Morse D R, Furst M L, Belott R M, Lefkowitz R D, Spritzer I B, Sideman B H
Department of Endodontology, Temple University School of Dentistry, Philadelphia, Pa.
Oral Surg Oral Med Oral Pathol. 1987 Dec;64(6):734-41. doi: 10.1016/0030-4220(87)90178-2.
To clarify the divergent viewpoints with respect to method of instrumentation in asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL), this prospective study was undertaken. The subjects were 106 patients with quiescent cases of PN/PL. Alternately, 53 had periapical instrumentation and 53 had intracanal instrumentation. Prophylactic antibiotics were not administered but the patients were told to take an antibiotic at the first sign of swelling. Flare-ups, non-flare-up-associated swelling and pain, and cases in which there were no postoperative problems were evaluated at 1-day, at 1 week, and at 2 months. A 6.6% incidence of flare-up was found with no statistically significant difference between periapical instrumentation (7.5%) and intracanal instrumentation (5.7%). A 27.4% incidence of swelling was found with no statistically significant difference between periapical instrumentation (24.5%) and intracanal instrumentation (30.2%). A 43.4% incidence of pain was found, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (47.2%). When moderate pain and severe pain were combined, the incidence was 21.7%, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (28.3%). An incidence of patients having no postoperative problems of 41.5% was found, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (35.8%). When flare-ups were combined with swelling, the incidence was 34.0%, with no statistically significant difference between periapical instrumentation (32.1%) and intracanal instrumentation (35.8%). When flare-ups were combined with pain, the incidence was 50.0%, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (52.8%).(ABSTRACT TRUNCATED AT 250 WORDS)
为了阐明关于无症状牙髓坏死及相关根尖周透射性病变（PN/PL）患牙的根管预备方法存在的不同观点，开展了这项前瞻性研究。研究对象为106例PN/PL静止期患者。将患者分为两组，每组53例，分别接受根尖周预备和根管内预备。未给予预防性抗生素，但告知患者出现肿胀迹象时服用抗生素。在术后1天、1周和2个月时评估急性发作、与急性发作无关的肿胀和疼痛以及无术后问题的病例。结果发现急性发作的发生率为6.6%，根尖周预备组（7.5%）和根管内预备组（5.7%）之间无统计学显著差异。肿胀的发生率为27.4%，根尖周预备组（24.5%）和根管内预备组（30.2%）之间无统计学显著差异。疼痛的发生率为43.4%，根尖周预备组（15.1%）和根管内预备组（47.2%）之间无统计学显著差异。当中度疼痛和重度疼痛合并计算时，发生率为21.7%，根尖周预备组（15.1%）和根管内预备组（28.3%）之间无统计学显著差异。无术后问题的患者发生率为41.5%，根尖周预备组（47.2%）和根管内预备组（35.8%）之间无统计学显著差异。当急性发作与肿胀合并计算时，发生率为34.0%，根尖周预备组（32.1%）和根管内预备组（35.8%）之间无统计学显著差异。当急性发作与疼痛合并计算时，发生率为50.0%，根尖周预备组（47.2%）和根管内预备组（52.8%）之间无统计学显著差异。（摘要截选至250词）
