Sevekar Shrirang Anand, Gowda Subhadra Halemane Nagaraj
Associate Professor, Department of Paediatric and Preventive Dentistry, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
Associate Professor, Department of Paediatric and Preventive Dentistry, YMT Dental College and Hospital, Navi Mumbai, Maharashtra, India.
J Clin Diagn Res. 2017 Mar;11(3):ZC09-ZC12. doi: 10.7860/JCDR/2017/22662.9377. Epub 2017 Mar 1.
Endodontic treatment performed in either single- or multiple visit can be followed by numerous short- and long term complications. One of the short term complications include postoperative pain and flare-ups. The ability to predict its prevalence and forewarn the patient may go some way towards enabling coping strategies and help dentist in pain management treatment decisions.
To compare the incidence and intensity of postoperative pain and flare-ups between single- and multiple visit pulpectomy in primary molars. Also, to correlate the preoperative status of the pulp to postoperative pain and flare-ups.
Eighty primary molars indicated for pulpectomy were included in the study and divided into two groups. Tooth treated and preoperative status of the pulp vitality was recorded. All the conventional steps in pulpectomy were followed. Teeth in Group 1 (single visit pulpectomy) were obturated on the same visit. Teeth in Group 2 (multiple visit pulpectomy) were obturated in the subsequent appointment. The recording of postoperative pain, flare-ups, use of medication were done after 24 hours, seven days and one month.
Four cases in both the groups reported postoperative pain (10%) at 24 hour recall, p=0.74. One flare-up (2.5%) was recorded in each group p=0.67. None of the patients reported pain at seventh day and one month recall. Postoperative pain was recorded in five non-vital teeth (13.5%) and three vital teeth (6.9%). However, it was statistically not significant p=0.53.
From the perspective of our study there was a low incidence of postoperative pain. The majority of patients in both groups reported no pain or only minimal pain within 24 hours of treatment. There were no differences between single- and multi visit treatment protocols with respect to the incidence of postoperative pain. No significant correlation could be found between pulp vitality and the incidence of postoperative pain.
无论是单次就诊还是多次就诊进行的牙髓治疗，都可能会出现许多短期和长期并发症。短期并发症之一包括术后疼痛和病情突然加重。预测其发生率并预先告知患者，可能在一定程度上有助于制定应对策略，并帮助牙医做出疼痛管理治疗决策。
比较乳牙单次就诊和多次就诊牙髓摘除术后疼痛和病情突然加重的发生率及严重程度。此外，将术前牙髓状态与术后疼痛和病情突然加重进行关联。
本研究纳入了80颗需要进行牙髓摘除术的乳牙，并将其分为两组。记录治疗的牙齿及牙髓活力的术前状态。遵循牙髓摘除术中的所有常规步骤。第1组（单次就诊牙髓摘除术）的牙齿在同一次就诊时进行充填。第2组（多次就诊牙髓摘除术）的牙齿在后续预约时进行充填。在术后24小时、7天和1个月记录术后疼痛、病情突然加重情况及用药情况。
两组均有4例患者在术后24小时复诊时报告有术后疼痛（10%），p = 0.74。每组均记录到1例病情突然加重（2.5%），p = 0.67。在第7天和1个月复诊时，没有患者报告疼痛。5颗无活力牙（13.5%）和3颗有活力牙（6.9%）记录到术后疼痛。然而，在统计学上无显著差异，p = 0.53。
从我们的研究来看，术后疼痛的发生率较低。两组中的大多数患者在治疗后24小时内报告无疼痛或仅有轻微疼痛。单次就诊和多次就诊治疗方案在术后疼痛发生率方面没有差异。牙髓活力与术后疼痛发生率之间未发现显著相关性。
