Comparing the Efficacy of Celecoxib, Ibuprofen and Acetaminophen Codeine in Pain Relief after Impacted Lower Third Molar Surgery

Background and Nonsteroidal anti-inflammatory drugs such as ibuprofen are the most commonly used drugs for pain relief after impacted third molar surgery. Recently, new generation of these drugs have been introduced that act more selectively and have lower gastrointestinal side effects. To the best of our knowledge there are not enough studies about the effectiveness of these drugs. This study compared the efficacy of celecoxib with ibuprofen and acetaminophen codeine. A randomized clinical trial was conducted in 180 patients attending oral and maxillofacial surgery department affiliated to Tehran University of Medical Sciences. Patients were divided into three groups to receive a single dose of celecoxib 100mg, Ibuprofen 400 mg or acetaminophen codeine (acetaminophen 300mg + codeine 20mg) after surgery. A questionnaire was completed by the patients in which the pain intensity was recorded at 2, 4, 6, 10, 16, and 24 hrs after surgery. At 2 and 4 hr after taking the medications the pain intensity was significantly lower in the group receiving celecoxib (P<0.05). Considering the time of use of rescue medication, there was no significant difference between ibuprofen and celecoxib (P>0.05) while significant difference was found in the acetaminophen codeine group (P<0.05). Also, considering the pain intensity, ibuprofen and celecoxib had similar effects and both were superior to acetaminophen codeine. Ibuprofen and celecoxib showed similar effects in decreasing the intensity of pain in subjects so, celecoxib could be considered as the drug of choice when there are contraindications for ibuprofen.