Post Graduate Institute of Dental Sciences, Pt.B.D. Sharma University of Health Sciences Rohtak, Haryana, India.
Post Graduate Institute of Dental Sciences, Pt.B.D. Sharma University of Health Sciences Rohtak, Haryana, India.
J Endod. 2021 Jul;47(7):1052-1060. doi: 10.1016/j.joen.2021.04.013. Epub 2021 Apr 24.
The purpose of this study was to evaluate the effect of the piezoelectric device on intraoperative hemorrhage control during surgery and the quality of life of patients after endodontic microsurgery.
A total of 40 patients were randomly divided into the piezo group (n = 20) and the control group (n = 20). In the piezo group, after flap reflection, bone cutting, granulation tissue removal, and root-end resection were performed using the piezoelectric surgical device and surgical carbide burs, and curettes were used in the control group. The quality of life of patients was evaluated daily for 1 week postsurgery for limitations of oral and general functions, pain, and other symptoms. Limitation of functions and other symptoms were recorded by a modified version of the patient's perception questionnaire using a 5-point Likert scale for mouth opening, chewing, speaking, sleeping, daily routine, missed work, swelling, nausea, and bad taste/breath, and the visual analog scale was adopted for pain. Hemorrhage control during surgery was independently assessed by the surgeon and 2 blinded observers and recorded as 0 (no hemorrhage control), 1 (intermittent control), and 2 (complete control). The chi-square test was used to assess hemorrhage control. For variables related to function and symptoms other than pain and analgesics taken, the Fisher exact test was used. For the assessment of pain between the 2 groups, the Mann-Whitney U test was used.
For parameters of quality of life, the piezo group showed significantly less swelling on the first, second, and third days and pain on the first and second days compared with the control group (P < .05). Analgesics taken were also significantly less in the piezo group (P < .05). In the piezo group, complete hemorrhage control was achieved in 10 patients, and in the control group, it was achieved only in 1 patient (P < .05).
Piezoelectric surgery resulted in improved quality of life of patients in the first week postsurgery with lower levels of pain and swelling as well as the number of analgesics taken and better hemorrhage control during surgery.
本研究旨在评估压电设备在手术过程中控制术中出血的效果以及对根管显微镜手术后患者生活质量的影响。
共 40 例患者随机分为压电组（n = 20）和对照组（n = 20）。在压电组中，在使用压电手术设备和外科碳化钨车针进行瓣反射、骨切割、肉芽组织切除和根尖切除后，使用刮匙；在对照组中，仅使用刮匙。术后第 1 天至第 7 天，每天评估患者的生活质量，评估口腔和全身功能受限、疼痛和其他症状。使用改良的患者感知问卷通过 5 分李克特量表记录功能受限和其他症状，包括张口、咀嚼、说话、睡眠、日常活动、缺工、肿胀、恶心和口臭/口气不佳以及疼痛的视觉模拟量表。手术过程中的出血控制由手术医生和 2 名盲法观察者独立评估，并记录为 0（无出血控制）、1（间歇性控制）和 2（完全控制）。采用卡方检验评估出血控制情况。对于疼痛以外的功能和症状相关变量，采用 Fisher 确切检验。对于两组之间疼痛的评估，采用 Mann-Whitney U 检验。
在生活质量参数方面，压电组在第 1、2 和 3 天的肿胀程度和第 1、2 天的疼痛程度明显低于对照组（P <.05）。压电组使用的镇痛药也明显较少（P <.05）。在压电组中，10 例患者实现了完全的出血控制，而在对照组中仅 1 例患者实现了完全的出血控制（P <.05）。
压电手术可提高术后第 1 周患者的生活质量，减轻疼痛和肿胀程度，减少镇痛药的使用，并且术中出血控制效果更好。
