Kumar Umesh, Parmar Pragnesh, Vashisht Ruchi, Tandon Namita, Kaur Charan Kamal
Unit of Conservative Dentistry & Endodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
J Dent Anesth Pain Med. 2023 Apr;23(2):91-99. doi: 10.17245/jdapm.2023.23.2.91. Epub 2023 Mar 28.
Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions.
Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7 day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7 day using a visual analogue scale.
There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed.
The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.
在使用各种器械和预备技术进行根管治疗时，碎屑挤出是导致术后疼痛的主要因素。因此，需要一种预备技术，既能将最少的碎屑挤出至根尖周区域，又能减轻疼痛。本研究旨在比较使用两种具有不同运动方式的单支锉和全序列连续旋转系统对下颌后牙进行根管治疗后，术后疼痛的发生率以及镇痛药物的服用情况（频率和剂量）。
105例患者中的35例根据所使用的预备系统被平均分为三组：ProTaper Next（PN）X2，25/06（登士柏，迈徕福，瑞士巴拉格）；One Shape（OS），#0.25/06（迈科梅加，法国贝桑松）；Wave One Gold（WG），Red - #0.25，0.07（登士柏，迈徕福，瑞士巴拉格）。本研究设计纳入了五名专家；每位专家预备21颗牙齿，并为每个器械系统随机选择7颗。使用范围为0至10的视觉模拟评分（VAS）表记录下颌前磨牙和磨牙单次就诊根管治疗后24、48和72小时以及7天时的初始疼痛和术后疼痛，这些牙齿诊断为无症状性不可逆性牙髓炎伴或不伴根尖周炎。术后，对于难以忍受的疼痛，给予400毫克布洛芬镇痛，剂量为每6小时1片。通过电话询问患者在24、48和72小时以及7天时使用视觉模拟量表评估的术后疼痛情况。
在评估的四个时间点中的任何一个，PN、OS和WG系统在术后疼痛发生率方面均无统计学显著差异（P>0.05）。
所有三种器械系统的术后疼痛强度、频率和镇痛药物服用情况相似；然而，往复式单支锉（WG）与全序列连续旋转锉相比，术后疼痛更少。
