Comparative Effectiveness of Paracetamol, Ibuprofen, and their Combination in Managing Post-Endodontic Treatment Pain

Although endodontic treatment is intended to eliminate long-term pain, pain after this treatment is commonly reported. Non-opioid analgesics like non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol, have been used with great success in treating patients with endodontic pain.

This study seeks to compare the effectiveness of doses of paracetamol, ibuprofen; each drug used alone, and a combination of both drugs in the management of post endodontic treatment pain.

A randomized placebo-controlled single-blind comparative study involving 80 patients who had endodontic treatment (instrumentation) was conducted by putting the patients into four groups of 20 patients each: paracetamol group, ibuprofen group, paracetamol + ibuprofen group, and placebo group. Numerical rating scale (NRS) was used to measure pain intensity at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5 and 6 h after drug administration. Inferential statistics included the Friedman's Test with Kruskal-Wallis H post-hoc test. Level of significance was set at 95% (p-value < 0.05).

Paracetamol was more effective compared to ibuprofen, the combination and placebo in the relief of post-endodontic pain within the first 2 h after administration of medications (p < 0.05). Ibuprofen + paracetamol combination showed a better relief of pain than ibuprofen alone within the first 2 h after administration but this was not statistically significant (p > 0.05).

Paracetamol significantly reduced post-endodontic pain better than ibuprofen and its combination with paracetamol within the first two hours.