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评价 Nd:YAG 和二极管激光经根管内应用于有症状不可复性牙髓炎和无症状坏死牙髓患者术后疼痛/不适的效果:一项随机对照试验。

Evaluation of postoperative pain/discomfort after intracanal use of Nd:YAG and diode lasers in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps: a randomized control trial.

机构信息

Dentistry Faculty, Department of Endodontics, Gaziantep University, Şehitkamil, 27060, Gaziantep, Turkey.

, Gaziantep, Turkey.

出版信息

Clin Oral Investig. 2021 May;25(5):2737-2744. doi: 10.1007/s00784-020-03588-8. Epub 2021 Jan 6.

DOI:10.1007/s00784-020-03588-8
PMID:33409689
Abstract

OBJECTIVES

This study aimed to investigate the ability of the diode and Nd:YAG lasers to decrease postoperative pain/discomfort after intracanal application in vital and devital endodontic cases.

MATERIAL AND METHODS

One hundred two patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps were selected and randomly divided into three groups. After chemomechanical preparation, Nd:YAG and diode laser was applied to first and second groups for final treatment of the root canals. In the control group, no further disinfection protocol was performed upon traditional procedures. Then all the teeth were obturated in the same appointment. Pre- and postoperative pain were recorded using the VAS at 0, 12th, 24th, 48th, and 72nd hours following the treatment Kruskal-Wallis and Dunn test.

RESULTS

VAS scores were significantly the most at 12-h period compared with other time periods after treatment for all groups. There was no significant difference among Nd:YAG laser, diode laser, and control groups in non-vital cases (p > 0.05). In vital cases, Nd:YAG laser group represented significantly fewer scores compared with diode laser and control groups at 48-h period (p < 0.05).

CONCLUSIONS

The processes involving the use of Nd:YAG and diode lasers after chemomechanical preparation was found to be equivalent in terms of postoperative pain intensity after completion of treatment in one session both in vital or non-vital cases except in vital cases in Nd:YAG group at 48 h.

CLINICAL RELEVANCE

Adjunct clinical use of Nd:YAG or diode lasers to traditional chemomechanical preparation did not cause any improvement or deterioration on postoperative discomfort and pain in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps.

摘要

目的

本研究旨在探讨二极管激光和 Nd:YAG 激光在有活力和无活力牙髓病例的根管内应用后,降低术后疼痛/不适的能力。

材料和方法

选择 102 例有症状不可复性牙髓炎和无症状坏死牙髓的患者,并随机分为三组。在化学机械预备后,Nd:YAG 和二极管激光分别应用于第一组和第二组,作为根管的最终治疗。在对照组中,传统操作后不进行进一步的消毒方案。然后所有牙齿都在同一预约中进行封闭。使用视觉模拟评分法(VAS)在治疗后 0、12、24、48 和 72 小时记录术前和术后疼痛。Kruskal-Wallis 和 Dunn 检验用于比较各组之间的差异。

结果

与其他时间点相比,所有组在治疗后 12 小时的 VAS 评分均显著最高。在非活力病例中,Nd:YAG 激光组、二极管激光组和对照组之间没有显著差异(p>0.05)。在有活力的病例中,与二极管激光组和对照组相比,Nd:YAG 激光组在 48 小时时的评分明显较低(p<0.05)。

结论

在一次性治疗完成后,化学机械预备后使用 Nd:YAG 和二极管激光的过程在有活力和无活力的病例中,在术后疼痛强度方面被发现是等效的,除了在 Nd:YAG 组的 48 小时时在有活力的病例中。

临床相关性

在有症状不可复性牙髓炎和无症状坏死牙髓的患者中,传统化学机械预备联合使用 Nd:YAG 或二极管激光并没有改善或恶化术后不适和疼痛。

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