Effect of Ibuprofen on IL-1β, TNF-α and PGE2 Levels in Periapical Exudates: A Double Blinded Clinical Trial

Background: Bone resorption is one of the main features of inflammatory periapical lesions and is mainly mediated by interleukin-1 beta (IL-1β), tumor necrosis factoralpha (TNF-α) and prostaglandin-E2 (PGE2). Recent investigations of these lesions revealed that pharmacological modulation may be possible. Objective: The aim of this study was to evaluate the effect of Ibuprofen on IL-1β, TNF-α and PGE2 levels in periapical exudates and compare the results with a group of placebo control. Methods: Thirty patients with non vital teeth and radiographic lesions were divided into two groups of case and control according to their entrance to the study. Periapical exudates were taken from root canals using absorbent paper points and followed by 400 mg Ibuprofen and placebo prescribed one tablet every 6 hour for three days and in the fourth day second samples were taken, then final cleaning, shaping and obturation of the canals were completed. IL-1β, TNF-α and PGE2 levels were determined by enzymelinked immunosorbent assays (ELISA). Data were analyzed using paired t-test and student's t-test. Results: The results showed that PGE2 levels were decreased significantly in the case group to 86.92 ± 72.42 Pg/ml following Ibuprofen treatment comparing with the pre-treatment (164.96 ± 12.255 Pg/ml) (p=0.02) and placebo group (154.2 ± 97.13 Pg/ml) (p=0.001). But there were no significant differences in IL-1β and TNF-α level between the two groups and in each group before and after treatment. Conclusion: The data indicate that Ibuprofen, as a non-steroidal anti-inflammatory drug (NSAID), can be used to block PGE2 release, enhance healing of inflammatory periapical lesions and possibly to inhibit bone resorption.