A Meta-Analysis of the Analgesic Efficacy of Single-Doses of Ibuprofen Compared to Traditional Non-Opioid Analgesics Following Third Molar Surgery

The purpose of this systematic review was to determine the analgesic efficacy and adverse effects of ibuprofen in comparison with other traditional non-opioid analgesics after third molar surgery. A total of 17 full texts were identified in PubMed and assessed using the Cochrane Collaboration’s risk of bias tool by two independent researchers. The sum of pain intensity differences, total pain relief, the overall evaluation, the number of patients requiring rescue analgesics, and adverse effects were collected. Data were analyzed using the Review Manager Software 5.3. for Windows. A total of 15 articles met the criteria. The qualitative and quantitative analysis showed that ibuprofen is more effective to relieve post-operative dental pain than acetaminophen, meclofenamate, aceclofenac, bromfenac, and aspirin. Moreover, ibuprofen and traditional non-steroidal anti-inflammatory drugs have a similar safety profile. In conclusion, ibuprofen 400 mg appears to have good analgesic efficacy and a safety profile similar to other traditional non-steroidal anti-inflammatory drugs after third molar surgery.

. Features summary of the high-quality studies. Single-dose study.
All treatments were administered using the oral route.
Healthy patients.
Assessment period was 6 h.
A mandibular third molar Single-dose study.
All treatments were administered using the oral route.
Healthy patients.
Assessment period was 6 h. Single-and multi-dose study.
Good health patients. Single-dose study.
Patients without clinical significand condition.
One to four third molar extractions.
Patients were evaluated during 8 h after surgery.
Similar frequency of adverse effects were observed in all groups.
Bromfenac 100 mg was more effective than ibuprofen.
Single-and multi-dose study.
Patients with good health.
One or more third molar surgeries.
Patients were evaluated 8 h following surgery.
Pain intensity evaluation, Single-and multi-dose study.
Group D: Placebo.
Patients with good health.
One or more third molar surgeries.
Patients were evaluated 6 h following surgery. Single-dose study.
Patients ASA I and II.
A third molar extraction. Single-dose study.
Healthy patients.
One or more third molar surgeries.
Patients with sufficient mental status to complete the assessment A third molar surgery.
Trial duration was 1 hour.
Pain was evaluated using VAS and the verbal scale.
PID and SPID were calculated.
There was no difference between treatment groups.
Metamizol 2000 mg was superior to ibuprofen and placebo for control of pain after surgery. Seymour et al., 1998. Randomized, double-blind, parallel, clinical trial.
Single-dose study.

Healthy patients or patients
with controlled systemic disease.
One or more third molar extractions.
Patients were evaluated 6 hours following surgery.
AUC pain, AUC pain relief, scape analgesic intake, and overall evaluation.
There was no difference between treatment groups.
Ibuprofen was better analgesic than aceclofenac for management of pain after oral surgery. Seymour et al., 2000. Randomized, double-blind, parallel, clinical trial.
Single-dose study.
One or more third molar removal.
Patients were evaluated 6 hours following surgery.
Similar number of adverse effects were recorded.
Ketoprofen was better than ibuprofen for control of pain. Table S2. Meta-analytical evaluation of the sum of pain intensity differences at 2 and 6 post-surgical hours.

Total Pain Relief at 4 Post-Operative Hours
Ibuprofen 200 mg versus ketoprofen 12.5 mg