Will adding acetaminophen (paracetamol) to ibuprofen be more effective in relieving postoperative pain on symptomatic necrotic teeth?

Abstract

Randomised controlled trial Patients with a clinical diagnosis of a symptomatic tooth with a pulpal diagnosis of necrosis and moderate to severe pain at the time of treatment were randomised to either 80 capsules of 150mg ibuprofen or 80 capsules of 150mg ibuprofen/250mg acetaminophen. Patients were to take four capsules every six hours. Escape medication (hydrocodone/acetaminophen) was also available; if patients had significant swelling or fever, they were seen clinically. Patients' preoperative pain was assessed on the/a visual analogue scale (VAS). Patients also received a six-day diary to be completed after anaesthesia wore off and every morning for five days, to record pain, symptoms and the number of capsules taken. The main outcome measures were pain and medication use. No significant differences were found between the two groups. There were decreases in pain levels and analgesic use over time for the ibuprofen and ibuprofen/acetaminophen groups. There was no statistically significant difference between the two groups for analgesic use or escape medication use. Approximately 20% of patients in both groups required escape medication to control pain.