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无症状性坏死下颌磨牙伴根尖周病变采用三种不同根管预备技术后的术后牙髓疼痛:一项前瞻性、随机、双盲临床试验

Postoperative endodontic pain of three different instrumentation techniques in asymptomatic necrotic mandibular molars with periapical lesion: a prospective, randomized, double-blind clinical trial.

作者信息

Shokraneh Ali, Ajami Majid, Farhadi Nastaran, Hosseini Mohsen, Rohani Bita

机构信息

Department of Endodontics, School of Dentistry, AJA University of Medical Sciences, Tehran, 8174755153, Iran.

Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Clin Oral Investig. 2017 Jan;21(1):413-418. doi: 10.1007/s00784-016-1807-2. Epub 2016 Apr 4.

Abstract

OBJECTIVES

The purpose of this prospective, randomized, double-blind study was to compare postoperative pain of root canal treatment in patients with asymptomatic mandibular molar teeth with necrotic pulp and periapical lesion using three different instrumentation techniques: hand, multi-file rotary (ProTaper Universal), and reciprocating single-file (Wave-One) instrumentation techniques.

MATERIALS AND METHODS

Ninety-six patients who fulfilled specific inclusion criteria were assigned to three groups according to the root canal instrumentation technique used: Hand (G1), ProTaper Universal (G2), and Wave-One (G3). One-visit root canal treatment was carried out, and the severity of the postoperative pain was assessed by the Heft-Parker visual analogue scale 6, 12, 18, 24, 48, and 72 h after treatment. Data were analyzed by Kruskal-Wallis, χ , Cochrane Q, one-way ANOVA, and Spearman's correlation analyses (α = 0.05).

RESULTS

The patients in group 3 reported significantly lower postoperative pain levels at 6, 12, and 18 h compared with the patients in the two other groups (P < .05). In addition, the patients in group 2 reported significantly lower postoperative pain levels at 6 and 12 h compared with the patients in group 1 (P < .05). There were no significant differences in postoperative pain between the three groups at other time intervals (P > .05). The analgesic consumption was significantly higher in group 1 (P < .05), but no difference was seen between the two other groups (P > .05).

CLINICAL RELEVANCE

Postoperative pain was significantly lower in patients undergoing root canal instrumentation with the Wave-One file compared with the ProTaper Universal and hand files.

摘要

目的

本前瞻性、随机、双盲研究的目的是比较采用三种不同根管预备技术(手动、多锉旋转[ProTaper Universal]和往复单锉[Wave-One]预备技术)对无症状下颌磨牙牙髓坏死伴根尖周病变患者进行根管治疗后的疼痛情况。

材料与方法

96例符合特定纳入标准的患者根据所使用的根管预备技术被分为三组:手动组(G1)、ProTaper Universal组(G2)和Wave-One组(G3)。进行一次性根管治疗,并在治疗后6、12、18、24、48和72小时通过Heft-Parker视觉模拟量表评估术后疼痛的严重程度。数据采用Kruskal-Wallis检验、χ检验、Cochrane Q检验、单因素方差分析和Spearman相关性分析(α = 0.05)。

结果

与其他两组患者相比,第3组患者在术后6、12和18小时的疼痛水平显著更低(P < 0.05)。此外,与第1组患者相比,第2组患者在术后6和12小时的疼痛水平显著更低(P < 0.05)。在其他时间间隔,三组之间的术后疼痛无显著差异(P > 0.05)。第1组的镇痛药消耗量显著更高(P < 0.05),但其他两组之间无差异(P > 0.05)。

临床意义

与ProTaper Universal锉和手动锉相比,使用Wave-One锉进行根管预备的患者术后疼痛显著更低。

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