In Vivo Evaluation of Effect of Preoperative Ibuprofen on Proinflammatory Mediators in Irreversible Pulpitis Cases

Preoperative administration of nonsteroidal anti-inflammatory drugs has been suggested as a method for increasing the efficacy of local anesthetics and decreasing postoperative pain in symptomatic irreversible pulpitis cases. However, the effects of ibuprofen at the molecular level are still unknown. Hence, the purpose of this study was to compare the levels of proinflammatory mediators in the dental pulp of teeth with irreversible pulpitis in patients who medicated with preoperative ibuprofen versus those who did not.

Thirty-four patients undergoing conventional endodontic therapy for teeth with irreversible pulpitis were selected and randomly assigned into either the ibuprofen or nonibuprofen group. Four patients undergoing endodontic therapy for prosthodontic reasons served as controls. Patients in the ibuprofen group were instructed to take 600 mg ibuprofen 1 hour before treatment, whereas patients in the nonibuprofen and control groups were asked to avoid analgesics before treatment. Blood samples obtained from the pulp upon access were tested for levels of prostaglandin E2, tumor necrosis efactor alpha, interleukin (IL)-6, IL-1β, and interferon gamma using high-sensitivity enzyme-linked immunosorbent assay. Postoperative pain levels were recorded for the groups. Data for the cytokine levels and postoperative pain were analyzed using statistical analysis.

There was a significant decrease in the levels of prostaglandin E2, tumor necrosis factor alpha, IL-6, and interferon gamma in the ibuprofen group compared with the nonibuprofen group. No significant differences were noted in the postoperative pain levels between these groups.

The data showed that preoperative ibuprofen significantly decreased the levels of most proinflammatory cytokines in the dental pulp, which could possibly help with anesthesia in irreversible cases.