Department of Pediatric and Preventive Dentistry, Dr G.D. Pol Foundation YMT Dental College and Hospital Sector 4, Navi Mumbai, India.
Eur Endod J. 2024 Aug;9(3):191-197. doi: 10.14744/eej.2023.18480.
Childhood experiences of pain associated with dental treatment can induce dental anxiety. Infe-rior alveolar nerve blocks are eight times more likely to fail in patients with irreversible pulpitis. The objective was to compare the effectiveness of lignocaine with and without pre-operative oral ibuprofen for controlling pain in primary mandibular molars scheduled for pulpectomy procedures in 5 to 9-year-old children.
One hundred and twenty-two children diagnosed with irreversible pulpitis in mandibular posterior teeth and scheduled for pulpectomy procedures were included. The children were assigned to one of the two groups, Treatment group A: Pre-operative with oral ibuprofen and local anaesthesia with 2% lignocaine (with adrenaline 1: 80000); Treatment group B: Pre-operative with oral placebo and local anaesthesia with 2% ligno-caine (with 1: 80000 adrenaline). Pain and pulse rate were recorded at baseline, one hour after administration of oral medication, fifteen minutes following administration of Inferior Alveolar Nerve Block (IANB), and also during the course pulpectomy. The results were statistically analysed using chi square test and repeated mea-sures analysis of variance (ANOVA).
In treatment group A, 90.16% children had IANB success compared to 9.83% in group B.. The differ-ence in the success rate between two groups was statistically significant (p<0.001) with an odds ratio of 84.
Oral medication with ibuprofen is effective in increasing the success rate of IANB with lignocaine for the treatment of irreversible pulpitis of 5 to 9-year-old children.
与牙科治疗相关的儿童期疼痛经历会引发牙科焦虑。对于不可复性牙髓炎患者,下牙槽神经阻滞麻醉的失败率高出八倍。本研究旨在比较在 5 至 9 岁儿童行下颌第一磨牙牙髓切除术时,利多卡因联合术前口服布洛芬与单独使用利多卡因对控制疼痛的效果。
将 122 名诊断为下颌后牙不可复性牙髓炎且拟行牙髓切除术的儿童纳入研究。将儿童分为两组,治疗组 A:术前口服布洛芬和 2%利多卡因(含肾上腺素 1:80000)局部麻醉;治疗组 B:术前口服安慰剂和 2%利多卡因(含肾上腺素 1:80000)局部麻醉。在基线时、口服药物后 1 小时、下牙槽神经阻滞麻醉后 15 分钟以及牙髓切除术过程中记录疼痛和脉搏率。采用卡方检验和重复测量方差分析(ANOVA)对结果进行统计学分析。
在治疗组 A 中,90.16%的儿童下牙槽神经阻滞麻醉成功,而在治疗组 B 中为 9.83%。两组间的成功率差异具有统计学意义(p<0.001),优势比为 84。
对于 5 至 9 岁儿童不可复性牙髓炎的治疗,口服布洛芬可提高利多卡因行下牙槽神经阻滞麻醉的成功率。