Efficacy of Ibuprofen and ibuprofen/acetaminophen on postoperative pain in
symptomatic patients with a pulpal diagnosis of necrosis.
Author(s): Wells LK, Drum M, Nusstein J, Reader A, Beck M.
Affiliation(s): Division of Endodontics, The Ohio State University, Columbus, Ohio, USA.
Publication date & source: 2011, J Endod. , 37(12):1608-12
INTRODUCTION: The purpose of this prospective, randomized, double-blind study was
to determine ibuprofen versus ibuprofen/acetaminophen use for postoperative
endodontic pain in symptomatic patients with a pulpal diagnosis of necrosis and
an associated periapical radiolucency who were experiencing moderate to severe
preoperative pain. We also recorded escape medication use.
METHODS: Seventy-one adult patients presenting for emergency endodontic treatment
with a symptomatic maxillary or mandibular tooth with a pulpal diagnosis of
necrosis, periapical radiolucent area, and moderate to severe pain participated
in this study. The patients were randomly divided into 2 groups by random
assignment and numeric coding. An emergency debridement of the tooth was
completed with hand and rotary instrumentation. At the end of the appointment,
the patients randomly received capsules of either 600 mg ibuprofen or 600 mg
ibuprofen combined with 1000 mg acetaminophen (blinded to both operator and
patient). Patients also received a 6-day diary to be completed after anesthesia
wore off and every morning for 5 days. Patients were asked to record pain,
symptoms, and the number of capsules taken. Patients received escape medication
(Vicodin) if the study medication did not control their pain. Postoperative data
were analyzed by randomization test and step-down Bonferroni method of Holm.
RESULTS AND CONCLUSIONS: 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 2 groups for analgesic use or
escape medication use. Approximately 20% of patients in both groups required
escape medication to control pain.
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