Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
J Endod. 2010 Aug;36(8):1295-301. doi: 10.1016/j.joen.2010.04.012. Epub 2010 Jun 19.
The extrusion of irrigation solutions beyond the apical constriction may result in postoperative pain. Sodium hypochlorite can cause severe tissue irritation and necrosis outside the root canal system if extruded into the periodontal ligament (PDL) space. Different delivery techniques were discussed to reduce this potential risk. The aim of this study was to compare the postoperative level of pain after root canal therapy using either endodontic needle irrigation or a negative apical pressure device.
In a prospective randomized clinical trial, 110 asymptomatic single-rooted anterior and premolar teeth were treated endodontically with two different irrigation techniques. The teeth were randomly assigned to two groups. In the MP group (n = 55), procedures were performed using an endodontic irrigating syringe (Max-i-Probe; Dentsply Rinn, Elgin, IL). The EV group (n = 55) used an irrigation device based on negative apical pressure (EndoVac; Discus Dental, Culver City, CA). Postoperatively, the patients were prescribed ibuprofen 200 mg to take every 8 hours if required. Pain levels were assessed by an analog scale questionnaire after 4, 24, and 48 hours. The amount of ibuprofen taken was recorded at the same time intervals.
During the 0- to 4-, 4- to 24-, and 24- to 48-hour intervals after treatment, the pain experience with the negative apical pressure device was significantly lower than when using the needle irrigation (p < 0.0001 [4, 24, 48 hours]). Between 0 and 4 and 4 and 24 hours, the intake of analgesics was significantly lower in the group treated by the negative apical pressure device (p < 0.0001 [0-4 hours], p = 0.001 [4-24 hours]). The difference for the 24- to 48-hour period was not statistically different (p = 0.08). The Pearson correlation coefficient revealed a strongly positive and significant relationship for the MP group (r = 0.851, p < 0.001) and the EV group (r = 0.596, p < 0.0001) between pain intensity and the amount of analgesics.
The outcome of this investigation indicates that the use of a negative apical pressure irrigation device can result in a significant reduction of postoperative pain levels in comparison to conventional needle irrigation.
灌洗溶液超出根尖缩窄部位挤出可能导致术后疼痛。如果次氯酸钠挤出根管系统外到牙周膜（PDL）空间，会引起严重的组织刺激和坏死。讨论了不同的输送技术以降低这种潜在风险。本研究的目的是比较使用根管内注射或负压吸引两种不同冲洗技术根管治疗术后疼痛水平。
在一项前瞻性随机临床试验中，110 颗无症状的单根前磨牙和前磨牙用两种不同的冲洗技术进行根管治疗。将牙齿随机分为两组。在 MP 组（n = 55）中，使用根管内冲洗注射器（Max-i-Probe；Dentsply Rinn，Elgin，IL）进行操作。EV 组（n = 55）使用基于负压的冲洗装置（EndoVac；Discus Dental，Culver City，CA）。术后，如果需要，患者每 8 小时服用布洛芬 200mg。术后 4、24 和 48 小时通过模拟量表问卷调查评估疼痛程度。同时记录布洛芬的用量。
治疗后 0-4 小时、4-24 小时和 24-48 小时，使用负压吸引装置的疼痛体验明显低于使用针管冲洗（p < 0.0001[4、24、48 小时]）。在 0-4 小时和 4-24 小时期间，使用负压吸引装置治疗的组镇痛剂的摄入量明显较低（p < 0.0001[0-4 小时]，p = 0.001[4-24 小时]）。24-48 小时期间的差异无统计学意义（p = 0.08）。Pearson 相关系数显示，MP 组（r = 0.851，p < 0.001）和 EV 组（r = 0.596，p < 0.0001）之间疼痛强度与镇痛药用量之间存在强烈的正相关关系。
本研究结果表明，与常规针管冲洗相比，使用负压吸引冲洗装置可显著降低术后疼痛水平。
