Bagheri Mona, Khimani Hussein, Pishbin Lida, Shahabinejad Hassan
Department of Endodontics, Kerman Dental School, Kerman, Iran.
Department of Endodontics, Boston University, Henry M Goldman School of Dental Medicine, Boston, USA.
Eur Endod J. 2019 Jun 20;4(2):69-74. doi: 10.14744/eej.2019.91885. eCollection 2019.
Endodontic post-treatment pain continues to be one of the main problems encountered by dental professionals. Therefore, pain control during and after endodontic treatment is one of the most important issues in endodontics. The purpose of this clinical trial was to compare postoperative pain relief achieved with dexamethasone (DEX) and mineral trioxide aggregate (MTA) used as pulp coverage after pulpotomy in human molars with irreversible pulpitis.
This prospective double-blind study was conducted on 54 patients complaining of dental pain due to irreversible pulpitis. The standard pulpotomy procedure was performed by the same dentist in all patients. At the time of the cotton pellet placement, patients were randomly divided into three groups: those in whom a sterile dry cotton (DC) pellet was used, patients treated with a cotton pellet soaked in MTA, and those who were treated with a cotton pellet soaked in DEX. After completion of the treatment, patients received rescue medication every 6 hours for the first day. Postoperative pain was assessed at 6-hour intervals for 24 hours, and then every day until day 7 using a visual analog scale.
In general, patients treated with MTA suffered the lowest levels of pain at all time intervals. Post-pulpotomy pain was significantly reduced at 18 and 24 hours and from days 2 to 7 post-treatment in the MTA group. DEX lowered the pain level more than the DC pellet. However, the differences observed in the mean pain scores of the DEX and DC pellet groups at all-time intervals were not statistically significant.
Pulpotomy procedures can reduce pain related irreversible pulpitis. Pulpotomy with MTA-soaked cotton pellet significantly reduces pain intensity in patients with irreversible pulpitis.
牙髓治疗后的疼痛仍是牙科专业人员面临的主要问题之一。因此，牙髓治疗期间及之后的疼痛控制是牙髓病学中最重要的问题之一。本临床试验的目的是比较在患有不可逆性牙髓炎的人类磨牙进行牙髓切断术后，使用地塞米松（DEX）和三氧化矿物凝聚体（MTA）作为牙髓覆盖物所实现的术后疼痛缓解情况。
本前瞻性双盲研究针对54名因不可逆性牙髓炎而抱怨牙痛的患者进行。所有患者均由同一位牙医进行标准的牙髓切断术操作。在放置棉球时，患者被随机分为三组：使用无菌干棉球（DC）的患者、用浸泡MTA的棉球治疗的患者以及用浸泡DEX的棉球治疗的患者。治疗完成后，患者在第一天每6小时接受一次急救药物。术后疼痛在24小时内每6小时评估一次，然后每天评估直至第7天，使用视觉模拟量表进行评估。
总体而言，在所有时间间隔内，接受MTA治疗的患者疼痛程度最低。在MTA组中，牙髓切断术后18小时和第24小时以及治疗后第2天至第7天，疼痛明显减轻。DEX比DC棉球更能降低疼痛程度。然而，DEX组和DC棉球组在所有时间间隔的平均疼痛评分差异无统计学意义。
牙髓切断术可减轻与不可逆性牙髓炎相关的疼痛。用浸泡MTA的棉球进行牙髓切断术可显著降低不可逆性牙髓炎患者的疼痛强度。
