Dhyani Vineet Kumar, Chhabra Sanjay, Sharma Vinay Kumar, Dhyani Abha
Dental Officer, Military Dental Centre, Amritsar Cantt, India.
Commanding Officer, 33 Corps Dental Unit, India.
Med J Armed Forces India. 2022 Sep;78(Suppl 1):S35-S41. doi: 10.1016/j.mjafi.2020.03.010. Epub 2020 Jul 9.
Irreversible pulpitis is a painful and debilitating condition. Root canal treatment (RCT) provides prompt relief and salvages the affected tooth/teeth. It has classically been performed as a multivisit procedure. A relatively newer approach constitutes performing all the steps in one single visit. This study was designed to explore if single-visit RCT could be confidently used as an effective and preferred treatment modality for irreversible pulpitis in the Indian Armed forces.
The study compared the incidence of postoperative pain, tenderness on percussion (TOP), flare-ups, and the analgesic drug use in 60 cases of acute irreversible pulpitis who were treated by either single or multiple visit root canal therapy. Each treatment group included 30 patients who were evaluated preoperatively and postoperatively at 24 h, one week and one month.
The study found statistically higher incidence of postoperative pain (mild variant) and TOP in single visit therapy, 24 h after the obturation while the difference was insignificant at one week and one month after therapy. Analgesic use was significantly higher after the single visit therapy in the first 24 h. No flare-ups were recorded in either group. Significant pain and tenderness was observed after chemo-mechanical preparation (appointment 2) in multivisit regimen.
Single visit therapy is a safe, practical, and effective approach. The treatment results are similar to the multivisit regimen. It should therefore be considered for wider adoption and application.
不可逆性牙髓炎是一种疼痛且使人衰弱的病症。根管治疗(RCT)能迅速缓解疼痛并挽救患牙。传统上它是一种多次就诊的治疗方法。一种相对较新的方法是在一次就诊中完成所有步骤。本研究旨在探讨单次就诊根管治疗是否可被放心地用作印度武装部队不可逆性牙髓炎的一种有效且首选的治疗方式。
该研究比较了60例急性不可逆性牙髓炎患者分别接受单次或多次就诊根管治疗后的术后疼痛发生率、叩诊痛(TOP)、炎症发作情况以及镇痛药使用情况。每个治疗组包括30例患者,在术前以及术后24小时、一周和一个月进行评估。
研究发现,单次就诊治疗在充填后24小时,术后疼痛(轻度)和叩诊痛的发生率在统计学上更高,而在治疗后一周和一个月时差异不显著。单次就诊治疗后最初24小时内镇痛药的使用显著更多。两组均未记录到炎症发作情况。在多次就诊治疗方案中,化学机械预备(第2次就诊)后观察到明显疼痛和压痛。
单次就诊治疗是一种安全、实用且有效的方法。治疗结果与多次就诊治疗方案相似。因此,应考虑更广泛地采用和应用该方法。