Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Clin Exp Dent Res. 2023 Oct;9(5):859-867. doi: 10.1002/cre2.754. Epub 2023 Jun 22.
This study aimed to determine the severity of pain after endodontic treatment of mandibular molars with irreversible pulpitis following the use of sodium hypochlorite (NaOCl) at different temperatures and concentrations.
In this randomized, controlled clinical trial, 72 patients with mandibular molars with irreversible pulpitis were randomly assigned to six groups. The teeth were anesthetized and the root canals were prepared. During the instrumentation, the root canals were irrigated with NaOCl solution at concentrations of 0.5% and 1% and temperatures of 2.5°C, 22°C, and 40°C, 2.5°C were achieved through cryotherapy. Assessment of pain was conducted before, immediately after, and 3, 24, 48, and 72 h after treatment. After obturation, the patients recorded their pain intensity at different time intervals on the visual analog scale (VAS) and reported the number of analgesics tablets they used. The frequency of analgesics tablets and their effect on pain sensation was recorded in the second part of the form. Repeated measures two-way analysis of variance test was used to compare the trend of pain changes over time between two intervals of time in each group. Friedman's nonparametric test was used to compare the intragroup mean score of pain over time and Kruskal-Wallis for comparing the intergroup mean score.
Changes in VAS pain scores of all the groups were significant over time (p < .001). Pain in all the groups decreased immediately after treatment and increased 3 h after treatment. There were no significant differences in pain ratings and the number of analgesics tablets used in the groups of NaOCl with different concentrations and temperatures over time.
Within the study's limitations, we concluded that there was no significant difference between concentrations of 0.5%, and 1% and temperatures of 2.5°C, 22°C, and 40°C in pain intensity following endodontic treatment of mandibular molars with irreversible pulpitis.
本研究旨在确定在不同温度和浓度的次氯酸钠(NaOCl)使用后,治疗不可复性牙髓炎下颌磨牙根管治疗后疼痛的严重程度。
在这项随机、对照的临床试验中,将 72 名患有不可复性牙髓炎的下颌磨牙患者随机分为六组。牙齿麻醉后,预备根管。在器械操作过程中,用浓度为 0.5%和 1%、温度为 2.5°C、22°C 和 40°C 的 NaOCl 溶液冲洗根管,2.5°C 通过冷冻疗法实现。在治疗前、治疗后立即、治疗后 3、24、48 和 72 小时评估疼痛。在充填补料后,患者在不同时间间隔使用视觉模拟量表(VAS)记录他们的疼痛强度,并报告他们使用的镇痛药片数量。表格的第二部分记录了镇痛药片的频率及其对疼痛感觉的影响。采用重复测量双向方差分析检验比较各组两个时间间隔之间疼痛变化趋势。采用 Friedman 非参数检验比较组内疼痛随时间的平均评分,采用 Kruskal-Wallis 检验比较组间平均评分。
所有组的 VAS 疼痛评分随时间的变化均具有统计学意义(p<0.001)。所有组的疼痛在治疗后立即减轻,在治疗后 3 小时增加。不同浓度和温度的 NaOCl 组在疼痛评分和镇痛药片使用数量方面,随时间无显著差异。
在研究的限制范围内,我们得出结论,在不可复性牙髓炎下颌磨牙根管治疗后,0.5%和 1%的浓度以及 2.5°C、22°C 和 40°C 的温度之间,疼痛强度没有显著差异。