Effectiveness of prophylactic use of rofecoxib in comparison with ibuprofen on postendodontic pain

The purpose of this study was to determine if prophylactic rofecoxib would significantly reduce postendodontic pain, when compared with ibuprofen or placebo. An additional objective was to establish if any relationship exists between periapical diagnosis and the need for additional medication after completion of pulpectomy. A total of 45 patients consented to a double-blind, single-dose oral administration of 50 mg of rofecoxib, 600 mg of ibuprofen, or a placebo before conventional root canal therapy. The root canal treatment was performed in two appointments. Patient-reported visual analog scale ratings of pain intensity were conducted upon initial clinical presentation and at 4, 8, 12, 24, 48, and 72 h after completion of pulpectomy. Results showed that at the 4- and 8-h periods, both rofecoxib and ibuprofen provided significantly better pain relief than placebo. At the 12- and 24-h periods, rofecoxib demonstrated significantly better pain relief than both ibuprofen and placebo. Patients with a periapical diagnosis of acute apical periodontitis showed a significantly increased need for additional medication after completion of pulpectomy compared with all other periapical diagnoses.