In�uence of maintaining apical patency in post-endodontic pain
In�uence of maintaining apical patency in post-endodontic pain
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保持根尖通畅对牙髓后疼痛的影响
DOI：
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
M. Nepal
中科院分区：
文献类型：
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作者：
S. Shubham;M. Nepal
根尖通畅是指在根尖孔外通过小的柔性支架内固定防止根尖堵塞。然而，该手术可能会导致术后疼痛，因此是否保持根尖通畅是一个两难的问题。因此，本研究的主要目的是比较根尖开放组和非根尖开放组的术后疼痛，次要目的是评估就诊次数、牙齿活力、牙齿组和术前疼痛对术后疼痛的影响。方法根据牙组和牙髓状况，将178例患者随机分为根尖通畅组和根尖不通畅组，两组分别采用单次或多次就诊进行治疗。排除后，纳入160例患者。每组（n=80）再细分为单次访牙（n= 40）和多次访牙（n= 40），包括生命牙（n=20）和非生命牙（n=20），单根牙（n=10）和多根牙（n=10）。在传统的手握步回整形过程中，根尖通畅保持10 K-le。采用数字评定量表（NRS-11）记录治疗前及治疗后第1、2、7天疼痛强度。统计学分析采用Mann -Whitney U检验、Spearman相关和多元线性回归分析。结果本研究的主要结局显示，术后疼痛评分在通畅组与非通畅组之间差异有统计学意义（p<0.05），通畅组在随访第1、2、7 d时疼痛评分较高。次要结果显示，维持通畅组的术后疼痛仅受牙髓状态和术前疼痛的影响。多次访视维持通畅组术后第1天疼痛差异有统计学意义（p=0.02）。术前疼痛与术后疼痛呈正相关，差异有统计学意义。结论维持根尖通畅会增加术后疼痛。评估就诊次数、牙髓状况、牙组及术前疼痛的影响
Background The concept of instrumentation beyond the apical foramen by small �exible �le to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the in�uence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain. Methods Preselected (n=178) patients based on group of teeth and status of pulp were randomly divided into 2 groups, apical patency and non-patency which was further treated in either single or multiple visit. After exclusion, 160 patients were included. Each group (n=80) was subdivided in single visit (n = 40) and multiple visits (n = 40), including vital (n=20) and non-vital teeth (n=20) and single-rooted (n=10) and multiple-rooted teeth (n=10). Apical patency was maintained with a size 10 K-le during conventional hand �ling step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann -Whitney U test, Spearman correlation and Multiple linear regression analysis. Results The primary outcome of this study showed statistically signi�cant difference (p<0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1 st , 2 nd and 7 th day follow up. The secondary outcome showed postoperative pain in patency maintained group was in�uenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically signi�cant (p=0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically signi�cant difference. Conclusions Our study concluded that maintenance of apical patency increased postoperative pain. Evaluation of in�uence of number of visits, status of pulp, group of tooth and preoperative pain revealed