Mohamed Sobh Yasmin Tawfik, Hamdy Ragab Mai
Department of Endodontics, Sinai University, Faculty of Dentistry, Ismailia, Egypt.
Department of Endodontics, Suez Canal University, Faculty of Dentistry, Ismailia, Egypt.
Eur Endod J. 2025 Jul;10(4):285-295. doi: 10.14744/eej.2025.75547.
Objectives The trial was conducted to assess the impact of passive ultrasonic irrigation, XP endo finisher, AF max file, and manual dynamic agitation on postoperative pain and analgesic consumption at 6 h., 12 h., 24 h., 48 h., 72 h., and a week later on single-rooted lower premolar teeth with acute irreversible pulpitis and apical periodontitis. Methods. Seventy patients were contributed in the trial. A total of 64 eligible patients were randomized into four equal groups (n=16 per group). Considering the irrigation activation approach, participants were separated into four groups as follows: Group 1: passive ultrasonic irrigation. Group 2: XP-endo Finisher. Group 3: Fanta AF max file Group 4: Manual dynamic agitation. Following the root canal procedure, the intensity of postoperative discomfort was measured by a verbal rating scale. The frequency and quantity of analgesics used were recorded. Results. Using an analysis of variance (ANOVA), there was a statistically significant difference between the percentage of preoperative and postoperative pain at most of the follow-up period (p<0.001**) in each group. Additionally, a significant difference (p<0.05) in the postoperative pain level and analgesic consumption was found among groups and most of the time intervals. Shapiro-Wilk and Kolmogorov-Smirnov tests, the Chi-square test, Fisher's exact test, and the McNemar test were used. The excessive percentage of postoperative pain and analgesic intake was found in the MDA group, followed by the Max file and the XPF, while the lowest postoperative pain and analgesic intake were related to the PUI group. There was a significant difference (p<0.05) between the PUI and MDA groups in the degree of pain severity and increase in analgesic intake at 72 h. Regarding the percentage of swelling, there was a statistically notable difference (p<0.05) between groups after 24 h time intervals. Conclusions Minimal postoperative pain and minimal analgesic intake were significantly accompanied by passive ultrasonic irrigation, while PUI and analgesic intake were increased in MDA. (EEJ-2025-03-041).
本试验旨在评估被动超声冲洗、XP根充锉、AF max锉以及手动动态搅拌对患有急性不可逆性牙髓炎和根尖周炎的单根下颌前磨牙在术后6小时、12小时、24小时、48小时、72小时及一周后的疼痛和镇痛药物消耗的影响。方法：70名患者参与了该试验。共有64名符合条件的患者被随机分为四组（每组n = 16）。根据冲洗激活方法，参与者被分为以下四组：第1组：被动超声冲洗。第2组：XP根充锉。第3组：Fanta AF max锉。第4组：手动动态搅拌。根管治疗术后，通过语言评定量表测量术后不适的强度。记录使用镇痛药物的频率和数量。结果：使用方差分析（ANOVA），在每个组的大多数随访期内，术前和术后疼痛百分比之间存在统计学显著差异（p < 0.001**）。此外，在组间和大多数时间间隔内，术后疼痛水平和镇痛药物消耗存在显著差异（p < 0.05）。使用了Shapiro-Wilk和Kolmogorov-Smirnov检验、卡方检验、Fisher精确检验和McNemar检验。术后疼痛和镇痛药物摄入量过高百分比出现在手动动态搅拌组，其次是Max锉组和XP根充锉组，而术后疼痛和镇痛药物摄入量最低与被动超声冲洗组相关。在72小时时，被动超声冲洗组和手动动态搅拌组在疼痛严重程度和镇痛药物摄入量增加程度方面存在显著差异（p < 0.05）。关于肿胀百分比，在24小时间隔后组间存在统计学显著差异（p < 0.05）。结论：被动超声冲洗显著伴随最小的术后疼痛和最小的镇痛药物摄入量，而手动动态搅拌会增加被动超声冲洗和镇痛药物摄入量。（EEJ - 2025 - 03 - 041）
