Addition of acetaminophen to ibuprofen fails to improve control of endodontic pain: Study

Most pain studies have been based on a postsurgical, third molar model using ibuprofen (IBU)/acetaminophen (APAP). Studies have found quicker onset of pain relief with a newer formulation of IBU - ibuprofen sodium dihydrate (ISD). The purpose of this study was to compare pain reduction of ISD/APAP to ISD in an acute endodontic pain model of untreated patients experiencing moderate to severe pain with symptomatic apical periodontitis. In this double-blind randomized study, 64 adult emergency patients in acute moderate to severe pain, a pulpal diagnosis of symptomatic irreversible pulpitis or necrosis, and symptomatic apical periodontitis participated. Each patient randomly received either one dose of 768 mg ISD/1000 mg APAP or one dose of 768 mg ISD. Pain intensity scores were recorded every 15 minutes over 240 minutes using the Heft-Parker VAS along with time to first sign of pain relief, time to meaningful pain relief, and time to 50% pain relief also recorded. The data were analyzed statistically. Results: Both ISD and ISD/APAP groups showed a progressive decrease in pain from baseline to 120 minutes after medication administration. Afterward, a relative plateau was seen in the patients’ pain. There was no difference in the VAS scores between the ISD and ISD/APAP at any given time point, time to first sign of pain relief, time to meaningful pain relief, and time to 50% pain relief. The addition of APAP to ISD for pain control in an untreated endodontic pain model did not differ significantly from ISD alone.

Reference:

Palya M, Chevere JM, Drum M, Fowler S, Nusstein J, Reader A, Ni A. Pain Reduction of Ibuprofen Sodium Dihydrate Alone and in Combination with Acetaminophen in an Untreated Endodontic Pain Model: A Randomized, Double-blind Investigation. J Endod. 2024 Apr 23:S0099-2399(24)00231-0. doi: 10.1016/j.joen.2024.04.005. Epub ahead of print. PMID: 38657900.

Keywords:

Addition, acetaminophen, ibuprofen, fails, improve, control, endodontic pain, study, Acetaminophen, endodontic pain, ibuprofen sodium dihydrate, journal of endodontics, Palya M, Chevere JM, Drum M, Fowler S, Nusstein J, Reader A, Ni A