Iqbal Mian, Kim Sara, Yoon Frank
Postdoctoral Endodontic Program, Department of Endodontics, University of Pennsylvania, School of Dental Medicine, Robert Schattner Center, Philadelphia, PA 19104-6030, USA.
J Endod. 2007 May;33(5):548-51. doi: 10.1016/j.joen.2007.01.006. Epub 2007 Mar 21.
Nine hundred fifty-one emergency and 997 nonemergency patients seeking endodontic treatment were the basis of this study. Variables of interest were 10 pain descriptors, percussion and palpation tests, causative factors, and paired pulpal and periapical diagnoses. A higher number of patients suffering from symptomatic pulpal conditions sought emergency care. Odds of caries being a causative factor were high in symptomatic pulps compared with asymptomatic pulpal and periapical conditions. Higher odds ratios were obtained for sharp pain in symptomatic pulps versus symptomatic periapical conditions. Conversely, odds ratios for dull pain were higher in symptomatic periapical conditions compared with asymptomatic periapical conditions. Percussion and palpation tests were significant in differentially diagnosing between pulpal and periapical conditions. In conclusion, caries was associated with painful pulpitis. The results confirm the differential diagnostic power of sharp and dull pain and percussion and palpation tests. Several symptoms previously believed to have differential diagnostic power were found insignificant.
本研究以951例寻求牙髓治疗的急诊患者和997例非急诊患者为基础。感兴趣的变量包括10种疼痛描述词、叩诊和触诊检查、致病因素以及牙髓和根尖周的配对诊断。患有症状性牙髓疾病的患者寻求急诊治疗的人数更多。与无症状牙髓和根尖周疾病相比，龋病作为症状性牙髓致病因素的几率较高。症状性牙髓出现锐痛与症状性根尖周疾病相比，比值比更高。相反，症状性根尖周疾病出现钝痛的比值比与无症状根尖周疾病相比更高。叩诊和触诊检查在牙髓和根尖周疾病的鉴别诊断中具有重要意义。总之，龋病与疼痛性牙髓炎相关。结果证实了锐痛和钝痛以及叩诊和触诊检查的鉴别诊断能力。先前认为具有鉴别诊断能力的几种症状被发现并无意义。
