Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
J Endod. 2020 May;46(5):611-618. doi: 10.1016/j.joen.2020.01.024. Epub 2020 Mar 4.
The aims of this study were to examine whether teeth adjacent and contralateral to endodontically diseased teeth showed co-occurring mechanical allodynia and to determine whether demographic and clinical variables were involved in such associations.
Patients with irreversibly inflamed or necrotic permanent first molars or second premolars were examined. From the 348 eligible patients (160 men and 188 women; mean age ± standard deviation = 30.4 ± 10.0 years), data on age, sex, health status, current presence of pain, tooth type, dental arc, and pulpal diagnosis were collected. Percussion testing was applied to all posterior teeth, and the degrees of pain were recorded using a 4-point verbal scale as follows: none to slight (coded as 0) and moderate to severe (coded as 1). Following association rule mining (with minimum support and confidence levels of 0.1), univariate and multiple logistic regression analyses were performed at various stringency levels (α = 0.05).
The number of painful associations was greater ipsilaterally than contralaterally and distally than mesially and increased with the severity of percussion pain in the diseased tooth. Successful regression models were established for the ipsilateral (between the diseased tooth and adjacent teeth; current pain: odds ratio = 3.37; 95% confidence interval, 1.94-5.83) and contralateral (between the diseased tooth and the tooth distal to the contralateral symmetrical tooth; dental arc: odds ratio = 2.40; 95% confidence interval, 1.21-4.76) sides (P < .05).
Healthy teeth adjacent and contralateral to symptomatic diseased teeth exhibited percussion sensitivity. Patients' current pain and dental arc, respectively, were involved in such painful associations.
本研究旨在检验患牙的邻牙和对侧牙是否存在并发的机械性触诱发痛，并确定人口统计学和临床变量是否与这些关联有关。
研究对象为患有不可逆性炎症或坏死的恒牙第一磨牙或第二前磨牙的患者。从 348 名符合条件的患者（160 名男性和 188 名女性；平均年龄±标准差=30.4±10.0 岁）中，收集了年龄、性别、健康状况、当前疼痛状况、牙位、牙弓、牙髓诊断等数据。对所有后牙进行叩诊检查，并使用 4 分制口述评分记录疼痛程度：无或轻微（编码为 0）和中度或重度（编码为 1）。在关联规则挖掘（最小支持度和置信度分别为 0.1）之后，在不同严格程度下（α=0.05）进行了单变量和多变量逻辑回归分析。
同侧的疼痛关联数量多于对侧，远中多于近中，且与患牙叩诊疼痛的严重程度呈正相关。建立了成功的回归模型，包括同侧（患牙与其相邻牙之间；当前疼痛：比值比=3.37；95%置信区间，1.94-5.83）和对侧（患牙与其对侧同名牙的远中牙之间；牙弓：比值比=2.40；95%置信区间，1.21-4.76）（P<0.05）。
患牙的健康邻牙和对侧牙存在叩诊敏感。患者当前的疼痛和牙弓分别与这些疼痛关联有关。
