Efficacy of Ibuprofen vs Acetaminophen for Pain Relief in Pediatric Dental Extractions: A Systematic Review

Background: Effective pain management after pediatric dental extractions is essential for patient comfort.Ibuprofen and acetaminophen are common analgesics, but their comparative efficacy requires clarification.Aim: To evaluate the effectiveness of ibuprofen vs acetaminophen in managing postextraction pain in pediatric dental patients.Design: A systematic search of PubMed, Scopus, Cochrane, and LILACS databases was conducted to identify randomized controlled trials (RCTs) from January, 1994 to September, 2024.Studies comparing ibuprofen, acetaminophen, or their combination in pediatric dental extractions were included.Two reviewers independently extracted data and assessed bias.The evaluation was conducted using the Cochrane Collaboration tool and Risk of Bias 2.0 (RoB 2.0).Six RCTs met the inclusion criteria.Results: Ibuprofen, when used alongside acetaminophen, is more effective in relieving pain within the first hour after extraction than acetaminophen alone.This combination offers greater pain reduction in the immediate postextraction period.It also significantly decreased the need for additional analgesics.Most studies demonstrated low risk of bias with proper randomization, allocation concealment, and blinding, except Kharouba et al., which showed high risk due to missing outcomes and selective reporting.Conclusions: Ibuprofen is superior to acetaminophen for managing postextraction pain.The combination of both drugs provides enhanced pain relief.Despite limitations such as variability in study designs, these findings highlight the need for further large-scale trials to confirm these results.Clinical significance: Optimizing postextraction pain management enhances pediatric patient comfort and compliance.Ibuprofen, alone or with acetaminophen, provides superior pain relief, supporting evidence-based analgesic protocols in dental practice.