Department of Endodontics, Faculty of Dentistry, The British University of Egypt, Cairo, Egypt.
Restorative and Dental Materials Department, National Research Centre, Cairo, Egypt.
BMC Oral Health. 2024 Jul 16;24(1):800. doi: 10.1186/s12903-024-04527-9.
This is a triple-blinded, prospective split-mouth clinical trial. It is important to shed light on the effect of different apical preparation sizes regarding postoperative pain within the same patient with the same pulpal histological status. The aim is to compare and evaluate the severity of postoperative pain following apical enlargement with two different sizes after the IBF using the visual analogue scale.
Fifty "teeth" in 25 patients were assigned into two equal groups (25 per group) using E3 Azure rotary files; Group A was prepared two sizes greater than the Initial binding file (IBF) (the largest K file to bind at the actual working length) mesial canals, which were enlarged to 35#/0.04 and 40#/0.04 for the distal canals. Group B was prepared in three sizes larger than the IBF: 40#/0.04 for mesial canals and 45#/0.04 for the distal canals. On a modified VAS form, patients were questioned to indicate the degree of their pain and assisted in narrating their pain intensity during the following periods: 12, 24, and 72 h, and after a week. VAS data were non-parametric and analyzed using the signed-rank test for intergroup comparisons, Freidman's test, and the Nemenyi post hoc test for intragroup comparisons. The significance level was set at p < 0.05.
showed that regardless of measurement time, enlargement of apical preparation was significantly associated with higher pain scores (p < 0.001). Within both groups, there was a significant reduction of measured pain score with time, with values measured after 12 and 24 h being significantly higher than values measured at other intervals (p < 0.001) and with values measured after three days being significantly higher than 1-week value (p < 0.001).
The size of apical preparation had a significant effect on postoperative pain.
TRIAL REGISTRATION NUMBER & DATE: NCT05847738, 08/05/2023.
这是一项三盲、前瞻性、分口临床试验。在同一患者的相同牙髓组织学状态下，揭示不同根尖预备尺寸对术后疼痛的影响非常重要。目的是使用视觉模拟量表比较和评估使用 IBF 后用两种不同尺寸进行根尖扩大后的术后疼痛严重程度。
使用 E3 Azure 旋转锉将 25 名患者的 50 颗“牙齿”分为两组（每组 25 颗）；A 组预备比初始结合锉（IBF）大两个尺寸的近中根管，近中根管扩大至 35#/0.04 和 40#/0.04，远中根管扩大至 40#/0.04。B 组预备比 IBF 大三个尺寸：近中根管为 40#/0.04，远中根管为 45#/0.04。在改良的 VAS 表格上，要求患者指出他们疼痛的程度，并在以下时期协助描述他们的疼痛强度：12、24 和 72 小时以及一周后。VAS 数据是非参数的，使用组间比较的符号秩检验、Friedman 检验和组内比较的 Nemenyi 事后检验进行分析。显著性水平设为 p<0.05。
结果表明，无论测量时间如何，根尖预备的扩大与更高的疼痛评分显著相关（p<0.001）。在两组内，测量疼痛评分随时间显著降低，12 和 24 小时测量的疼痛评分明显高于其他时间间隔测量的疼痛评分（p<0.001），并且 3 天后测量的疼痛评分明显高于 1 周后的疼痛评分（p<0.001）。
根尖预备的尺寸对术后疼痛有显著影响。
NCT05847738，2023 年 8 月 5 日。
