Oginni Adeleke O, Udoye Christopher I
Department of Restorative Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
BMC Oral Health. 2004 Nov 26;4(1):4. doi: 10.1186/1472-6831-4-4.
Until recently the most accepted technique of doing root canal treatment stresses multiple visit procedure. Most schools also concentrated upon teaching the multi-visit concept. However, it has now been reported that the procedure of single visit treatment is advocated by at least 70% of schools in all geographical areas. It was therefore the aims of the present study to find the incidence of post-obturation flare-ups following single and multiple visit endodontic treatment procedures, and to establish the relationship between pre-operative and post-obturation pain in patients referred for endodontic therapy in a Nigerian teaching Hospital. METHODS: Data collected included pulp vitality status, the presence or absence of pre-operative, inter-appointment and post-obturation pain. Pain was recorded as none, slight, or moderate/severe. Flare-ups were defined as either patient's report of pain not controlled with over the counter medication or as increasing swelling. The patients were recalled at three specific post-obturation periods, 1st, 7th and 30th day. The presence or absence of pain, or the appropriate degree of pain was recorded for each recall visits and the interval between visits. The compiled data were analysed using chi-square where applicable. P level </= 0.05 was taken as significant. RESULTS: Ten endodontic flare-ups (8.1%) were recorded in the multiple visit group compared to 19 (18.3%) flare-ups for the single visit group, P = 0.02. For both single and multiple visit procedures, there were statistically significant correlations between pre-operative and post-obturation pain (P = 0.002 and P = 0.0004 respectively). Teeth with vital pulps reported the lowest frequency of post-obturation pain (48.8%), while those with nonvital pulps were found to have the highest frequency of post-obturation pain (50.3%), P = 0.9. CONCLUSION: The present study reported higher incidences of post-obturation pain and flare-ups following the single visit procedures. However, single visit endodontic therapy has been shown to be a safe and effective alternative to multiple visit treatment, especially in communities where patients default after the first appointment at which pain is relieved.
直到最近，最被认可的根管治疗技术强调多次就诊程序。大多数院校也专注于教授多次就诊的概念。然而，现在有报道称，所有地理区域至少70%的院校提倡单次就诊治疗程序。因此，本研究的目的是找出单次和多次就诊牙髓治疗术后根管充填后疼痛发作的发生率，并确定在尼日利亚一家教学医院接受牙髓治疗的患者术前和根管充填后疼痛之间的关系。方法：收集的数据包括牙髓活力状态、术前、复诊间和根管充填后疼痛的有无。疼痛记录为无、轻微或中度/重度。疼痛发作定义为患者报告非处方药物无法控制的疼痛或肿胀加剧。在根管充填后的三个特定时期，即第1天、第7天和第30天对患者进行回访。记录每次回访时疼痛的有无或适当的疼痛程度以及回访之间的间隔。在适用的情况下，使用卡方检验对汇编数据进行分析。P值≤0.05被视为具有显著性。结果：多次就诊组记录到10例牙髓疼痛发作（8.1%），而单次就诊组为19例（18.3%），P = 0.02。对于单次和多次就诊程序，术前和根管充填后疼痛之间均存在统计学显著相关性（分别为P = 0.002和P = 0.0004）。牙髓活力正常的牙齿根管充填后疼痛发生率最低（48.8%），而牙髓无活力的牙齿根管充填后疼痛发生率最高（50.3%），P = 0.9。结论：本研究报告单次就诊程序后根管充填后疼痛和疼痛发作的发生率较高。然而，单次就诊牙髓治疗已被证明是多次就诊治疗的一种安全有效的替代方法，尤其是在患者在首次预约疼痛缓解后违约的社区。
