appliances or aligners) | Orthodontic patients aged 9 to 30 years (13 trials) |
| Intervention | Acetaminophen for pain control | Acetaminophen 500 to 650 mg (13 trials) |
| Comparison | Ibuprofen (other comparison or placebo groups allowed) | Ibuprofen 200 to 400 mg (13 trials) |
| Outcomes | Pain measured by visual analog scale | Pain VAS at rest 24h and 48h (3 trials each); chewing 6h (3), 24h (4), 48h (4) |
| Study designs | Randomized or non-randomized clinical trials; no language or date restriction | 13 randomized clinical trials |
| Timing | Rest and chewing at 6, 24 and 48 hours | Rest 24h, 48h; chewing 6h, 24h, 48h |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Low | no |