Will adding acetaminophen (paracetamol) to ibuprofen be more effective in relieving postoperative pain on symptomatic necrotic teeth?

Methods: Randomised controlled trial Methods: Patients with a clinical diagnosis of a symptomatic tooth with a pulpal diagnosis of necrosis and moderate to severe pain at the time of treatment were randomised to either 80 capsules of 150mg ibuprofen or 80 capsules of 150mg ibuprofen/250mg acetaminophen. Patients were to take four capsules every six hours. Escape medication (hydrocodone/acetaminophen) was also available; if patients had significant swelling or fever, they were seen clinically. Patients' preoperative pain was assessed on the/a visual analogue scale (VAS). Patients also received a six-day diary to be completed after anaesthesia wore off and every morning for five days, to record pain, symptoms and the number of capsules taken. Methods: The main outcome measures were pain and medication use.

Results: No significant differences were found between the two groups.

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 two groups for analgesic use or escape medication use. Approximately 20% of patients in both groups required escape medication to control pain.