三种不同根管封闭剂在热牙胶一次法根管治疗术中的疼痛情况观察

Postoperative pain relief after one- off thermal gutta- percha root canal therapy: a comparative study of three root canal sealers

目的观察三种不同的根管封闭剂用于热牙胶一次法根管治疗术后患牙近期疼痛情况。方法需根管治疗的126颗患牙随机分为三组,每组42颗,分别采用Roekoseal、Cortisomol和Vitapex三种不同的封闭剂结合牙尖胶为填充材料给予热牙胶垂直加压法填充根管,以VAS视觉模糊疼痛评分、疼痛持续时间及疼痛指数评价患牙术后疼痛情况。结果 Roekoseal组和Cortisomol组术后各有6例发生疼痛,占总牙数的14.29%;Vitapex组术后14例发生疼痛,占总牙数的33.33%;疼痛程度秩和检验结果显示三组间疼痛发生率存在差异(χ2=54.032,P<0.05),Vitapex组术后疼痛发生率较Roekoseal组和Cortisomol组高,Roekoseal组和Cortisomol组间疼痛发生率比较差异无显著性(Z=-0.088,P=0.930);术后1、2 d患者VAS评分无显著差异(F=1.292,P=0.638),术后3 d VAS评分出现差异(F=39.483,P=0.002);术后平均VAS评分(F=15.635,P=0.017),疼痛持续时间(F=11.589,P=0.023),平均疼痛指数(F=35.677,P=0.004)三组间均存在差异,Vitapex组疼痛反应较Roekoseal组和Cortisomol组重。结论以Roekoseal封闭剂和Cortisomol封闭剂为填充材料进行热牙胶垂直加压法填充根管可有效减少患者术后疼痛的发生及反应程度。

Objective To observe the occurrence of postoperative pain of three different mot canal sealers which were applied in one - off thermal gutta - percha root canal therapy. Methods 126 vital pulp permanent teeth required for root canal therapy were randomly divided into three groups, each group of 42 cases. The warm vertical condensation （WVC） technique was applied to fill the root canal with Roekoseal, Cortiso- tool and Vitapex as sealers respectively. The occurrence of postoperative pain was evaluated by the visual analog scale （VAS） , the duration of pain and pain index after root canal filling were assessed. Results The number of postoperative pain in Roekoseal group, Cortisomol group and Vitapox group were 6, 6, 14 cases respectively, which accounted for 14.29%, 14.29% and 33.33% of the total number; the incidence of pain among the three groups were statistically significant by grading rank test （ X2 = 54. 032, P 〈 0.05 ）. The incidence of postoperative pain of Vitapex group was higher than the other two groups, and that was not statistically significant between Roekoseal and Cortisomol groups （ Z = - 0. 088, P = 0. 930）. The VAS scores showed no statistically significant difference on the 1 st day and 2 nd day after operation （ F = 1. 292, P =0. 638）, and that showed the difference on the 3 th day after operation （ F =39.483, P =0.002）. There were significant differences in the mean VAS score （ F =15.635, P =0.017）, duration of pain （ F =11.589, P =0.023） and mean pain index （ F =35.677, P =0.004） among the three groups. Conclusion The one - off thermal gutta - percha root canal treatment with Roekoseal and Cortisomol sealer can be effective in reducing the occurrence of postoperative pain and pain intensity.