title: Efficacy of Ibuprofen and ibuprofen/acetaminophen on postoperative pain in symptomatic patients with a pulpal diagnosis of necrosis.
abstract: BACKGROUND
  The purpose of this prospective, randomized, double-blind study was to determine ibuprofen versus ibuprofen/acetaminophen use for postoperative endodontic pain in symptomatic patients with a pulpal diagnosis of necrosis and an associated periapical radiolucency who were experiencing moderate to severe preoperative pain. We also recorded escape medication use.
  
  
  METHODS
  Seventy-one adult patients presenting for emergency endodontic treatment with a symptomatic maxillary or mandibular tooth with a pulpal diagnosis of necrosis, periapical radiolucent area, and moderate to severe pain participated in this study. The patients were randomly divided into 2 groups by random assignment and numeric coding. An emergency debridement of the tooth was completed with hand and rotary instrumentation. At the end of the appointment, the patients randomly received capsules of either 600 mg ibuprofen or 600 mg ibuprofen combined with 1000 mg acetaminophen (blinded to both operator and patient). Patients also received a 6-day diary to be completed after anesthesia wore off and every morning for 5 days. Patients were asked to record pain, symptoms, and the number of capsules taken. Patients received escape medication (Vicodin) if the study medication did not control their pain. Postoperative data were analyzed by randomization test and step-down Bonferroni method of Holm.
  
  
  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 2 groups for analgesic use or escape medication use. Approximately 20% of patients in both groups required escape medication to control pain.
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio, USA.
authors.forename: L Kevin
authors.initials: LK
authors.lastname: Wells
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D002133:Calcium Sulfate / Q000627:therapeutic use; D003738:Dental Cements / Q000627:therapeutic use; D003790:Dental Pulp Necrosis / Q000628:therapy*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006853:Hydrocodone / Q000627:therapeutic use; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008499:Medical Records; D010149:Postoperative Pain / Q000188:drug therapy*; D010483:Periapical Diseases / Q000628:therapy; D011145:Polyvinyls / Q000627:therapeutic use; D011446:Prospective Studies; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D015034:Zinc Oxide / Q000627:therapeutic use
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003738:Dental Cements; D004338:Drug Combinations; D011145:Polyvinyls; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; C083640:acetaminophen, hydrocodone drug combination; D000082:Acetaminophen; C020872:Cavit; D006853:Hydrocodone; D015034:Zinc Oxide; D002133:Calcium Sulfate; D007052:Ibuprofen