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青少年患者一次和两次就诊根管治疗后的充填后疼痛及相关因素

Postobturation pain and associated factors in adolescent patients undergoing one- and two-visit root canal treatment.

作者信息

Risso P A, Cunha A J L A, Araujo M C P, Luiz R R

机构信息

School of Medicine, Federal University of Rio de Janeiro, Brazil.

出版信息

J Dent. 2008 Nov;36(11):928-34. doi: 10.1016/j.jdent.2008.07.006. Epub 2008 Sep 3.

Abstract

OBJECTIVES

This prospective study evaluated the frequency and intensity of postobturation pain and associated factors in adolescents undergoing one- and two-visit root canal treatment.

METHODS

121 patients aged 11-18 years presenting with molars with pulp necrosis were assigned randomly into two treatment groups: one- and two-visit (including interappointment dressing with calcium hydroxide paste). The canals of all teeth were prepared using a preflaring (2/3 middle-cervical) and step-back (1/3 apical) preparation techniques and filled with laterally compacted gutta-percha and sealer. Postobturation pain was recorded on a visual analogue scale (VAS) of 0-5. Data were statistically analyzed using multivariate logistic regression.

RESULTS

The frequencies of postobturation pain were 10.5% (6/57) in the one-visit group and 23.0% (14/61) in the two-visit group. There were no statistically significant differences between the groups (p=0.07). The intensity of the pain was similar in both groups, particularly flare-ups, with a prevalence of 1.75% in the one-visit group and 1.65% in the two-visit group. Postobturation pain was significantly associated with the presence of preoperative pain (p=0.04; OR=3.54; CI 95%=1.02-12.30) and a positive culture at the time of obturation (p=0.00; OR=9.43; CI 95%=2.93-30.35).

CONCLUSIONS

Postobturation pain was more present in the two-visit group, but was not statistically significant. The intensity of postobturation pain was similar. Effective microbiological control and the presence of preoperative pain may influence the postobturation pain in adolescents.

摘要

目的

本前瞻性研究评估了接受一次就诊和两次就诊根管治疗的青少年根管充填后疼痛的频率、强度及相关因素。

方法

121例年龄在11至18岁、患有牙髓坏死磨牙的患者被随机分为两个治疗组:一次就诊组和两次就诊组(包括用氢氧化钙糊剂进行诊间封药)。所有牙齿的根管均采用预扩锉(2/3中颈段)和逐步后退法(1/3根尖段)进行预备,并用侧向加压热牙胶和封闭剂充填。根管充填后疼痛采用0至5的视觉模拟量表(VAS)记录。数据采用多因素逻辑回归进行统计学分析。

结果

一次就诊组根管充填后疼痛的发生率为10.5%(6/57),两次就诊组为23.0%(14/61)。两组间差异无统计学意义(p = 0.07)。两组疼痛强度相似,尤其是疼痛发作,一次就诊组患病率为1.75%,两次就诊组为1.65%。根管充填后疼痛与术前疼痛的存在显著相关(p = 0.04;OR = 3.54;95%CI = 1.02 - 12.30)以及充填时培养结果为阳性显著相关(p = 0.00;OR = 9.43;95%CI = 2.93 - 30.35)。

结论

两次就诊组根管充填后疼痛更为常见,但差异无统计学意义。根管充填后疼痛强度相似。有效的微生物控制和术前疼痛的存在可能影响青少年根管充填后疼痛。

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