Al-Nahlawi Talal, Hatab Talaat Abo, Alrazak Mahmoud Abd, Al-Abdullah Ahmad
Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Syrian Private University, Damascus Syrian Arab Republic.
Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Syrian Private University, Damascus Syrian Arab Republic Phone: +00963932805605, e-mail:
J Contemp Dent Pract. 2016 Dec 1;17(12):990-996.
To evaluate the effect of intracanal cryotherapy with negative pressure irrigation (EndoVac) on postendodontic pain after vital single-visit root canal treatment (RCT).
A total of 75 single-rooted teeth with single root canal were treated endodontically. After root canal preparation with Protaper Universal rotary system and irrigation, teeth were divided randomly into three groups (n = 25) according to additional irrigation protocol as follows: Group I: No additional irrigation was applied (control); group II: A 20 mL of room temperature saline was irrigated during 5 minutes using EndoVac, and group III: A 20 mL of 2 to 4°C cold saline was irrigated during 5 minutes using EndoVac. Pain levels were assessed by visual analog scale (VAS) and verbal evaluation of pain questionnaire after 6, 12, 24, 48 hours, and 7 days of canal obturation. The data were then analyzed using Statistical Package for the Social Sciences (SPSS) 13.0 using Kruskal-Wallis and Mann-Whitney U tests at p-value of 0.05.
The results showed that pain levels were high in groups I and II after 6 hours that decreased with time to almost diminish after 1 week, and on the other hand, group III showed no pain among different monitoring periods. Also pain levels in groups II were lower compared with group I after only 6 hours, with significance p < 0.05.
Postendodontic pain presented with highest values after 6 hours of treatment and reduced to almost nil after 1 week. Intracanal cryotherapy eliminated postendodontic pain clinically. Negative pressure reduced postendodontic pain after 6 hours of treatment.
The outcome of this study indicates that the use of intracanal cryotherapy technique with negative pressure irrigation eliminates postendodontic pain after single-visit RCTs.
评估根管内冷冻疗法联合负压冲洗（EndoVac）对活髓一次性根管治疗（RCT）后根管治疗后疼痛的影响。
选取75颗单根管的单根牙进行根管治疗。使用Protaper通用旋转系统进行根管预备和冲洗后，根据额外冲洗方案将牙齿随机分为三组（n = 25），如下：第一组：不进行额外冲洗（对照组）；第二组：使用EndoVac在5分钟内冲洗20 mL室温生理盐水；第三组：使用EndoVac在5分钟内冲洗20 mL 2至4°C冷生理盐水。在根管充填后6、12、24、48小时及7天，通过视觉模拟量表（VAS）和疼痛问卷的语言评估来评估疼痛程度。然后使用社会科学统计软件包（SPSS）13.0，采用Kruskal-Wallis检验和Mann-Whitney U检验对数据进行分析，p值设为0.05。
结果显示，第一组和第二组在6小时后的疼痛程度较高，随时间推移疼痛程度降低，至1周后几乎消失；另一方面，第三组在不同监测时间段均未出现疼痛。此外，仅在6小时后，第二组的疼痛程度就低于第一组，差异有统计学意义（p < 0.05）。
根管治疗后疼痛在治疗后6小时达到最高值，1周后几乎消失。根管内冷冻疗法在临床上消除了根管治疗后疼痛。负压冲洗在治疗6小时后减轻了根管治疗后疼痛。
本研究结果表明，采用根管内冷冻疗法联合负压冲洗技术可消除一次性RCT后的根管治疗后疼痛。
