A recent study found that the combination of acetaminophen (APAP) and a new formulation of ibuprofen, also called as ibuprofen sodium dihydrate (ISD), does not improve pain relief for patients with severe dental pain linked to apical periodontitis when compared to ISD alone. The critical findings were published in the Journal of Endodontics.

This double-blind, randomized study included a total of 64 adult patients presenting at an emergency dental service with acute symptoms of irreversible pulpitis or necrosis, as well as symptomatic apical periodontitis associated with a severe form of dental pain. Each participant was assigned to receive a single dose of either 768 mg of ISD combined with 1000 mg of APAP or 768 mg of ISD alone.

The study utilized the Heft-Parker Visual Analogue Scale (VAS) to evaluate the effectiveness of these treatments. Assessments were recorded every 15 minutes over a four-hour period following medication. This research also tracked the time to the first sign of pain relief, time to meaningful pain relief and time to achieve 50% pain reduction.
The findings revealed that both treatment groups underwent a significant reduction in pain within the first two hours following medication administration. However, after 120 minutes, the decrease in pain levels plateaued, with no substantial differences noted between the two groups in terms of VAS scores at any time point or in the recorded times to pain relief milestones.

The results of this study are particularly significant as they challenge the common practice of combining ibuprofen with acetaminophen for more effective pain management. ISD which is a newer formulation of ibuprofen is designed to be absorbed more quickly could potentially offer faster pain relief. This study suggests that ISD alone is equally effective as when combined with acetaminophen for treating severe dental pain associated with apical periodontitis.
The benefits of these findings are considerable for clinical practices in settings where rapid pain relief is paramount. The clinicians may consider simplifying their pain management strategies for endodontic conditions by potentially reducing medication intake for patients without compromising the efficacy. Further research may explore different combinations or dosages, but this study adds pivotal knowledge to the field of pain management in dental care by suggesting that simpler may be just as effective.
Reference:
Palya, M., Chevere, J. M., Drum, M., Fowler, S., Nusstein, J., Reader, A., & Ni, A. (2024). Pain Reduction of Ibuprofen Sodium Dihydrate Alone and in Combination with Acetaminophen in an Untreated Endodontic Pain Model: A Randomized, Double-blind Investigation. In Journal of Endodontics. Elsevier BV. https://doi.org/10.1016/j.joen.2024.04.005