EFFECT OF A NONSTEROIDAL ANTIINFLAMMATORY DRUG ON TISSUE-LEVELS OF IMMUNOREACTIVE PROSTAGLANDIN E(2), IMMUNOREACTIVE LEUKOTRIENE, AND PAIN AFTER PERIODONTAL SURGERY

THE AIM OF THIS STUDY was to measure tissue levels of immunoreactive p rostaglandin E(2) (iPGE(2)), immunoreactive leukotriene B4 (iLTB4), an d pain after periodontal surgery and to evaluate the effect of the non -steroidal anti-inflammatory drug (NSAID), ibuprofen, on these levels. Two contralateral quadrants in each of nine patients were selected to undergo separate surgical procedures, one with ibuprofen (800 mg 1 ho ur presurgery and 400 mg postsurgery) and one with a placebo. Intra-op eratively, a custom-made microdialysis probe, with a 3,000 dalton mole cular weight cut-off, was inserted beneath the soft tissue flap and a dialysate collected every 20 minutes for 4 hours after surgery. Pain p erception was measured at the same time intervals using two pain scale s. Dialysate samples were assayed using two enzyme immunoassays. Mean tissue levels of iPGE(2) in the placebo group increased from 74 nM at 40 minutes to a peak of 261 nM at 200 minutes. Mean tissue levels of i LTB4 in the placebo group fluctuated between 0.2 and 0.6 nM. Pain leve ls in this group increased continuously with time, peaking at 4 hours. Mean tissue levels of iPGE(2) in the ibuprofen group were significant ly suppressed, exhibiting more than a 95% reduction. This was accompan ied by a significant reduction in pain. Ibuprofen had no detectable ef fect on tissue levels of iLTB4. These data indicate that iPGE(2) and i LTB4 are present at relatively high concentrations in the periodontal tissues after surgery. Since these concentrations exceed the Kd values for binding to their respective receptors, PGE(2) and LTB4 may be ass ociated with the development of postsurgical pain and inflammation. Th ese data also indicate that ibuprofen can successfully inhibit iPGE(2) production in the periodontal tissues and in this way may help reduce postoperative pain and inflammation.