Does long-term use of pain relievers have an impact on the rate of orthodontic tooth movement? A systematic review of animal studies

Pain relief drugs are used and misused widely and may theoretically affect the events leading to orthodontic tooth movement. To systematically investigate and appraise the quality of the available evidence regarding the effect of pain relief medications on the rate of orthodontic tooth movement. Search without restrictions in eight databases (including grey literature) and hand searching until October 2018. Animal controlled studies investigating the effect of pain relievers on the rate of orthodontic tooth movement. Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE's risk of bias tool. Fourteen studies were finally identified, most of which at unclear risk of bias. Ibuprofen and loxoprofen did not show any significant effects on the rate of orthodontic tooth movement, whereas indomethacin, ketorolac, morphine, and high doses of etoricoxib were found to decrease it. Inconsistent or conflicting effects were noted after the administration of acetaminophen, acetylsalicylic acid, celecoxib, meloxicam, and tramadol. The quality of the available evidence was considered at best as low. Long-term consumption of pain relievers may affect the rate of orthodontic tooth movement. The orthodontist should be capable of identifying patients taking pain relievers independently of orthodontic treatment and consider the possible implications. PROSPERO (CRD42017078208).