São Leopoldo Mandic School of Dentistry, Rua Emilio Ribas 776 sala 13, Campinas, SP, 13025-141, Brazil.
Universidade Federal Fluminense - UFF, School of Dentistry, Department of Endodontics, Niterói, RJ , Brazil.
Photodiagnosis Photodyn Ther. 2021 Sep;35:102348. doi: 10.1016/j.pdpdt.2021.102348. Epub 2021 May 24.
This study aimed to evaluate the impact of photodynamic therapy (PDT) after root canal preparation on pain relief in posterior teeth presenting with symptomatic apical periodontitis (SAP). A visual analog scale (VAS) was completed by the patients which registered their pain perception as none (0), mild (1-3), moderate (4-7), or severe (8-10). Only patients who registered moderate or severe pain were included. Seventy patients were allocated to two groups (n=35): a control group (CG) without the PDT application and an intervention group with PDT application (PG). The same chemo-mechanical preparation was achieved in both groups. In the PG, 150 µM methylene blue (MB)Please remove the underline was placed inside the canal for 2 minutes and a 660 nm wavelength laser was applied through a fiber for 3 minutes (100 mW, 600 J/cm², total 18J). The patients were asked to register their pain perception in the VAS document after 24-h, 72-h, and 1-week intervals. The number of tablets taken for pain relief was also recorded. The Mann-Whitney, Students T-test and Fisher´s exact tests were used for statistical analysis (P < .05). After 1 week, 32 patients in the CG and 33 in the PG returned their VAS cards. The PG resulted in lower pain levels after the 24-hour interval (median 0) than the CG (median 2); there was no difference between both groups at 72-h and 1-week intervals. The decrease in pain was higher in the PG at all time-intervals when compared to the CG. There was no difference in the mean number of tablets taken for pain relief (P > .05). Within the limitations of this study, it can be concluded that PDT was efficient in decreasing pain in teeth presenting with SAP. There was no difference observed after 72 hours and there was no impact on the intake of pain relief medication.
本研究旨在评估根管预备后光动力疗法（PDT）对有症状的根尖周炎（SAP）后牙缓解疼痛的影响。患者使用视觉模拟量表（VAS）登记其疼痛感知，分为无（0）、轻度（1-3）、中度（4-7）或重度（8-10）。仅纳入中度或重度疼痛的患者。70 名患者被分为两组（n=35）：对照组（CG）无 PDT 应用，实验组（PG）有 PDT 应用。两组均采用相同的化学机械预备。在 PG 中，将 150µM 亚甲蓝（MB）放入根管内 2 分钟，然后用光纤施加 660nm 波长激光 3 分钟（100mW，600J/cm²，总 18J）。患者在 24 小时、72 小时和 1 周间隔后在 VAS 文档中登记疼痛感知。还记录了用于缓解疼痛的片剂数量。使用曼-惠特尼、学生 t 检验和 Fisher 确切检验进行统计分析（P<.05）。1 周后，CG 组有 32 名患者和 PG 组有 33 名患者返回了他们的 VAS 卡。PG 组在 24 小时间隔后的疼痛水平低于 CG 组（中位数 0）；两组在 72 小时和 1 周间隔时无差异。与 CG 相比，PG 在所有时间间隔的疼痛减轻程度更高。用于缓解疼痛的片剂平均数量无差异（P>.05）。在本研究的限制范围内，可以得出结论，PDT 可有效降低 SAP 后牙齿的疼痛。72 小时后无差异，对缓解疼痛药物的摄入无影响。
