Ghanbarzadegan Arash, Ajami Majid, Aminsobhani Mohsen
Department of Endodontic, Dental School, Aja University of Medical Sciences, Tehran, Iran.
Iran Endod J. 2019 Winter;14(1):1-6. doi: 10.22037/iej.v14i1.22815.
After treating the tooth root canal, pain is one of the problems that many patients are facing. In order to reduce pain, and regarding the advice of treating necrotic teeth during several sessions, intra-canal medicaments can be used between sessions. The purpose of this study is to compare pain relieving effect of calcium hydroxide combined with three solutions of normal saline, chlorhexidine 2% and dexamethasone.
This triple blind randomized clinical trial was performed on 90 necrotic molars and premolars. The patients were classified in three medicaments' groups including mixture of calcium hydroxide and normal saline (G1), chlorhexidine 2% (G2) or dexamethasone (G3) that were placed in the canal during the first treatment session. The patients were provided with a Heft-Parker Visual Analog Scale form to record their pain in different intervals of 4, 24, 48, 72 and 96 h after cleaning and shaping the root canal. Data analysis was carried out using the Chi-Square, one-way ANOVA and Repeated Measure tests.
No significant difference was observed in the mean pain of the groups after 4 h (>0.05). However, a significant difference was found between G1 and G3 in the mean pain from day 1 to 72 h after treatment. The mean pain was less in dexamethasone (G3) group (<0.05), but the difference was not statistically significant at 96 h after treatment (>0.05). No significant difference was found between "G2-G1" and "G2-G3" groups at different time intervals (>0.05).
The mixture of calcium hydroxide and dexamethasone compared to calcium hydroxide and normal saline in short and medium time had a significant effect on reducing pain after cleaning and shaping the root canal. It seems that the mixture of calcium hydroxide and dexamethasone can be considered as an effective medicament on reducing pain during root canal treatment sessions.
在进行根管治疗后，疼痛是许多患者面临的问题之一。为了减轻疼痛，并考虑到关于分多次治疗坏死牙齿的建议，在治疗期间可以使用根管内药物。本研究的目的是比较氢氧化钙与三种溶液（生理盐水、2%洗必泰、地塞米松）联合使用时的止痛效果。
本三盲随机临床试验针对90颗坏死磨牙和前磨牙进行。患者被分为三个药物组，包括氢氧化钙与生理盐水混合组（G1）、2%洗必泰组（G2）或地塞米松组（G3），在首次治疗时将药物置于根管内。为患者提供Heft-Parker视觉模拟量表，以记录他们在根管清理和成形后4、24、48、72和96小时不同时间段的疼痛情况。数据分析采用卡方检验、单因素方差分析和重复测量检验。
4小时后，各治疗组的平均疼痛程度无显著差异（>0.05）。然而，治疗后第1天至72小时，G1组和G3组的平均疼痛程度存在显著差异。地塞米松（G3）组的平均疼痛程度较低（<0.05），但治疗后96小时差异无统计学意义（>0.05）。在不同时间间隔，“G2-G1”组和“G2-G3”组之间无显著差异（>0.05）。
与氢氧化钙和生理盐水相比，氢氧化钙与地塞米松的混合物在根管清理和成形后的短期和中期对减轻疼痛有显著效果。氢氧化钙与地塞米松的混合物似乎可被视为根管治疗期间减轻疼痛的有效药物。
