Kuwait Board of Endodontics, Specialized Dental Center, Salmiya, Kuwait.
Kuwait Institute for Medical Specializations, Sulaibkhat, Kuwait.
Int Endod J. 2024 Sep;57(9):1168-1179. doi: 10.1111/iej.14102. Epub 2024 May 30.
Post-operative pain may occur after non-surgical root canal treatment (NSRCT). The root filling technique and choice of sealer may be contributing factors. This randomized controlled clinical trial compared post-operative pain and analgesics intake after NSRCT using a sealer-based obturation technique (SBO) with single-cone gutta-percha and calcium silicate sealer (CSS) versus a warm-vertical compaction (WVC) technique with gutta-percha and a resin-based sealer (RBS).
This study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www.
gov (NCT04753138). Patients referred for NSRCT fulfilling the inclusion criteria participated in this study. Pre-operative periapical radiographs and CBCT scans were taken and numerical rating scale (NRS) pain scores were recorded. Upon completion of canal instrumentation, participants were randomly allocated to either Group SBO: SBO with CSS or Group WVC: Warm-vertical compaction with RBS. Post-operative pain and analgesics intake were recorded at 1, 3 and 7 days after endodontic treatment completion. Non-parametric Mann-Whitney U and Friedman tests and a generalized estimating equation were used to assess differences in pain scores between the groups, within each treatment group at different time points and for correlations, respectively.
The study included 195 participants (212 teeth). One participant declined to submit the NRS form. Therefore, 194 participants (211 teeth) were included in the final analysis (99.5% response rate). No statistically significant differences in post-operative pain or analgesic intake existed between the two groups at any time point (p > .05). Age, pre-operative pain, apical diagnosis and post-operative analgesic intake were significantly related to post-operative pain (p < .05).
Sealer-based obturation technique with CSS was associated with similar post-operative pain levels and analgesics intake as WVC with RBS. Regarding post-operative pain, SBO with CSSs may be a suitable clinical alternative.
非手术根管治疗（NSRCT）后可能会出现术后疼痛。根充技术和密封剂的选择可能是致病因素。本随机对照临床试验比较了使用基于密封剂的根管填充技术（SBO）联合单尖牙糊剂和硅酸钙密封剂（CSS）与温热垂直加压（WVC）技术联合牙胶和树脂基密封剂（RBS）治疗 NSRCT 后术后疼痛和镇痛药摄入的情况。
本研究设计为平行双臂、双盲、随机优效性临床试验，在 www.CLINICALTRIALS.gov（NCT04753138）注册。符合纳入标准的 NSRCT 患者参加了本研究。术前拍摄根尖片和 CBCT 扫描，并记录数字评分量表（NRS）疼痛评分。根管预备完成后，患者被随机分配到 SBO 组：SBO 联合 CSS 或 WVC 组：温热垂直加压联合 RBS。根管治疗完成后 1、3 和 7 天记录术后疼痛和镇痛药摄入情况。使用非参数 Mann-Whitney U 检验、Friedman 检验和广义估计方程分别评估两组间、每组内不同时间点疼痛评分的差异以及相关性。
本研究共纳入 195 名患者（212 颗牙）。1 名患者拒绝提交 NRS 表。因此，194 名患者（211 颗牙）纳入最终分析（响应率为 99.5%）。在任何时间点，两组间术后疼痛或镇痛药摄入均无统计学差异（p>0.05）。年龄、术前疼痛、根尖诊断和术后镇痛药摄入与术后疼痛显著相关（p<0.05）。
SBO 联合 CSS 与 WVC 联合 RBS 相比，术后疼痛程度和镇痛药摄入相似。就术后疼痛而言，SBO 联合 CSS 可能是一种合适的临床替代方案。
