Shresha R, Shrestha D, Kayastha R
Department of Dental, National Academy of Medical Sciences (NAMS) Bir Hospital, Maha Boudha, Kathmandu.
Department of Conservative Dentistry and Endodontics, Kathmandu Medical College, Duwakot.
Kathmandu Univ Med J (KUMJ). 2018 Apr-Jun;16(62):220-223.
Background Pain after root canal therapy is unwanted yet common experience for the patient and unpleasant for the dentist so it is always desirable to predict such pain. Objective To evaluate the frequency, intensity and associated factors of post-operative pain after single visit endodontic therapy on teeth with vital pulps. Method A total of 418 single visit root canal treatments were performed on patients of age 18 years and above by two endodontists. Canals were shaped with rotary ProTaper files. After the canal preparation, the canals were obturated, using lateral compaction technique, with ProTaper universal gutta-percha and AH-Plus sealer. Independent factors were recorded during the treatment and characteristics of postoperative pain were later surveyed through questionnaires. The severity of pain was recorded on a visual analogue scale (VAS) of 0-5. The data were analyzed using logistic regression models. Result The prevalence of post-operative pain within first six hours after treatment was high (79.2%) which decreased to 22% at the end of 72 hours however majority (70%) of the patients had mild to moderate pain (VAS 1-2). The factors that significantly influenced post-obturation pain experience were: gender (OR=0.55, 95%CI=0.32- 0.93; p=0.03), tooth type (OR-0.67; 95% CI=10.56-0.81, p=0.00), history of preoperative pain (OR=1.26; 95% CI= 1.04-1.51; p=0.02) and number of canals (OR=2.03; 95% CI=1.40-2.95; p=0.00). Conclusion The prevalence of some level of post -operative pain after single visit root canal therapy was high and was significantly influenced by female gender, increased number of canals, posterior tooth type and positive history of pre-operative pain.
根管治疗后的疼痛对患者来说是不良且常见的经历,对牙医而言也令人不快,因此预测此类疼痛一直是人们所期望的。目的:评估对活髓牙进行单次就诊根管治疗后术后疼痛的发生率、强度及相关因素。方法:两位牙髓病医生对418例18岁及以上患者进行了单次就诊根管治疗。使用旋转ProTaper锉对根管进行预备。根管预备后,采用侧向加压技术,用ProTaper通用型牙胶尖和AH-Plus封闭剂对根管进行充填。治疗过程中记录独立因素,之后通过问卷调查术后疼痛的特征。疼痛严重程度采用0-5的视觉模拟量表(VAS)记录。使用逻辑回归模型对数据进行分析。结果:治疗后首6小时内术后疼痛的发生率较高(79.2%),到72小时结束时降至22%,然而大多数(70%)患者有轻度至中度疼痛(VAS 1-2)。显著影响充填后疼痛体验的因素有:性别(OR=0.55,95%CI=0.32-0.93;p=0.03)、牙位(OR=0.67;95%CI=0.56-0.81,p=0.00)、术前疼痛史(OR=1.26;95%CI=1.04-1.51;p=0.02)和根管数量(OR=2.03;95%CI=1.40-2.95;p=0.00)。结论:单次就诊根管治疗后一定程度术后疼痛的发生率较高,且受女性性别、根管数量增加、后牙位及术前疼痛阳性史的显著影响。