Ibuprofen superior to paracetamol for pain relief following the third molar removal

• Risk ratio (RR) for at least 50% pain relief (based on TOTPAR) at six hours was 1.47 favouring 400 mg ibuprofen over 1000 mg paracetamol, RR for not using rescue medication (also favouring ibuprofen) was 1.50

• For combined drug RR for at least 50% of the maximum pain relief over six hours of 1.77 (paracetamol 1000 mg and ibuprofen 400 mg) (one trial; moderate quality evidence).

• RR not using rescue medication 1.60 (two trials; moderate quality evidence).

• Adverse events were comparable between the treatment groups, but no formal analysis could be undertaken.

There is high quality evidence that ibuprofen is superior to paracetamol at doses of 200 mg to 512 mg and 600 mg to 1000 mg respectively based on pain relief and use of rescue medication data collected at six hours postoperatively. The majority of this evidence (five out of six trials) compared ibuprofen 400 mg with paracetamol 1000 mg, these are the most frequently prescribed doses in clinical practice. The novel combination drug is showing encouraging results based on the outcomes from two trials when compared to the single drugs.

Reference:

Ferraiolo, D., Veitz-Keenan, A. Ibuprofen is superior to paracetamol for pain relief following third molar removal. Evid Based Dent 15, 106–107 (2014). https://doi.org/10.1038/sj.ebd.6401059