Fernandes Leonardo Alexandre, de Sousa Santos Cristiane Flaviana, Ditzel Westphalen Vania Portela, da Silva Neto Ulisses Xavier, Carneiro Everdan
Graduate Program, Dentistry Course, Life Sciences School, Pontifical Catholic University of Paraná, Curitiba, Brazil.
Iran Endod J. 2023;18(3):145-151. doi: 10.22037/iej.v18i3.33925.
This randomized clinical trial aimed to determine whether the XP-endo finisher combined with or without foraminal enlargement has any significant effect on the incidence and intensity of postoperative pain in necrotic pulps.
Clinical pain levels were measured after 6, 12, 24, 48, and 72 hours and at 7 postoperative days. All treatments were performed by an endodontist in a single visit. One hundred and twenty patients were included. All patients had a single tooth treated. The patients were divided into four groups: No FE (None Foraminal Enlargement) (=30), FE (Foraminal Enlargement) (=30), No FE+XPF (None Foraminal Enlargement+XP-endo Finisher) (=30) and XPF+FE (XP-endo Finisher and Foraminal Enlargement) (=30). The canals were irrigated with sodium hypochlorite, shaped using WaveOne Gold Medium file, and then filled by using a matching single cone and AH-Plus sealer. The cavity was filled using glass ionomer cement. Pain intensity was assessed using the visual analog scale. The data were analyzed with the ANOVA and Games-Howell test. The significance level was 5%.
The XPF+FE group experienced a higher level of pain, being classified on the visual analog scale as moderate for 48 postoperative hours and mild for 7 postoperative days (<0.05). In the other groups, the pain was mild, only with different time intervals (>0.05).
Foraminal enlargement associated with XP-endo Finisher may cause moderate postoperative pain.
本随机临床试验旨在确定XP根管锉结合或不结合根尖孔扩大术对坏死牙髓术后疼痛的发生率和强度是否有显著影响。
在术后6、12、24、48和72小时以及术后7天测量临床疼痛水平。所有治疗均由一名牙髓病医生在一次就诊时完成。纳入120例患者。所有患者均为单颗牙齿接受治疗。患者被分为四组:无根尖孔扩大(No FE)(=30例)、根尖孔扩大(FE)(=30例)、无根尖孔扩大+XP根管锉(No FE+XPF)(=30例)和XP根管锉+根尖孔扩大(XPF+FE)(=30例)。根管先用次氯酸钠冲洗,使用WaveOne Gold Medium锉进行预备,然后使用匹配的单尖锉和AH-Plus封闭剂进行充填。窝洞用玻璃离子水门汀充填。使用视觉模拟评分法评估疼痛强度。数据采用方差分析和Games-Howell检验进行分析。显著性水平为5%。
XPF+FE组疼痛程度较高,在视觉模拟评分中,术后48小时为中度疼痛,术后7天为轻度疼痛(<0.05)。在其他组中,疼痛为轻度,只是时间间隔不同(>0.05)。
XP根管锉联合根尖孔扩大术可能会导致中度术后疼痛。