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The effect of Ibuprofen premedication on postoperative pain following primary teeth pulpotomy : a randomized clinical trial
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Introduction
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pain 37% to 95% tooth extraction,pulpotomy and SSC Facial expression
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Wong- Baker faces
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Pulpotomy The most common treatment of primary teeth.
Shafie:65/6% of patients reported pain after pulpotomy
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premedication Several studies pre-treatment with analgesic medications reduces post-operative pain after RCT following tooth extraction in children Ibuprofen, paracetamol, diclofenac, tramadol paracetamol and ibuprofen for post-operative pain in children and OTC ibuprofen (4-10 mg/kg) = paracetamol (7-15 mg/kg) for moderate to severe pain
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Method & Material Randomized clinical trial –split mouth
IRCT N1 The mean pain score during the first 24 h following treatment was considered the primary outcome Sample size : (6-10 years) informed consent
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The inclusion criteria were:
patients aged 6-10 years old bilateral primary molar teeth with carious lesions the teeth were restorable, no tenderness to percussion and no pain except after eating no clinical and/or radiographic signs of pulp degeneration no sinus tract, no or minimal physiological resorption
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Exclusion criteria were:
Usage of analgesic in last 24 hours any systemic diseases that contra-indicated conservative pulp therapy (such as leukemia and some types of malignancies) radiographic findings internal resorption & widening of PDL furcation or periapical radiolucency root canal calcifications
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Results
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Results 49 children 45 children 17 girls and 28 boys
Mean of age year All of the patients reported post-operative pain in both groups
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روز اول روز دوم روز سوم Mean of pain(placebo/ibuprofen) P value
Mean of pain(placebo/ibuprofen) P value روز اول ( 2.09±0.79/ 1.76±0.91) 0.032 روز دوم (1/24±0/061 1/07±0/72) 0.154 روز سوم (0.69± ±0/62) 0.197
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The number of patient who had pain at different days after pulpotomy
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Incidence of use of analgesia among 2 groups
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Discussion
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Discussion pre-treatment with ibuprofen significantly decreased post-operative pain MTA & CEM : pulp capping, perforation repair, apical plug and root- end filling & as pulpotomy agents in primary molar teeth In the present study, CEM cement was used as the pulpotomy agent
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mean pain score(day 1) Placebo /09± 0/79 Ibuprofen /76±0/91
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Discussion the mean pain score(day 2 and 3) in the placebo group was higher than ibuprofen(not significant) Baygin(2011) ibuprofen-paracetamol Gazal(2007) (ibuprofen+paracetamol)-ibuprofen Primosch(1995) acetaminophen-ibuprofen- placebo
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Discussion following dental extractions or GA
administration of paracetamol, ibuprofen and diclofenac
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Discussion ibuprofen and paracetamol had the same analgesic and antipyretic effect higher pain relief with ibuprofen when compared to paracetamol(meta-analysis) 400 mg ibuprofen provided superior analgesia over 1,000 mg paracetamol both medications have similar safety spectra
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Conclusion
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The amount of post-operative pain was significantly lower in patients who received ibuprofen before treatment in comparison with placebo group
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If it is not contraindicated, using ibuprofen as a premedication can be useful.it can be administrated 45 min before procedure to decrease postoperative pain
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