Das Supriya, Govind Shashirekha, Jena Debkant, Dash Sumit, Jena Siba Prasad, Yadav Deepika, Karan Smita, Kancherla Jyothsna, Jena Amit, Mishra Lora, Bal Sourav Chandra Bidyasagar, Pattanaik Satabdi
Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to Be) University, Bhubaneswar 751003, Odisha, India.
Department of Dentistry, Shadan Institute of Medical Sciences Research Centre and Teaching Hospital, Himayat Sagar, Hyderabad 500086, Telangana, India.
J Clin Med. 2023 May 24;12(11):3646. doi: 10.3390/jcm12113646.
The study aims to evaluate and compare the onset of local anesthesia (LA) and pain perception during endodontic treatment in hemophilic and thalassemic patients. The study included 90 patients with symptomatic irreversible pulpitis of the mandibular molars. Three groups ( = 30 in each group) were included. Group 1: hemophilic patients; group 2: thalassemic patients; and group 3: individuals without any systemic diseases. Onset of LA and visual analogue scale (VAS) scores was recorded immediately after the administration of local anesthesia, during the pulp exposure procedure, and during canal instrumentation, and were compared between the three groups. Frequency distribution, ANOVA, and linear regression analysis ( < 0.05) were applied. The mean onset time was 46 ± 34 s in the hemophilic group, 42 ± 23 s in the thalassemic group, and 38 ± 12 s in controls, but the differences were statistically insignificant. After LA administration (LA-VAS), all three groups experienced a statistically significant reduction in pain ( = 0.048). On pulp exposure (PE-VAS) ( = 0.82) and during canal instrumentation (CI-VAS) ( = 0.55), there was no statistically significant difference in pain perception between the groups. The coefficients indicate a positive correlation between the VAS and onset time, indicating a positive reduction in the VAS following the administration of LA. Hemophilic patients exhibited a clinically longer average onset time for LA. However, the difference among the three groups with regard to the overall pain perception after LA administration, during and after pulp exposure, and during canal instrumentation was statistically insignificant.
本研究旨在评估和比较血友病患者和地中海贫血患者在牙髓治疗过程中局部麻醉（LA）的起效时间和疼痛感知。该研究纳入了90例下颌磨牙有症状的不可逆性牙髓炎患者。分为三组（每组n = 30）。第1组：血友病患者；第2组：地中海贫血患者；第3组：无任何全身性疾病的个体。在局部麻醉给药后、牙髓暴露过程中和根管预备期间，记录LA的起效时间和视觉模拟评分（VAS），并在三组之间进行比较。应用频率分布、方差分析和线性回归分析（P < 0.05）。血友病组的平均起效时间为46 ± 34秒，地中海贫血组为42 ± 23秒，对照组为38 ± 12秒，但差异无统计学意义。局部麻醉给药后（LA-VAS），三组患者的疼痛均有统计学意义的减轻（P = 0.048）。在牙髓暴露时（PE-VAS）（P = 0.82）和根管预备期间（CI-VAS）（P = 0.55），各组之间的疼痛感知无统计学意义的差异。系数表明VAS与起效时间之间呈正相关，表明局部麻醉给药后VAS呈正向降低。血友病患者的LA临床平均起效时间较长。然而，三组在局部麻醉给药后、牙髓暴露期间及之后以及根管预备期间的总体疼痛感知差异无统计学意义。
