牙根管内两种药尖封药对根管治疗术后疼痛的影响

Effect of intracanal medication with calcium hydroxide plus point and chlorhexidine diacetate active point on postoperative pain in root canal treatment

目的观察两种根管内药尖在根管治疗术后疼痛的影响。方法收集门诊口腔内科患慢性牙髓炎和慢性根尖周炎的前牙102例，按不同根管内封药随机分为3组，A组：氢氧化钙药尖组35例；B组：醋酸氯己定药尖组33例；C组（空白对照组）：无任何封药34例。术前记录疼痛情况；采用逐步后退技术和冠向下技术结合的方法预备根管，用直观模拟疼痛标尺度（visual-analogue pain scale）记录患者术后4—96h疼痛情况，术后1周复诊收集记录结果。结果术前疼痛分值平均为17．833，术后4h平均疼痛分值为19．647，术后24h平均疼痛分值为16．892，术后48h平均疼痛分值为14．539，术后72h平均疼痛分值为11．843，术后96h平均疼痛分值为8．206；3组不同封药之间进行重复测量方差分析，差异无统计学意义（P〉0．05），但时间分组之间差异具有统计学意义（P〈0．05）。结论醋酸氯己定药尖和氢氧化钙药尖对根管治疗术后约诊期间疼痛的发生没有明显的影响，但作为一种缓释剂型，仍不失为一种有效和简便的根管内消毒药物。

Objective To assess the clinical effect of intracanal medication with calcium hydroxide plus point and chlorhexidine diacetate active point on postoperative pain in root canal treatment. Methods 102 anterior teeth were included in the study;they were limited to patients with a diagnosis of chronic pulpitis and chronic apical periodontitis. All teeth underwent conventional root canal treatment with a step - back technique, GG bur and K - file. The canals were dried and one of the following three medicaments was inserted into the canal in random sequence：group 1, calcium hydroxide plus point（ n = 35 ） ;group 2, chlorhexidine diacetate active point （n = 33 ） ;and group 3：no dressing（ n = 34）. The preoperative pain experienced in the previous night was recorded using a visual analogue pain scale. Patients were then instructed to record the degree of pain experienced 4 h after treatment and daily for a further 4 days. Results Mean preoperative pain level was 17. 833 （ maximum 100 ） for all groups, and 19. 647,16. 892,14. 539,11. 843, 1 h 843,8. 206 after 4 h to 96 h,respectively. There was no significant difference among three treatments （P 〉 0.05 ）. But there was a statistically significant difference with time in pain scores（ P 〈 0.05 ）. The interaction between treatment and time was not significant（ P〉 0. 05 ） . Conclusions Under the conditions of this study, no differences were observed between calcium hydroxide plus point and chlorhexidine diacetate active point in postoperative pain. As a drug of eontrolled- release containing calcium hydroxide and chlorhexidine diacetate,it is a simple and convenient intracanal disinfectant.