LAUSR

INTRODUCTION Pre-operative administration of NSAIDs have been suggested as a method for increasing the efficacy of local anesthetics and decreasing post-operative pain in symptomatic irreversible pulpitis cases. However, the effects of ibuprofen at the molecular level are still unknown. Hence, the purpose of this study is to compare the levels of pro-inflammatory mediators in the dental pulp of teeth with irreversible pulpitis in patients who medicated with pre-operative ibuprofen versus those who did not. METHODS Thirty-four patients undergoing conventional endodontic therapy for teeth with irreversible pulpitis were selected and randomly assigned into either the ibuprofen or non-ibuprofen group. Four patients undergoing endodontic therapy for prosthodontic reasons served as controls. Patients in the ibuprofen group were instructed to take 600mg of ibuprofen one-hour prior to treatment, while patients in the non-ibuprofen and control groups were asked to avoid analgesics prior to treatment. Blood samples obtained from the pulp upon access were tested for levels of PGE2, TNF-α, IL-6, IL-1β and IFN-γ using high sensitivity ELISAs. Post-operative pain levels were recorded for the groups. Data for the cytokine levels and post-operative pain were analyzed using statistical analysis. RESULTS There was a significant decrease in the levels of PGE2, TNF-α, IL-6, and IFN-γ in the ibuprofen group as compared to the non-ibuprofen group. No significant differences were noted in the post-operative pain levels between these groups. CONCLUSIONS The data demonstrated that the pre-operative ibuprofen significantly decreased the levels of most pro-inflammatory cytokines in the dental pulp, which could possibly help with anesthesia in irreversible cases.