Department of Dentistry, Federal University of Santa Catarina, Delfino Conti S/N, Trindade, Santa Catarina, 88040-370, Florianopolis, Brazil.
Department of Diagnosis & Oral Health, School of Dentistry, University of Louisville, Louisville, KY, USA.
Clin Oral Investig. 2023 Aug;27(8):4157-4171. doi: 10.1007/s00784-023-05151-7. Epub 2023 Jul 19.
To determine the prevalence of postoperative pain after endodontic treatment using low (LC) and high (HC) concentrations of sodium hypochlorite (NaOCl).
Six databases and the grey literature were searched to identify randomized clinical trials that evaluated postoperative pain after endodontic treatment using NaOCl. NaOCl concentrations were dichotomized into 'LC' (0.5% to 3%) and 'HC' (≥ 5%) and a proportion meta-analysis was applied to determine the postoperative pain prevalence: overall and according to pain intensity and postoperative time. The prevalence of patients using pain control medication was also determined. A significance level of 5% and a random effect model were applied for data analysis. Between-study heterogeneity was assessed by I index. Risk of bias (RoB) was assessed using the Cochrane Risk-of-Bias 2.0 tool. The certainty of evidence was assessed using the GRADE approach.
Ten studies were included in the review and eight in the meta-analysis. The overall prevalence of postoperative pain was 45% in LC and 39% in HC. The prevalence of pain in LC and HC after 24 h was 25% and 40%, respectively. After 48 h, the prevalence decreased to 10% in LC and 25% in HC. 'Absent pain' was the most prevalent score. The prevalence of patients who used medication was 9% in LC and 15% in HC. Three studies were classified as 'high RoB', five as 'low RoB', and two as 'some concerns'. The certainty of evidence was very low.
The overall prevalence of postoperative pain after endodontic treatment using LC and HC of NaOCl was 45% and 39%, respectively.
Postoperative pain is common after endodontic treatment using NaOCl, but tends to decrease over time.
确定使用低浓度（LC）和高浓度（HC）次氯酸钠（NaOCl）进行根管治疗后术后疼痛的发生率。
检索了六个数据库和灰色文献，以确定评估使用 NaOCl 进行根管治疗后术后疼痛的随机临床试验。将 NaOCl 浓度分为“LC”（0.5%至 3%）和“HC”（≥5%），并应用比例荟萃分析来确定术后疼痛的发生率：总体发生率以及根据疼痛强度和术后时间的发生率。还确定了使用止痛药物的患者比例。数据分析采用 5%的显著性水平和随机效应模型。通过 I 指数评估研究间异质性。使用 Cochrane 风险偏倚 2.0 工具评估偏倚风险（RoB）。使用 GRADE 方法评估证据的确定性。
综述纳入了 10 项研究，荟萃分析纳入了 8 项研究。LC 组术后疼痛总发生率为 45%，HC 组为 39%。24 小时后 LC 和 HC 组的疼痛发生率分别为 25%和 40%。48 小时后，LC 组的疼痛发生率降至 10%，HC 组降至 25%。“无疼痛”是最常见的评分。使用药物的患者在 LC 组和 HC 组中的比例分别为 9%和 15%。三项研究被归类为“高 RoB”，五项研究被归类为“低 RoB”，两项研究被归类为“存在一些关注”。证据的确定性非常低。
使用 LC 和 HC 的 NaOCl 进行根管治疗后，术后疼痛的总体发生率分别为 45%和 39%。
使用 NaOCl 进行根管治疗后，术后疼痛很常见，但随着时间的推移会逐渐减轻。
