后磨牙牙髓疼痛3种止痛方法的效果比较  

Comparison of the effects of three analgesic therapies on odontalgia caused by pulpitis in molars

作　　者：王效平[1] 王忠桂[1] 王小婷[1] 叶荣[1] 

机构地区：[1]北京大学口腔医学院急诊室,北京100081

出　　处：《上海口腔医学》2004年第2期147-149,共3页Shanghai Journal of Stomatology

摘　　要：目的:评价后磨牙牙髓疼痛3种止痛方法的效果。方法:173例急性牙髓炎、慢性牙髓炎急性发作后磨牙随机分组治疗。第1组46例,采用分次失活法;第2组52例,采用即刻失活法;第3组75例,局麻下直接行牙髓摘除术。疗效评定参照VAS视觉分析标尺法,将疼痛分为(0～4)5级,对其止痛效果分为完全止痛、有效止痛和无效进行比较。采用χ2检验对数据进行统计学处理。结果:各组的完全止痛率分别为50.0%、63.5%和76.0%。局麻下直接行牙髓摘除术的完全止痛效果明显好于分次失活组(P<0.01),并可避免因使用砷失活剂产生的不良反应。结论:局麻下直接行牙髓摘除术可以有效去痛,并且疗程短,并发症少。PURPOSE:To compare the effects of analgesic therapies on odontalgia caused by pulpitis in molars by three different methods. METHODS:173 molars were diagnosed as irreversible pulpitis, and randomized block designed in three groups. Under block or local anesthesia: 46 cases of the first group, leaving teeth on open drainage, after 1 day, sealing devitalized material (arsenic), arranged next appointment 2 weeks later. 52 molars of the second group, enlarging exposure site, drainage several minutes only, sealed devitalized material, re-examined 2 weeks later. 75 cases of the third group, removing roof of pulp chamber, undergoing pulpectomy directly, re-examined 1 week later. Adopting VAS(vital analogue scale) to analyze the pulp receptivity of three different methods and to evaluate the analgesic effects by complete analgesia, effective analgesia, and no response. The data was analysed using chi-square test. RESULTS:The rate of complete analgesia was 50.0%, 63.46% and 76.0%, respectively. There was a significant difference in complete analgesia among the three methods. The analgesic effect of the third group (pulpectomy) was significantly higher than that of the first group (P<0.01).Pulpectomy group had impossibility of adverse effects caused by using devitalizing material (arsenic). CONCLUSIONS: It is worthy to adopt pulpectomy extensively to relieve the pain of molars caused by pulpitis clinically. The course of treatment of the third group was significantly shorter than other groups, and the simultaneous symptoms occurred rarely.

关 键 词：牙痛 牙髓失活 牙髓摘除术 后磨牙 牙髓疼痛 止痛方法 

分 类 号：R781.3[医药卫生—口腔医学]