Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.
Int Endod J. 2024 Dec;57(12):1758-1768. doi: 10.1111/iej.14137. Epub 2024 Aug 16.
The pathways to post-operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient-related predictors of post-operative pain following root canal treatment.
A total of 154 patients received a single-visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post-operative pain was assessed using the Numeric Rating Scale at multiple time-points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient-related predictors on a theoretical model of post-operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%).
Dental anxiety (coefficient 0.028; p < .01), dental fear (coefficient 0.007; p = .02) and irrigant solution (coefficient 0.004; p = .03) exerted a direct effect on post-operative pain. SOC exerted an indirect effect on post-operative (coefficient 0.006; p = .01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p = .04) exerted an indirect effect on post-operative pain through dental anxiety.
Dental anxiety, dental fear, previous negative experiences and SOC are patient-related predictors of post-operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post-operative pain.
术后疼痛的发生机制复杂，涉及许多超出治疗方案本身的因素。本研究旨在确定根管治疗后患者发生术后疼痛的相关预测因素。
共有 154 例患有无症状坏死下颌磨牙的患者接受单次根管治疗。在治疗前，使用经过验证的问卷评估每位患者的牙科焦虑症、牙科恐惧和社会凝聚力（SOC），以确定这些因素是否为预测因素。其他测量的预测因素包括性别、年龄、以前在牙科诊所的负面经历和以前的根管治疗。在 30 天内的多个时间点使用数字评分量表评估术后疼痛。采用结构方程分析评估患者相关预测因素对术后疼痛理论模型的直接和间接影响。模型中还包括冲洗液，因为它是治疗方案中唯一变化的方面（2.5%和 8.25%次氯酸钠）。
牙科焦虑症（系数 0.028；p<.01）、牙科恐惧（系数 0.007；p=.02）和冲洗液（系数 0.004；p=.03）对术后疼痛有直接影响。SOC 通过牙科焦虑症和牙科恐惧对术后疼痛有间接影响（系数 0.006；p=.01）。此外，以前的负面经历（系数 0.048；p=.04）通过牙科焦虑症对术后疼痛有间接影响。
牙科焦虑症、牙科恐惧、以前的负面经历和 SOC 是根管治疗后术后疼痛的患者相关预测因素。在临床实践中应考虑这些因素，因为具有这些特征的患者可能面临更高的术后疼痛风险。
