牙隐裂伴牙髓炎患者修复治疗后急性疼痛的影响因素分析

Influencing factors of acute pain in patients with cracked teeth complicated by pulpitis after prosthetic treatment

目的观察牙隐裂伴牙髓炎患者修复治疗后急性疼痛的发生情况,并分析急性疼痛发生的影响因素。方法抽取2018年3月至2019年11月于驻马店市第二中医院接受修复治疗的92例牙隐裂伴牙髓炎患者作为研究对象,依据患者修复治疗后有无发生急性疼痛分为发生组和未发生组,设计一般情况调查表调查并详细记录患者的基线资料,经单因素与多因素分析找出牙隐裂伴牙髓炎患者修复治疗后急性疼痛的影响因素。结果92例患者中发生急性疼痛者12例,发生率为13.04%,纳入发生组,其余80例患者纳入未发生组。发生组死髓牙、根管超充、下颌牙、牙髓组织残留占比均高于未发生组,前列腺素E2(PGE2)和白三烯B4(LTB4)水平均高于未发生组(P均<0.05)。多因素分析结果显示,死髓牙、根管超充、下颌牙、牙髓组织残留及PGE2、LTB4过表达均是牙隐裂伴牙髓炎患者修复治疗后发生急性疼痛的影响因素(OR>1,P均<0.05)。结论死髓牙、根管超充、下颌牙、牙髓组织残留及PGE2、LTB4过表达均会导致牙隐裂伴牙髓炎患者修复治疗后发生急性疼痛,临床应重视伴有上述风险因素患者的早期干预。

Objective To observe the occurrence of acute pain in patients with cracked teeth combined with pulpitis after prosthetic treatment,and to analyze the influencing factors of acute pain.Methods A total of 92 patients with cracked teeth complicated by pulpitis who received prosthetic treatment in Zhumadian Second Hospital of Traditional Chinese Medicine from March 2018 to November 2019 were selected as the research subjects.And patients were divided into occurrence group and non-occurrence group according to occurrence of acute pain after repair treatment.The baseline data were recorded in detail by self-made general data questionnaire.The influencing factors of acute pain in patients with cracked teeth complicated by pulpitis after prosthetic treatment were detected by univariate and multivariate analysis.Results There were 12 cases of acute pain in 92 patients,and the incidence was 13.04%,included into occurrence group.The remaining 80 patients were included into the non-occurrence group.The proportion of dead pulp teeth,root canal overfilled,mandibular teeth and pulp tissue residues in the occurrence group were higher than those in the non-occurrence group,and the levels of prostaglandin E2(PGE2)and leukotriene B4(LTB4)in the occurrence group were higher than those in the non-occurrence group(all P<0.05).Multivariate analysis showed that dead pulp teeth,root canal overfilled,mandibular teeth,pulp tissue residual,PGE2,LTB4 overexpression were the influencing factors of acute pain in patients with cracked teeth complicated by pulpitis after prosthetic treatment(OR>1,all P<0.05).Conclusions Dead pulp teeth,root canal overfilled,mandibular teeth,pulp tissue residual,and overexpression of PGE2 and LTB4 may induce acute pain in cracked teeth with pulpitis after prosthetic treatment.For patients with these risk factors,early intervention is significant in clinical.