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麻醉后冷觉测试能否作为下颌磨牙症状性不可逆牙髓炎患者下牙槽神经阻滞疗效的评估工具?——一项研究。

Can postanesthetic cold sensibility test be used as a tool for the efficacy of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis of mandibular molars? - study.

作者信息

Kalantri Sarika Sunil, Shiraguppi Vijaykumar L, Deosarkar Bharat Anantrao

机构信息

Department of Conservative Dentistry and Endodontics, Saraswati Dhanwantari Dental College and Hospital, Postgraduate and Research Institute, Parbhani, Maharashtra, India.

出版信息

J Conserv Dent Endod. 2024 Aug;27(8):795-800. doi: 10.4103/JCDE.JCDE_179_24. Epub 2024 Aug 7.

Abstract

OBJECTIVES

The goal of this investigation was to determine the efficiency of a postanesthetic cold test for the detection of pulpal anesthesia to improve diagnostic accuracy.

MATERIALS AND METHODS

Fifty-two participants who showed symptomatic irreversible pulpitis on the mandibular first molar, aged from 18 to 65 years, were given inferior alveolar nerve block (IANB), and subjective anesthetic symptoms were seen after 15 min and were finally assigned for studies. To determine the effectiveness of a postanesthetic cold test for the detection of pulpal anesthesia, the target tooth was separated and Endo-Frost was utilized to conduct a postanesthetic cold sensibility test and was compared to the gold standard test, painful or painless sensation during actual root canal therapy. Of 52 participants, 9 had a positive response to the postanesthetic cold test and 43 had a negative response; 10 responded positively to the gold standard test, whereas 42 gave negative results.

RESULTS

The postanesthetic cold sensibility test can diagnose the effectiveness of pulp anesthesia showing a sensitivity of 80%, specificity of 97.62%, positive likelihood ratio of 33.6, negative likelihood ratio of 0.2, positive predictive value of 88.89%, negative predictive value of 95.35%, accuracy of 94.23%, and Youden's index of 0.78.

CONCLUSIONS

The postanesthetic cold sensibility test can be used as a tool for the efficiency of IANB before starting root canal therapy to minimize pain and anxiety in patients.

摘要

目的

本研究旨在确定麻醉后冷测试用于检测牙髓麻醉的有效性,以提高诊断准确性。

材料与方法

选取52名年龄在18至65岁之间、下颌第一磨牙表现为症状性不可逆性牙髓炎的参与者,给予下牙槽神经阻滞(IANB),15分钟后观察到主观麻醉症状,最终将其纳入研究。为确定麻醉后冷测试用于检测牙髓麻醉的有效性,将目标牙隔湿,使用Endo - Frost进行麻醉后冷敏测试,并与金标准测试(实际根管治疗期间的疼痛或无痛感觉)进行比较。52名参与者中,9名对麻醉后冷测试呈阳性反应,43名呈阴性反应;10名对金标准测试呈阳性反应,42名呈阴性结果。

结果

麻醉后冷敏测试可诊断牙髓麻醉的有效性,其敏感性为80%,特异性为97.62%,阳性似然比为33.6,阴性似然比为0.2,阳性预测值为88.89%,阴性预测值为95.35%,准确性为94.23%,约登指数为0.78。

结论

麻醉后冷敏测试可作为一种工具,在开始根管治疗前评估IANB的有效性,以尽量减少患者的疼痛和焦虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb38/11451690/3556b8ab1ab2/JCDE-27-795-g001.jpg

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