Department of Conservative Dentistry and Endodontics, Meenakshi Academy of Higher Education and Research (MAHER), Faculty of Dentistry, Maduravoyal, Chennai, 600095, India.
Clin Oral Investig. 2019 Sep;23(9):3501-3507. doi: 10.1007/s00784-018-2768-4. Epub 2018 Dec 14.
The purpose of the present study was to evaluate the effect of Endo-Ice followed by intrapulpal ice application for reducing pain during pulp extirpation in mandibular molars with symptomatic irreversible pulpitis.
Sixty patients diagnosed with symptomatic irreversible pulpitis participated in the present study. Subjects were randomly allocated to any one of the following groups: control group-inferior alveolar nerve block with lignocaine (2%) adrenaline (1:80000), articaine group-inferior alveolar nerve block with lignocaine (2%) adrenaline (1:80000) + Buccal infiltration with articaine (4%) with adrenaline (1:100000); or cold group-inferior alveolar nerve block with lignocaine (2%) adrenaline (1:80000) + cold application. The outcome assessor measured the level of pain during access opening and pulp extirpation using the visual analogue scale. The anxiety level of the patient was also measured.
During access opening, there was a significant difference in the pain reduction in the articaine group when compared to cold and control group (p value = 0.02). During pulp extirpation, cold group and articaine group showed a significant reduction in pain levels as compared to the control group (p value = 0.001). There was no difference in the pain level during pulp extirpation among the two test arms (articaine and cold) (p value = 0.99). Further, cold significantly reduced the level of anxiety when compared to the articaine or control group (p value = 0.001).
Hence, cold is a simple, supplementary technique in reducing pain during pulp extirpation.
Application of cold may help in minimizing the fear of additional injection in managing pain during endodontic treatment.
本研究旨在评估 Endo-Ice 联合牙髓内冰应用在缓解有症状不可复性牙髓炎下颌磨牙牙髓切除术中疼痛的效果。
本研究纳入了 60 名诊断为有症状不可复性牙髓炎的患者。将受试者随机分配至以下任一组别：对照组-下牙槽神经阻滞麻醉含 2%利多卡因和 1:80000 肾上腺素；阿替卡因组-下牙槽神经阻滞麻醉含 2%利多卡因和 1:80000 肾上腺素+颊侧浸润含 4%阿替卡因和 1:100000 肾上腺素；或冷疗组-下牙槽神经阻滞麻醉含 2%利多卡因和 1:80000 肾上腺素+冷疗。使用视觉模拟评分法评估术野暴露和牙髓切除过程中的疼痛程度，评估疼痛缓解效果。同时还评估了患者的焦虑程度。
术野暴露时，与冷疗组和对照组相比，阿替卡因组的疼痛缓解程度有显著差异（p 值=0.02）。牙髓切除时，冷疗组和阿替卡因组的疼痛缓解程度与对照组相比有显著差异（p 值=0.001）。在牙髓切除过程中，两组测试组（阿替卡因和冷疗）之间的疼痛水平无差异（p 值=0.99）。进一步的，与阿替卡因组或对照组相比，冷疗组的焦虑水平显著降低（p 值=0.001）。
因此，冷疗是一种简单的辅助技术，可在牙髓切除术中减轻疼痛。
在牙髓治疗中，应用冷疗可能有助于减轻患者对额外注射的恐惧，从而缓解疼痛。
