Comparison between Soft Gelatin Capsule Containing Ibuprofen and Ibuprofen Regular Tablet in Pain Control Following Scaling and Root Planing

Abstract

Aim: Scaling and root planning (SRP) is a major component of periodontal therapy which is often accompanied by painful experiences for the patient. The objective of the present study is to evaluate the pain control of two available types of ibuprofen, soft gelatin capsules and tablets, following SRP in patients with chronic periodontitis. Methodology: 75 patients with chronic periodontitis, undergoing routine periodontal SRP were selected. Following probing the amount of pain perceived was recorded as the baseline pain using visual analog scale (VAS). Further, they received either 800 mg ibuprofen tablet, 800 mg ibuprofen capsule or placebo and the pain level was measured thirty minutes thereafter. Participants underwent SRP procedure and the pain levels were recorded immediately and then at 30 and 60 minutes after SRP. Results: The mean VAS pain scores assessed immediately, thirty minutes and an hour after SRP for both ibuprofen and ibuprofen capsule groups were lower than placebo. Significant difference in the pain parameter only immediately after SRP between three groups were observed (p=0.012).The mean VAS pain score difference after thirty minutes and an hour upon SRP with baseline was insignificant in all study groups (p≤0.0001). However, the mean VAS pain score measured an hour after SRP showed significant difference between both NSAID groups and placebo group (p=0.012) Conclusions: Soft gelatin ibuprofen capsules are well suitable for pain management during SRP procedure in patients with chronic periodontitis due to reported rapid onset of action and less gasterointestinal intolerance.

Analgesic Efficacy of COX-2 Inhibitors in Periodontal Surgery: A Systematic Review and Meta-Analysis

“…Thereafter, the abstracts were read, and three reports were deleted because were not clinical trials. Next, 9 clinical trials were fully evaluated, and only 7 of these 9 clinical trials met the inclusion criteria for this systematic review [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] ( Figure 1 ).…”

“…The assessment of bias shows that 7 out of 9 included articles in this systematic review present no high risk of bias [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. The main problems of those 2 excluded clinical trials were the performance bias, detection bias, attrition bias, reporting bias, and selection bias [ 22 , 23 ] ( Figure 2 ).…”

“…The qualitative analysis of the analgesic efficacy of COX-2 inhibitors was completed with 7 clinical trials ( n = 337) [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. The most widely used COX-2 inhibitor was Celecoxib 200 mg, which was used in 4 of the 7 clinical trials [ 24 , 26 , 28 , 30 ], followed by etoricoxib 90 mg [ 29 ] and 120 mg [ 27 ], and finally, lumiracoxib in a double-blind randomized clinical trial [ 25 ]. The main active control was dexamethasone, which was used in four clinical trials [ 25 , 26 , 27 , 29 ].…”

“…The doses of this drug used were 4 mg [ 25 , 26 ] and 8 mg [ 27 , 29 ]. According to the conclusion of each study, only one clinical trial had results in favor of a COX-2 inhibitor when compared to a placebo [ 28 ], one clinical study informed that a COX-2 was better than an active control [ 24 ], four studies showed similar analgesic efficacy to active controls [ 25 , 26 , 27 , 29 ], and one clinical study informed the analgesic effect of one celecoxib-caffeine combination in comparison with celecoxib alone and placebo [ 30 ]. For more details, such as ID study, first author, publishing year, treatments, sample size, details of patients, dental procedure, and evaluation, see Table 1 .…”

“…There are two types of NSAIDs, those that non-selectively inhibit the cyclooxygenase-2 (COX-2) enzyme [ 18 , 19 ] and the drugs that selectively inhibit that enzyme [ 20 , 21 ]. This last kind of drug has been used in clinical trials to determine its efficacy for pain management after periodontal surgery [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], and has been compared with placebo, other NSAIDs, and glucocorticosteroids [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. The aim of this systematic review and meta-analysis was to evaluate the analgesic effect of the selective COX-2 drugs in comparison to the placebo, and active controls for pain control after periodontal surgery.…”