Does preoperative ibuprofen reduce pain during treatment of deep caries in children?

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Abstract A Commentary on Bilmez Selen M, Kuru B. Effect of preoperative ibuprofen on pain perception and pulse rate in paediatric patients with deep caries: a randomised controlled trial. Eur J Paediatr Dent. 2026:1. https://doi.org/10.23804/ejpd.2026.2598 . Design A prospective, parallel single-blinded randomised controlled trial aimed to evaluate the effect of pre-operative ibuprofen administration on pain control during vital pulp therapy (VPT) procedures for a mandibular molar diagnosed with reversible pulpitis. Participants were randomised through a computer-generated random sequence that was concealed in sealed envelopes. Participants received either oral ibuprofen (10 mg/kg) 40 minutes before treatment (intervention group) or no pre-operative analgesia (control group). Case selection A total of 46 participants, aged 7–13 years, were recruited from the Department of Paediatric Dentistry at the Faculty of Dentistry in Malatya, Türkiye. The sample size was based on a power calculation, determining the estimated effect size from a prior study restoring teeth in children with MIH. One participant from each group was excluded (suspected irreversible pulpitis) prior to randomising. Inclusion criteria included no history of systemic disease, cooperative behaviour, a clinical and radiographic diagnosis of reversible pulpitis (positive cold test response and no swelling, abscess or periapical pathology), in a mandibular molar, due to dental caries (ICDAS 5–6). A standardised treatment protocol was provided and undertaken by a single paediatric dentist. The type of VPT included protective liner, direct pulp capping, partial pulpotomy, or coronal pulpotomy, and was determined by the operator and based on cavity depth and presence, or not, of a pulp exposure. Data analysis The primary outcome measured was intraoperative pain intensity, assessed using the visual analogue scale (VAS; 0–10) at the point of