Bamini Lavanya, Sherwood Anand, Arias Ana, Subramani Savadamoorthi Kamatchi, Bhargavi Puridi
Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu 625 001, India.
Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain.
Dent J (Basel). 2020 Jul 7;8(3):73. doi: 10.3390/dj8030073.
The objective of this prospective study was to assess tooth-related factors that play a role in the incidence of postoperative pain (PP) and determining if procedural errors influence PP occurrence. A total of 442 patients referred for root canal treatment met the inclusion criteria and were included in this prospective study. The same protocol was used in all root canal treatments. Patient, tooth, treatment related factors and the occurrence of procedural errors were registered. Incidence and intensity of PP was assessed at 24 and 48 h by telephonic interview and in person seven and 15 days after treatment. A logistic and ordinal regression analysis was used to assess the role of patient, tooth and treatment related factors in the incidence and intensity of PP, respectively. Preoperative and intraoperative factors differently affected the incidence of PP at the different time intervals. The presence of procedural errors did not significantly influence PP occurrence. The presence of preoperative pain and the need of additional anesthesia during treatment were associated with higher incidence of PP 24 and 48 h after treatment; the extent of apical enlargement played a significant role in the presence of PP after seven days of treatment; and the excessive occlusal load induced by the absence of a contralateral tooth was the only factor related to the maintenance of PP up to 15 days. In conclusion, the presence of preoperative pain, the need of additional anesthesia during treatment, the extent of apical enlargement and the excessive occlusal load induced by the absence of a contralateral tooth were related to a higher incidence of PP.
这项前瞻性研究的目的是评估与牙齿相关的因素在术后疼痛（PP）发生率中所起的作用，并确定操作失误是否会影响PP的发生。共有442名因根管治疗前来就诊的患者符合纳入标准，并被纳入这项前瞻性研究。所有根管治疗均采用相同的方案。记录患者、牙齿、治疗相关因素以及操作失误的发生情况。通过电话访谈在24小时和48小时评估PP的发生率和强度，并在治疗后7天和15天进行当面评估。分别采用逻辑回归和有序回归分析来评估患者、牙齿和治疗相关因素在PP发生率和强度中的作用。术前和术中因素在不同时间间隔对PP发生率的影响不同。操作失误的存在并未显著影响PP的发生。术前疼痛的存在以及治疗期间需要额外麻醉与治疗后24小时和48小时PP的较高发生率相关；根尖扩大的程度在治疗7天后PP的发生中起重要作用；对侧牙齿缺失导致的过度咬合负荷是与PP持续至15天相关的唯一因素。总之，术前疼痛的存在、治疗期间需要额外麻醉、根尖扩大的程度以及对侧牙齿缺失导致的过度咬合负荷与PP的较高发生率相关。
