Journal of Dental Medicine

Postoperative pain following Root Canal Therapy (RCT) is the common problem for patients,dentist and dental staff. Regardless of cause it appears that postoperative pain and discomfort is related to periapical inflammation. The purpose of this study was to investigate histologically the effect of Ibuprofen on acute apical inflammation following RCT. on cat. Fifty-six cuspids teeth of 14 cats were divided into three groups, 6 cats for experimental group, 6 cats for positive control group and 2 cats for negative control group. In first group, to anesthesize the animals each cat received 10 mg/kg Ibuprofen 36 hours before RCT and repeated every 24 hours. In second group RCT was performed in 24 cat teeth without any prescription. In negative control groups 2 cats, no RCT were done.Following vital perfusion, in interval of 6, 12, 24 hours, samples were post fixed in 10% formalin and five micron sections were prepared, and stained with H&E and studied under the Mann Whitney parameter test. Infilteration of inflamatory cells in 6 hours interval in experimental group was significantly less than two control groups. In 12 hours samples, however, inflammation in experimental group reduced, but it was not significant. In 24 hours samples there was no significant difference between experimental groups and controls. The result of this in-vivo study shows prescription of Ibuprofen before root canal therapy can reduce inflammatory reaction.

Background and Aims: Despite the significant improvement in dentistry, pain after endodontic therapy is still of concern for patients. Non-steroidal anti-inflammatory drugs are the most commonly prescribed oral analgesics used for dental pain relief after root canal treatment. The purpose of this study was to compare the effectiveness of Ibuprofen versus slow-released Diclofenac Sodium in controlling pain following root canal treatment.

Materials and Methods: In this randomized clinical trial, mandibular molars with irreversible pulpitis in 90 patients were selected. The patients were divided into three groups (Ibuprofen, slow-released Diclofenac Sodium and placebo). After examination patients filled in the consent form. Then they received one of the mentioned drugs. After inferior alveolar nerve block, access cavity was prepared and the root canals were prepared using passive step back method. The canals were dried and temporary filling material was placed. Then the pain evaluation form (visual analog scale) was explained and delivered to the patients. Data were analyzed using Repeated Measurement ANOVA, Kruskal-wallis and Man-Whitney U tests.

Results: The mean pain intensity in slow-released Diclofenac Sodium group was 0.87 0.95, 1.17 1.10 for Ibuprofen group, and 2.14  1.70 for placebo group. The differences between groups were statistically significant (P<0.001). The effect of Ibuprofen in controlling post endodontic pain in the first 2 hours was more than slow-released Diclofenac Sodium (P=0.01), but in 10, 18, and 36 hours after treatment, slow-released Diclofenac Sodium was more effective than Ibuprofen (P<0.001).

Conclusion: Premedication with single dose of slow-released Diclofenac Sodium can control post endodontic pain for a longer period of time compared with Ibuprofen.

.