3种根管预备器械对约诊间疼痛影响的临床研究

Clinical study of three kinds of root canal preparation apparatuses on endodontic inter appointment pain

目的:通过使用机用镍钛器械U+File、ProTaper Next及手用不锈钢K锉预备根管,比较3种器械根管治疗约诊间疼痛(endodontic inter appointment pain,EIAP)的发生情况,为减轻EIAP的发生提供临床数据。方法:选择90例患者的90颗上颌前磨牙作为研究对象,采用简单随机化方式分成3组,每组30颗,分别使用机用镍钛器械U+File(U+File组)、机用镍钛器械ProTaper Next(ProTaper Next组)及手用不锈钢K锉(K锉组)预备根管,采用视觉模拟评分(visual analogue scale,VAS)表记录术前及术后12、24、48、72 h及1周的疼痛情况,并计算术后12 h的疼痛发生率。采用SPSS 20.0软件进行统计学分析。结果:治疗前,3组疼痛情况比较差异无统计学意义(P>0.05)。术后1周内,随着时间的延长,3组的VAS值逐渐降低。U+File组和ProTaper Next组术后12、24、48 h的VAS值显著低于K锉组(P<0.05),3组术后72 h、1周时的VAS值比较差异无统计学意义(P>0.05),U+File组与ProTaper Next组术后12、24、48、72 h及1周的VAS值比较差异均无统计学意义(P>0.05)。3组术后疼痛程度最大值均出现在术后12 h。术后12 h,U+File组、ProTaper Next组疼痛发生率分别为60%、46.7%,均显著低于K锉组(83.3%)(P<0.05);U+File组与ProTaper Next组疼痛发生率比较差异无统计学意义(P>0.05)。结论:机用镍钛器械U+File、ProTaper Next较手用不锈钢K锉均能减轻根管治疗EIAP程度,降低疼痛发生率;而U+File与ProTaper Next对减轻根管治疗EIAP无明显差别,医师可以根据需要进行选择。

Objective To compare the incidences of endodontic inter appointment pain(EIAP)due to U+File,ProTaperNext and K-file during the preparation of the root canal,so as to provide clinical data for further prevention of postoperative pain.Methods Totally 90 maxillary premolars were randomly divided into three groups with 30 teeth in each group,and U+File,ProTaper Next and K-File were used to prepare the root canal respectively in the three groups.The pain degrees before and 12,24,48,72 hours and 1 week after operation were recorded by using Visual Analogue Scale,and the postoperative pain incidence was calculated 12 h after operation.SPSS 20.0 software was used for statistical analysis.Results Before operation there were no significant differences between the three groups in pain degree(P>0.05).Within one week after the operation,the VAS values of the three groups decreased gradually with the extension of time.The VAS values of U+File group and ProTaper Next group were significantly lower than those of K-File group(P<0.05)at 12,24 and 48 hours after operation.There were no statistical differences between the VAS values of the three groups at 72 hours and 1 week after operation(P>0.05).There was no significant differences between U+File group and ProTaper Next group at 12,24,48,72 hours and 1 week after operation(P>0.05).The maximum degree of postoperative pain in all the three groups occurred 12 hours after operation.At 12 hours after operation,the incidences of pain in U+File group(60%)and ProTaper Next group(46.7%)were significantly lower than that in K File group(83.3%)(P<0.05);there was no significant difference in the incidences of pain between U+File group and ProTaper Next group(P>0.05).Conclusion Compared with the stainless steel K-File,the U+File and ProTaper Next reduce the degree and the incidence of EIAP during the preparation of the root canal;meanwhile,there is not any significant difference between U+File and ProTaper Next in reducing the EIAP,and the doctor can choose treatment means as needed.