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对坏死牙进行大面积故意扩大根管口后的根管治疗术后疼痛

Postoperative pain after endodontic treatment of necrotic teeth with large intentional foraminal enlargement.

作者信息

Machado Ricardo, Comparin Daniel, Ignácio Sérgio Aparecido, da Silva Neto Ulisses Xavier

机构信息

Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil.

Department of Endodontics, School of Dentistry, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil.

出版信息

Restor Dent Endod. 2021 May 31;46(3):e31. doi: 10.5395/rde.2021.46.e31. eCollection 2021 Aug.

Abstract

OBJECTIVES

To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE).

MATERIALS AND METHODS

The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%.

RESULTS

Age, gender, periradicular status and tooth type did not influence postoperative pain ( > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively ( = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours ( = 0.04). Sealer extrusion did not influence the postoperative pain ( > 0.05).

CONCLUSIONS

Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.

TRIAL REGISTRATION

The Brazilian Clinical Trials Registry Identifier: RBR-3r967t.

摘要

目的

评估采用大有意性根尖孔扩大术(LIFE)对坏死牙进行根管治疗后的术后疼痛情况。

材料与方法

样本包括60颗无症状的坏死牙(伴有或不伴有慢性根尖周炎),牙周探诊深度为3mm,此前已进行开髓并准备进行根管治疗。在完成前期操作后,分别使用根尖定位仪和K型flexo锉确定根尖孔(AF)的位置和大致大小。使用Profile 04锉在AF超出2mm处进行化学机械预备以实现LIFE,每次更换锉时使用2.5mL 2.5%的次氯酸钠。采用Tagger混合技术和EndoFill封闭剂进行充填。在治疗后24、48和72小时对所有患者进行电话随访,对术后疼痛进行分类。采用不同检验进行统计分析,显著性水平为5%。

结果

年龄、性别、根尖周状况和牙齿类型均不影响术后疼痛(P>0.05)。仅1例患者(1.66%)在72小时后报告有重度疼痛。分别有7、4和3例患者在24、48和72小时后报告有中度疼痛(P = 0.0001)。然而,配对分析显示仅在24和72小时之间存在统计学显著差异(P = 0.04)。封闭剂挤出不影响术后疼痛(P>0.05)。

结论

采用LIFE对坏死牙进行根管治疗后,急性或中度术后疼痛并不常见。

试验注册

巴西临床试验注册标识符:RBR-3r967t。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74f3/8411006/9667aaf928bd/rde-46-e31-g001.jpg

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