Almeida Gustavo, Marques Eduardo, De Martin Alexandre Sigrist, da Silveira Bueno Carlos Eduardo, Nowakowski Anthony, Cunha Rodrigo Sanches
division of endodontics CIODONTO, Ilhéus, BA, Brazil.
J Can Dent Assoc. 2012;78:c84.
To compare 2 irrigation solutions in terms of postoperative pain after single-visit treatment of chronic apical periodontitis with pulp necrosis.
A total of 126 patients requiring treatment of apical periodontitis and pulp necrosis were randomly assigned to 2 groups according to the solution used for irrigation: 5.25% sodium hypochlorite (NaOCl) or 2% chlorhexidine gel (CLX) (63 patients in each group). To assess postoperative pain, a questionnaire and pain intensity scale were administered at 24, 48 and 72 hours and 7 days after the procedure. The χ2 test was used to compare the intensity of pain with the 2 irrigation solutions.
No patients reported severe pain at any stage. Moderate pain was reported by 3% of patients (2/63 in each group) after 24 hours and by no patients beyond 24 hours, regardless of the irrigant used. Mild pain was more frequent but diminished rapidly (reported by 19% [12/63] of patients in the NaOCl group and 16% [10/63] in the CLX group at 24 hours, by 10% [6/63] in the NaOCl group and 11% [7/63] in the CLX group at 48 hours, by 3% [2/63] in both groups at 72 hours and by 2% [1/63] in both groups at 7 days). There were no statistically significant differences in postoperative pain between the 2 groups at any time point (p > 0.05).
The incidence of postoperative pain after single-visit endodontic treatment of chronic apical periodontitis with pulp necrosis was uniformly low, regardless of the irrigant used.
比较两种冲洗液用于单次治疗慢性根尖周炎伴牙髓坏死术后疼痛的情况。
总共126例需要治疗根尖周炎和牙髓坏死的患者，根据冲洗所用溶液随机分为两组：5.25%次氯酸钠（NaOCl）组或2%氯己定凝胶（CLX）组（每组63例患者）。为评估术后疼痛，在术后24、48和72小时以及7天采用问卷和疼痛强度量表进行评估。采用χ2检验比较两种冲洗液的疼痛强度。
在任何阶段均无患者报告严重疼痛。术后24小时，每组有3%（2/63）的患者报告中度疼痛，24小时后无患者报告中度疼痛，无论使用何种冲洗剂。轻度疼痛更常见但迅速减轻（24小时时，NaOCl组19%[12/63]的患者和CLX组16%[10/63]的患者报告有轻度疼痛；48小时时，NaOCl组10%[6/63]的患者和CLX组11%[7/63]的患者报告有轻度疼痛；72小时时，两组均有3%[2/63]的患者报告有轻度疼痛；7天时，两组均有2%[1/63]的患者报告有轻度疼痛）。两组在任何时间点的术后疼痛均无统计学显著差异（p>0.05）。
无论使用何种冲洗剂，单次根管治疗慢性根尖周炎伴牙髓坏死术后疼痛的发生率均较低。
