Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey.
Department of Endodontics, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Cumhuriyet Mahallesi Sahilyolu Cad. No: 5 Kepez, Çanakkale, Turkey.
Odontology. 2022 Oct;110(4):786-794. doi: 10.1007/s10266-022-00700-0. Epub 2022 Mar 10.
To investigate the efficacy of a new laser irrigation activation system [shock wave-enhanced emission photo-acoustic streaming (SWEEPS)] in terms of postoperative pain after primary root canal treatment compared with other techniques, namely photon-induced photo-acoustic streaming (PIPS), sonic system with EDDY, passive ultrasonic system (PUI), and manual dynamic activation (MDA). Two hundred patients with symptomatic irreversible pulpitis in mandibular premolar teeth were enrolled and randomly allocated to five different irrigation activation groups (n = 40) after chemo-mechanical root canal preparation. For irrigation activation, the SWEEPS and PIPS tips were attached to the Er-YAG laser system in the respective groups, while the Irrisafe tip was used in the PUI group and the EDDY tip in the sonic group. In the MDA group, irrigation was agitated with the master gutta-percha cone. At postoperative hours 8, 24, and 48 and on day 7, pain intensity was evaluated using the 10-mm Visual Analog Scale (VAS) and analgesic intake was recorded. The Kruskal-Wallis test was used to analyze the VAS scores, and pain prevalence and analgesic intake were examined with the Pearson's chi-square test at the 5% significance level. The PIPS and SWEEPS groups had the lowest level and prevalence of pain when compared to the remaining groups (P < 0.001). The PUI, sonic and MDA groups did not differ in terms of pain scores at hours 8 and 48 (P > 0.05). On day 7, the highest score and pain prevalence were recorded in the MDA group (P < 0.001). There was no difference between the groups in terms of analgesic intake (P > 0.05). Laser-activated irrigation systems provided lower postoperative pain scores and levels compared to the other activation systems. The MDA group had the highest pain scores and incidence at the end of the seventh day.
为了研究一种新的激光冲洗激活系统[冲击波增强发射光声流(SWEEPS)]在原发性根管治疗后术后疼痛方面的疗效，与其他技术相比，即光子诱导光声流(PIPS)、带有 EDDY 的声系统、被动超声系统(PUI)和手动动态激活(MDA)。将 200 名下颌前磨牙有症状不可复性牙髓炎的患者纳入研究，并在化学机械根管预备后随机分为 5 个不同的冲洗激活组(n=40)。对于冲洗激活，SWEEPS 和 PIPS 尖端分别连接到 Er-YAG 激光系统中，而 Irrisafe 尖端用于 PUI 组，EDDY 尖端用于声组。在 MDA 组中，用主牙胶尖搅拌冲洗。在术后 8、24 和 48 小时以及第 7 天，使用 10mm 视觉模拟量表(VAS)评估疼痛强度，并记录镇痛药摄入量。采用 Kruskal-Wallis 检验分析 VAS 评分，采用 Pearson 卡方检验分析疼痛发生率和镇痛药摄入，检验水准为 5%。与其他组相比，PIPS 和 SWEEPS 组的疼痛程度最低，疼痛发生率最低(P<0.001)。在 8 小时和 48 小时，PUI、声组和 MDA 组的疼痛评分没有差异(P>0.05)。在第 7 天，MDA 组记录到最高的评分和疼痛发生率(P<0.001)。各组之间的镇痛药摄入量无差异(P>0.05)。激光激活冲洗系统比其他激活系统提供的术后疼痛评分和水平更低。在第 7 天结束时，MDA 组的疼痛评分和发生率最高。
