Ramachandran Anupama, Khan Sulthan I R, Siddeeqh Salman, Gopinathan Pillai A, Bijai Laliytha K, Iyer Kiran
Department of Conservative Dentistry and Endodontics, Chettinad Dental College, Rajiv Gandhi Salai, Kelambakkam, Chennai, Tamil Nadu, India.
Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S383-S390. doi: 10.4103/jpbs.jpbs_99_23. Epub 2023 Jul 5.
Pain management is a cornerstone in the practice of endodontics. However, optimum pain control has been a challenge in cases of symptomatic irreversible pulpitis resulting in a "hot tooth." Thus, the objective of the study is to assess the knowledge and attitude and to determine the clinical protocols of "hot tooth" management followed among general practitioners and specialists.
The KAP questionnaire contained 05 knowledge, 04 attitudes, and 06 practice-related items. The questionnaire was pretested among 10 randomly selected general dentists and endodontists. Testing-retesting was also performed. The questionnaire was self-administered and the acceptance to answer the questionnaire was considered consent to participate in the study. The sample size was calculated to be 200 with a 95% level of confidence. Descriptive statistics were used. For significance level, < 0.05 was considered statistically significant. The Chi-square test was used for comparison between the endodontists and the general dentists.
The anesthetic techniques that clinicians are most skilled in are infiltration and inferior alveolar nerve block (IANB) - 96.6% and 98.5% respectively. The intraosseous technique (IO) was the least preferred technique (6.8%). The most common supplementary injection used among both the BDS and MDS graduates was intrapulpal anesthesia. In cases of acute pulpitis, 54% of the respondents prescribed NSAIDs as a pre-anesthetic medication.
The current study shows that supplemental injections like intraosseous and intraligamental techniques are underutilized. Also, the benefits of preanesthetic medication for hot tooth management are not harnessed among clinicians despite the sufficient body of evidence.
疼痛管理是牙髓病学实践的基石。然而,在有症状的不可逆性牙髓炎导致“热牙”的病例中,实现最佳的疼痛控制一直是一项挑战。因此,本研究的目的是评估全科医生和专科医生对“热牙”管理的知识和态度,并确定其遵循的临床方案。
KAP问卷包含5项知识、4项态度和6项与实践相关的项目。该问卷在10名随机选择的普通牙医和牙髓病医生中进行了预测试。还进行了重测。问卷采用自填式,接受回答问卷即视为同意参与本研究。计算得出样本量为200,置信水平为95%。采用描述性统计。对于显著性水平,P<0.05被认为具有统计学意义。采用卡方检验对牙髓病医生和普通牙医进行比较。
临床医生最熟练掌握的麻醉技术是浸润麻醉和下牙槽神经阻滞(IANB),分别为96.6%和98.5%。骨内注射技术(IO)是最不常用的技术(6.8%)。BDS和MDS毕业生中最常用的辅助注射是牙髓内麻醉。在急性牙髓炎病例中,54%的受访者将非甾体抗炎药作为麻醉前用药。
当前研究表明,骨内注射和韧带内注射等辅助注射技术未得到充分利用。此外,尽管有充分的证据,但临床医生并未利用麻醉前用药对“热牙”进行管理的益处。