A systematic review and meta-analysis depicted that compared to the combination of 600 mg acetaminophen and 60 mg codeine (A/C), ibuprofen led to better pain reduction in patients who underwent third molar extraction. Hunter Watson et al. aimed to compare the combination of acetaminophen and codeine with ibuprofen for pain management after dental extraction.

Databases such as the trial registry ClinicalTrials.gov and PubMed were explored with the keywords "pain", "extraction", "tooth or teeth," and "molar or molars." Randomized, blinded, placebo-controlled trials were included. Those studies were incorporated in which either ibuprofen or a single-dose combination of 600 mg acetaminophen with 60 mg codeine were used, and recording of standardized pain relief (PR) at 6 hours, or summed total pain relief over 6 hours (TOTPAR6) was done.

Out of 2,949 articles, retrieval of  79 studies was done for full-text assessment. Out of 79 articles, 20 articles fulfilled the criteria for inclusion. For A/C and ibuprofen, the weighted standardized mean differences (SMD) for PR at 6 hours and TOTPAR6 are depicted in Table 1:

An SMD of 0.8 or greater indicated a large effect. Hence, a single dose of 400 mg ibuprofen is highly efficient in the management of pain following third molar extraction.