根管治疗术后疼痛的临床研究

Clinical Study on Postendodontic Treatment Pain after Root Canal Treatment

目的:评估活髓牙、坏死性牙髓炎和根管再治疗患者在经根管治疗后根管治疗后疼痛(PEP)的发生率和强度。方法:选择2011年7-12月在本院接受RCT的患者137例为研究对象,根据其牙髓症状分为活髓牙组71例、死髓牙组26例和再治疗组40例。所有患者由同一程序进行根管治疗。比较分析各组患者在治疗6、18 h的疼痛发生率和强度等级。结果:活髓牙组患者PEP的发生率和强度(63.8%,2.46±1.4)均高于死髓牙组(38.5%,1.78±1.2)和再治疗组(43.8%,1.89±1.1),比较差异均有统计学意义(P<0.05)。女性患者治疗6、18 h的平均疼痛强度分别为(2.29±1.38)和(1.97±1.21),均高于男性患者的(1.95±1.19)和(1.68±0.99),比较差异均有统计学意义(P=0.034、P=0.041)。结论:活髓牙患者RCT术后的PEP较坏死性牙髓炎和根管再治疗相比有着较高发生率及强度。

Objective：To assess the incidence and severity of postendodontic treatment pain（PEP） subsequent to root canal treatment（RCT） in vital teeth, necrotic pulp teeth and re-treatment teeth.Method：One hundred and thirty-seven patients undergoing RCT in our hospital from July 2011 to December 2012 were selected as the objects and devided into vital pulp group（n=70）,necrotic pulp group（n=26） and re-treatment group（n=40） according to their different clinical manifestations.All patients were given the same procedure of RCT.The incidence and severity of postendodontic treatment pain（PEP） at 6 and 18 hours posttreatment of patients from different group were compared.Result：The incidence and severity of PEP in the vital pulp group（63.8%,2.46±1.4） were significantly higher than the necrotic pulp group（38.5%,1.78±1.2） and the re-treatment group（43.8%,1.89±1.1）,the differences were statistically significant（P〈0.05）.Gender was significantly associated with the intensity of PEP.After treatment of 6,18 hours,women reported a higher mean pain intensity than men （2.29±1.38） versus （1.95±1.19） and （1.97±1.21） versus （1.68±0.99）,the differences were statistically significant（P=0.034,0.041）.Conclusion：RCT of teeth with vital pulp induce significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or re-treatment teeth.