Canakçi Cenk Fatih, Canakçi Varol
Department of Periodontology, School of Dentistry, Atatürk University, 25240 Erzurum, Turkey.
J Am Dent Assoc. 2007 Dec;138(12):1563-73. doi: 10.14219/jada.archive.2007.0105.
The authors assessed the levels of postoperative pain, postoperative dentin hypersensitivity and discomfort patients experienced during various periodontal treatments by using a visual analog scale (VAS). They aimed to determine whether VAS scores could be predicted by patient's age and sex and to evaluate the factors associated with the pain.
The study was carried out with 56 patients who had chronic periodontitis. Using a split-mouth design, the authors selected one quadrant in each patient and treated it with scaling and root planing (SRP). They treated other quadrants with the surgical therapies of modified Widman flap (MWF), flap with osseous resection (OF) and gingivectomy (GV), depending on the patient's diagnosis and treatment needs. They measured patients' discomfort during periodontal treatments, postoperative pain and postoperative dentin hypersensitivity by asking patients to mark a VAS.
The authors' analysis showed no statistically significant differences between the patients' discomfort levels associated with the four therapy types during periodontal treatment. However, postoperative pain was significantly higher for OF (P < .01) and GV (P < .05) procedures than for SRP and MWF procedures. All surgical procedures produced significantly more dentin hypersensitivity than did nonsurgical therapy. The analysis showed no statistically significant differences between male and female patients' discomfort during periodontal treatments. For all periodontal treatments, VAS scores decreased with increasing age.
Discomfort during periodontal treatments, postoperative pain and postoperative dentin hypersensitivity were associated significantly with age, type of therapy and higher scores on Corah's Dental Anxiety Scale.
Periodontal treatment is experienced as painful by substantial numbers of patients. Therefore, the dentist should count the pain responses during and after treatment and estimate the degree of pain according to sex, age and therapy type.
作者使用视觉模拟评分法(VAS)评估了患者在各种牙周治疗过程中经历的术后疼痛、术后牙本质过敏和不适程度。他们旨在确定VAS评分是否可以通过患者的年龄和性别进行预测,并评估与疼痛相关的因素。
该研究对56例慢性牙周炎患者进行。采用半口设计,作者在每位患者中选择一个象限进行龈上洁治和根面平整(SRP)治疗。根据患者的诊断和治疗需求,用改良Widman瓣术(MWF)、骨切除术瓣术(OF)和牙龈切除术(GV)等手术疗法治疗其他象限。通过让患者标记VAS来测量患者在牙周治疗期间的不适、术后疼痛和术后牙本质过敏。
作者的分析表明,在牙周治疗期间,与四种治疗类型相关的患者不适程度之间没有统计学上的显著差异。然而,OF(P <.01)和GV(P <.05)手术的术后疼痛明显高于SRP和MWF手术。所有手术治疗产生的牙本质过敏都比非手术治疗明显更多。分析表明,男性和女性患者在牙周治疗期间的不适没有统计学上的显著差异。对于所有牙周治疗,VAS评分随着年龄的增加而降低。
牙周治疗期间的不适、术后疼痛和术后牙本质过敏与年龄、治疗类型以及科拉牙科焦虑量表上的高分显著相关。
大量患者在牙周治疗时会感到疼痛。因此,牙医应在治疗期间和治疗后考虑疼痛反应,并根据性别、年龄和治疗类型估计疼痛程度。