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双氯芬酸钾与泼尼松龙对症状性不可复性牙髓炎患者根管治疗后疼痛和牙髓白细胞介素-8 表达的影响:一项随机安慰剂对照试验。

Influence of Diclofenac Potassium versus Prednisolone on Postendodontic Pain and Pulpal Interleukin-8 Expression in Symptomatic Irreversible Pulpitis Cases: A Randomized Placebo-controlled Trial.

机构信息

Faculty of Dentistry, Endodontics Department, Cairo University, Cairo, Egypt; School of Dentistry, Newgiza University, Cairo, Egypt.

Faculty of Dentistry, Endodontics Department, Cairo University, Cairo, Egypt.

出版信息

J Endod. 2024 Sep;50(9):1213-1220. doi: 10.1016/j.joen.2024.05.019. Epub 2024 Jun 24.

Abstract

AIM

This prospective, randomized, double-blind clinical trial investigated the impact of diclofenac potassium, prednisolone, and placebo as oral premedication on postendodontic pain and pulpal interleukin (IL)-8 expression in patients with irreversible pulpitis.

METHODS

Thirty-six patients undergoing conventional endodontic treatment were assigned into one of 3 groups (n = 12). Pulpal blood samples were taken after access cavity preparation and stored until they were analyzed using enzyme-linked immunosorbent asssay for quantification of IL-8. Postendodontic pain was scored using the visual analogue scale. Outcome data were statistically analyzed using one-way analysis of variance, Kruskal-Wallis, Friedman's, Dunn's, Chi-square, and Fisher's exact tests and Spearman's correlation coefficient. The significance level (α) was set at 0.05.

RESULTS

Apart from preoperative pain scores, all groups had similar baseline characteristics (P > .05). Immediate postendodontic pain scores had a significant difference between all groups (P < .05) where placebo group showed the highest score. There was no significant difference between all groups at 6 and 12 hours postoperatively (P > .05). Furthermore, there was no significant difference in the incidence of postendodontic pain and in mean IL-8 levels between the 3 groups (P > .05).

CONCLUSIONS

The only impact the premedications had was on the immediate postendodontic pain intensity, and they had no influence on the later time points, incidence of postendodontic pain or pulpal IL-8 levels.

摘要

目的

本前瞻性、随机、双盲临床试验旨在研究双氯芬酸钾、泼尼松龙和安慰剂作为口腔预给药对不可逆性牙髓炎患者根管治疗后疼痛和牙髓白细胞介素(IL)-8 表达的影响。

方法

将 36 例行常规根管治疗的患者分为 3 组(每组 n=12)。在制备开髓腔后采集牙髓血样,并储存至使用酶联免疫吸附测定法分析 IL-8 定量。根管治疗后疼痛采用视觉模拟评分法进行评分。采用单因素方差分析、Kruskal-Wallis 检验、Friedman 检验、Dunn 检验、卡方检验、Fisher 确切概率法和 Spearman 相关系数对结果数据进行统计学分析。显著性水平(α)设定为 0.05。

结果

除术前疼痛评分外,各组基线特征相似(P>0.05)。即刻根管治疗后疼痛评分各组间差异有统计学意义(P<0.05),其中安慰剂组评分最高。术后 6 小时和 12 小时各组间差异无统计学意义(P>0.05)。此外,3 组间根管治疗后疼痛的发生率和平均 IL-8 水平差异无统计学意义(P>0.05)。

结论

预给药的唯一影响是即刻根管治疗后疼痛强度,对后续时间点、根管治疗后疼痛发生率或牙髓 IL-8 水平无影响。

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