Abstract：
This systematic review aimed to investigate whether vital pulp therapy and root canal treatment (RCT) promote different postoperative pain.
The authors searched PubMed, Cochrane Library, Embase, and Latin American and Caribbean Health Sciences Literature databases for studies published through June 30, 2022. The authors included randomized clinical trials if they reported on the assessment of postoperative pain after direct pulp capping, partial pulpotomy, pulpotomy, or single-visit RCT. The authors assessed the frequency of no, mild, moderate, and severe postoperative pain. They conducted meta-analyses to compare postoperative pain after full pulpotomy (PULP) and RCT.
The qualitative synthesis included 57 studies, and the authors conducted meta-analysis of 3. PULP leads to more asymptomatic cases (relative risk [RR], 1.06; 95% CI, 1.01 to 1.11; P < .01; I2 = 67%) and to a lower occurrence of mild (RR, 0.89; 95% CI, 0.79 to 0.99; P < .04; I2 = 37%) and moderate (RR, 0.70; 95% CI, 0.51 to 0.95; P < .02; I2 = 57%) postoperative pain than RCT. The frequency of severe pain was very low for both vital pulp therapy and RCT. Moderate to severe postoperative pain was more common at 48 hours through 72 hours after RCT and up to 36 hours after PULP. Pain intensity after PULP was higher using calcium-enriched material compared with using mineral trioxide aggregate at 12, 18, and 36 hours (P < .001).
PULP showed a significantly higher incidence of no pain and a lower incidence of mild and moderate pain than single-visit RCT. Clinical decisions for RCT or PULP should not be based on differences in postoperative pain. When analgesia is indicated, it probably should be limited to a short time after PULP.
The authors searched PubMed, Cochrane Library, Embase, and Latin American and Caribbean Health Sciences Literature databases for studies published through June 30, 2022. The authors included randomized clinical trials if they reported on the assessment of postoperative pain after direct pulp capping, partial pulpotomy, pulpotomy, or single-visit RCT. The authors assessed the frequency of no, mild, moderate, and severe postoperative pain. They conducted meta-analyses to compare postoperative pain after full pulpotomy (PULP) and RCT.
The qualitative synthesis included 57 studies, and the authors conducted meta-analysis of 3. PULP leads to more asymptomatic cases (relative risk [RR], 1.06; 95% CI, 1.01 to 1.11; P < .01; I2 = 67%) and to a lower occurrence of mild (RR, 0.89; 95% CI, 0.79 to 0.99; P < .04; I2 = 37%) and moderate (RR, 0.70; 95% CI, 0.51 to 0.95; P < .02; I2 = 57%) postoperative pain than RCT. The frequency of severe pain was very low for both vital pulp therapy and RCT. Moderate to severe postoperative pain was more common at 48 hours through 72 hours after RCT and up to 36 hours after PULP. Pain intensity after PULP was higher using calcium-enriched material compared with using mineral trioxide aggregate at 12, 18, and 36 hours (P < .001).
PULP showed a significantly higher incidence of no pain and a lower incidence of mild and moderate pain than single-visit RCT. Clinical decisions for RCT or PULP should not be based on differences in postoperative pain. When analgesia is indicated, it probably should be limited to a short time after PULP.
摘要：
背景：本系统综述旨在研究活髓治疗和根管治疗（RCT）是否会促进不同的术后疼痛。
方法：作者搜索了PubMed，科克伦图书馆,Embase,以及拉丁美洲和加勒比健康科学文献数据库，用于2022年6月30日之前发表的研究。作者纳入了随机临床试验，如果他们报告了直接盖髓后术后疼痛的评估，部分牙髓切除术,牙髓切除术,或单次访问RCT。作者评估了不，温和,中度,和严重的术后疼痛。他们进行了荟萃分析，以比较全牙髓切除术（PULP）和RCT术后疼痛。
结果：定性综合包括57项研究，作者对3.PULP导致更多无症状病例(相对风险[RR]，1.06；95%CI，1.01至1.11；P<.01；I2=67%），轻度发生率较低（RR，0.89；95%CI，0.79至0.99；P<.04；I2=37%）和中等（RR，0.70；95%CI，0.51~0.95；P<.02；I2=57%）术后疼痛比RCT。对于重要的牙髓治疗和RCT，剧烈疼痛的频率都很低。中度至重度术后疼痛在RCT后48小时至72小时以及PULP后36小时更为常见。在12、18和36小时，使用富钙材料的PULP后的疼痛强度高于使用三氧化矿物质聚集体的疼痛强度（P<.001）。
结论：PULP显示无疼痛的发生率明显高于单诊RCT，轻度和中度疼痛的发生率明显低于单诊RCT。RCT或PULP的临床决策不应基于术后疼痛的差异。当需要镇痛时，它可能应该限制在PULP后的短时间内。
方法：作者搜索了PubMed，科克伦图书馆,Embase,以及拉丁美洲和加勒比健康科学文献数据库，用于2022年6月30日之前发表的研究。作者纳入了随机临床试验，如果他们报告了直接盖髓后术后疼痛的评估，部分牙髓切除术,牙髓切除术,或单次访问RCT。作者评估了不，温和,中度,和严重的术后疼痛。他们进行了荟萃分析，以比较全牙髓切除术（PULP）和RCT术后疼痛。
结果：定性综合包括57项研究，作者对3.PULP导致更多无症状病例(相对风险[RR]，1.06；95%CI，1.01至1.11；P<.01；I2=67%），轻度发生率较低（RR，0.89；95%CI，0.79至0.99；P<.04；I2=37%）和中等（RR，0.70；95%CI，0.51~0.95；P<.02；I2=57%）术后疼痛比RCT。对于重要的牙髓治疗和RCT，剧烈疼痛的频率都很低。中度至重度术后疼痛在RCT后48小时至72小时以及PULP后36小时更为常见。在12、18和36小时，使用富钙材料的PULP后的疼痛强度高于使用三氧化矿物质聚集体的疼痛强度（P<.001）。
结论：PULP显示无疼痛的发生率明显高于单诊RCT，轻度和中度疼痛的发生率明显低于单诊RCT。RCT或PULP的临床决策不应基于术后疼痛的差异。当需要镇痛时，它可能应该限制在PULP后的短时间内。
