根管预备及根管消毒期间诊间疼痛的临床观察  

Clinical evaluation of the prevalence of endodontic interappointment emergencies during intracanal medication before and after root canal preparation

作　　者：杨红丽[1] 唐睿[2] 龚瑜[1] 张玉皓[3] 

机构地区：[1]昆明医科大学附属口腔医院急诊科,云南昆明650101 [2]中国科学院动物研究所,北京100101 [3]昆明理工大学附属昆华医院牙周种植科,云南昆明650032

出　　处：《上海口腔医学》2016年第2期227-230,共4页Shanghai Journal of Stomatology

摘　　要：目的 :通过临床观察根管预备及根管消毒期间诊间疼痛的发生及归转,为根管治疗术疼痛的管理提供依据。方法:选择临床需要做根管治疗的患牙324颗,采用ProTaper机用镍钛器械根管预备后封入氢氧化钙做根管消毒,术后疼痛标准参照Negm分为4级,使用MATLAB及SPSS19.0软件包分析数据,观察患者术前和术后不同时间点疼痛发生的情况及归转。结果:术后即刻所有病例均出现疼痛,根管治疗约诊间痛(endodontic interappointment emergencies,EIAE)发生率为1.54%;1 d后EIAE达到峰值(25.62%),3 d后趋于缓解(3.71%)。通过MATLAB拟合数据,EIAE百分比随时间变化的函数关系式为P(t)=100%×0.066t exp[-0.076t](其中t以小时为单位,拟合RMSE为3.91);术后6 h开始出现完全无痛的患者,2周时达82.72%。术前及术后2周完全无痛的水平有显著差异(P<0.01)。结论:随着术后时间的延长,疼痛病例数和程度相应增加,3 d后趋于缓解;术后2周,完全无痛的患者明显增加。PURPOSE： To evaluate the incidence of pain during intracanal medication before and after root canal instrumentation for therapeutic reference. METHODS： Three hundred and twenty four teeth were selected in this study,and the teeth received root canal therapy with crown-down technique using Pro Taper rotary system, followed by calcium hydroxide intracanal medication. The degree of reported pain was recorded as 4 levels after treatment according to the Negm criteria. The incidence of endodontic interappointment emergencies（EIAE） at various recording times starting from root canal preparation was evaluated based on the results analyzed with MATLAB and SPSS19.0 software package.RESULTS： All patients reported of pain immediately after root canal therapy and calcium hydroxide intracanal medication, of which 1.54% were diagnosed as EIAE, the prevalence and degree of pain were increased. The prevalence of EIAE reached 25.62% one day after treatment, and decreased to 3.70% 3 days later. Most of the pain released without treatment; however, few patients experienced severe pain. The relationship between the EIAE percentage and time duration after treatment was fitted by using MATLAB as P（t）=100%×0.066 t exp[-0.076t]（t： hour; RMSE=3.91）. The patient started to report free of pain 6 hours after the treatment, 33.64% of the patients were painless 1 week after treatment, and 82.71%were painless 2 weeks later. There was significant difference between the pain level before and 2 weeks after treatment（P〈0.01）. CONCLUSIONS： During root canal preparation and intracanal medication, the prevalence and degree of pain were increased immediately after treatment, decreased 3 days later, and most of the pain was released 2 weeks after treatment.

关 键 词：根管治疗 根管预备 根管消毒 诊间疼痛 

分 类 号：R781.05[医药卫生—口腔医学]