Burgoyne Corey C, Giglio James A, Reese Sarah E, Sima Adam P, Laskin Daniel M
Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298-0566, USA.
J Oral Maxillofac Surg. 2010 Jan;68(1):144-8. doi: 10.1016/j.joms.2009.06.033.
This prospective randomized clinical study assessed the efficacy of pain control for postextraction alveolar osteitis comparing the use of eugenol on a gauze strip versus a thermosetting gel containing 2.5% prilocaine and 2.5% lidocaine.
Thirty-five patients who presented with postextraction alveolar osteitis were randomly assigned to either a control group or test group. After irrigation of the extraction site with normal saline solution, the control patients were treated with eugenol on a gauze strip placed in the socket and the test patients were treated with the thermosetting gel placed directly into the socket. All patients were given a series of visual analog scales to record their pretreatment pain and post-treatment pain at 5, 10, and 15 minutes and then at 1-hour increments during waking hours for the next 48 hours. They were also given a prescription for an analgesic to use for breakthrough pain during the 48-hour period, if necessary, and instructed to record the dose and timing of any pain medication taken. All patients were seen for follow-up at 48 hours after treatment.
The mean pretreatment pain score was 6.72 on a scale ranging from 1 to 10 for the eugenol group and 6.37 for the prilocaine-lidocaine group (SE, 0.46), and the 2 groups were not different (P = .62). In the immediate post-treatment period (0-15 minutes) the pain levels were significantly reduced in both groups (Ps < .001). However, the thermosetting gel produced a significantly greater reduction in pain (mean, 3.23; SE, 0.62) than the eugenol (mean, 4.83; SE, 0.43) (P = .022). Over the next 48 hours, the pain level was nominally less with the thermosetting gel, but this difference was not statistically significant (Ps = .2).
Although the efficacy of the 2 treatments was not significantly different, the nominal superiority and ease of using the thermosetting gel warrant further investigation.
本前瞻性随机临床研究比较了含丁香酚的纱布条与含2.5%丙胺卡因和2.5%利多卡因的热凝凝胶用于拔牙后干槽症疼痛控制的疗效。
35例拔牙后发生干槽症的患者被随机分为对照组和试验组。用生理盐水冲洗拔牙创后，对照组患者在牙槽窝内置入含丁香酚的纱布条进行治疗，试验组患者则直接在牙槽窝内注入热凝凝胶。所有患者均接受一系列视觉模拟量表评估，以记录其治疗前疼痛情况，以及治疗后5分钟、10分钟和15分钟时的疼痛情况，随后在接下来的48小时清醒时间内，每隔1小时记录一次疼痛情况。必要时，还为他们开具了用于48小时内爆发性疼痛的镇痛药处方，并指导他们记录所服用的任何止痛药物的剂量和时间。所有患者在治疗后48小时进行随访。
丁香酚组治疗前平均疼痛评分为6.72（评分范围为1至10），丙胺卡因-利多卡因组为6.37（标准误为0.46），两组无差异（P = 0.62）。在治疗后即刻（0 - 15分钟），两组疼痛水平均显著降低（P值均<0.001）。然而，热凝凝胶使疼痛降低的程度（平均值为3.23；标准误为0.62）显著大于丁香酚（平均值为4.83；标准误为0.43）（P = 0.022）。在接下来的48小时内，热凝凝胶组的疼痛水平名义上较低，但这种差异无统计学意义（P值 = 0.2）。
虽然两种治疗方法的疗效无显著差异，但热凝凝胶名义上的优势及使用便利性值得进一步研究。
