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使用TruNatomy或ProTaper Next镍钛系统对无症状根尖周炎下颌磨牙进行器械操作后术后疼痛的比较:一项随机临床试验。

Comparison of postoperative pain after instrumentation with TruNatomy or ProTaper Next Ni-Ti systems in mandibular molars with asymptomatic apical periodontitis: a randomized clinical trial.

作者信息

Vardar Korkman Çağla, Haznedaroğlu Faruk

机构信息

Faculty of Dentistry, Department of Endodontics, Istanbul University, Prof. Dr. Cavit Orhan Tütengil Sk. No:4, Süleymaniye, Fatih, İstanbul, 34116, Turkey.

出版信息

BMC Oral Health. 2025 Apr 13;25(1):564. doi: 10.1186/s12903-025-05895-6.

Abstract

BACKGROUND

Ni-Ti instruments with varying design features may lead to different levels of postoperative pain, which is a significant clinical concern, particularly in previously asymptomatic teeth. Therefore, the purpose of this randomized clinical trial is to compare postoperative pain following instrumentation with TruNatomy versus ProTaper Next Ni-Ti systems in mandibular molars with asymptomatic apical periodontitis.

METHODS

90 healthy participants were randomly assigned to two groups: TruNatomy (TN) or ProTaper Next (PTN) instruments. After single-visit root canal treatments, participants were asked to rate their postoperative pain levels at 6, 12, 24, 48, and 72 h and seven days later, using the Numerical Rating Scale (NRS) through an online questionnaire. In cases of pain, 400 mg of ibuprofen was prescribed. Data from 80 participants were finally included in the analysis. Data were analyzed using the Mann-Whitney U, Friedman, and Fisher's Chi-Square tests (p < 0.05).

RESULTS

There was no statistically significant difference in postoperative pain intensity at 6, 12, 24, and 48 h and seven days between the groups (p > 0.05). At the 72-hour time point, TN group showed statistically higher postoperative pain intensity (p < 0.05). No statistically significant differences in the incidence of postoperative pain were observed at any of the time points (p > 0.05). Analgesic intake and flare-up incidence were not significantly different between the groups (p > 0.05).

CONCLUSION

Postoperative pain levels were not significantly influenced by the type of rotary Ni-Ti instrument. Both TN and PTN instruments led to low-level and similar postoperative pain intensity, minimal analgesic use, and a low incidence of flare-ups in teeth with asymptomatic apical periodontitis.

TRIAL REGISTRATION

ClinicalTrials.gov ID NCT06545773, Registration Date 8 August 2024 (retrospectively registered).

摘要

背景

具有不同设计特点的镍钛器械可能导致不同程度的术后疼痛,这是一个重要的临床问题,尤其是在先前无症状的牙齿中。因此,本随机临床试验的目的是比较在下颌磨牙无症状性根尖周炎中,使用TruNatomy与ProTaper Next镍钛系统进行根管预备后的术后疼痛情况。

方法

90名健康参与者被随机分为两组:TruNatomy(TN)组或ProTaper Next(PTN)组。在单次就诊根管治疗后,要求参与者通过在线问卷,使用数字评分量表(NRS)在术后6、12、24、48和72小时以及7天后对疼痛程度进行评分。对于疼痛情况,开具400毫克布洛芬的处方。最终80名参与者的数据纳入分析。使用曼-惠特尼U检验、弗里德曼检验和费舍尔卡方检验进行数据分析(p < 0.05)。

结果

两组在术后6、12、24、48小时以及7天时的疼痛强度无统计学显著差异(p > 0.05)。在72小时时间点,TN组术后疼痛强度在统计学上更高(p < 0.05)。在任何时间点,术后疼痛发生率均无统计学显著差异(p > 0.05)。两组之间的镇痛药物摄入量和疼痛发作发生率无显著差异(p > 0.05)。

结论

旋转镍钛器械的类型对术后疼痛水平无显著影响。TN和PTN器械在无症状性根尖周炎的牙齿中均导致低水平且相似的术后疼痛强度、最少的镇痛药物使用以及低疼痛发作发生率。

试验注册

ClinicalTrials.gov标识符NCT06545773,注册日期2024年8月8日(追溯注册)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/611d/11995650/85710e4b5ea3/12903_2025_5895_Fig1_HTML.jpg

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