背景:尽管在仪器系统和药物干预方面取得了重大突破,牙髓治疗后的疼痛仍然是一个严重的问题.牙髓器械系统类型在牙髓治疗后的术后疼痛中的作用一直存在争议。
目的:为了评估不同的牙髓仪器系统,即Reciproc(GmbH,慕尼黑),OneShape®(MicroMega,法国),ProtaperGold(DentsplySirona,美国),和Hyflex®EDM(Coltène/WhaledentInc.,美国)文件系统,关于牙髓治疗后的术后疼痛方法和材料:牙髓科治疗了20至50岁的健康患者,这些患者在一个或多个上颌磨牙或下颌磨牙中出现不可修复的牙髓炎症状。五百是样品的确定大小。研究参与者分为五类,每人包括100名参与者。这些类别是:类别1:Reciproc仪器系统。类别2:OneShape®仪器系统。第3类:ProtaperGold仪表系统。第4类:HyFlex®EDM仪表系统。第5类:控制(不锈钢K文件)。牙髓治疗后,这些分数是在6小时记录的,12小时,24小时,48小时,和72小时使用VAS量表。
结果:对照组的视觉模拟量表(VAS)评分(平均值±SD)为0.73±0.40(<0.001)。Reciproc组的VAS评分为0.43±0.05(<0.001)。OneShape®组的VAS评分为0.36±0.09(<0.001)。ProteceGold组的VAS评分为0.41±0.08(<0.001)。HyFlex®EDM组的VAS评分为0.55±0.02(<0.001)。与对照组相比,在72小时随访时,所有仪器技术的VAS评分均较低,具有有意义的统计学意义(<0.001)。然而,Reciproc术后疼痛,OneShape®,ProtaperGold,和HyFlex®EDM仪器系统之间的比较在临床上没有差异。然而,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM的VAS值更高,与Reciproc和ProtaperGold相比,OneShape和HyFlex®EDM显示术后疼痛增加。还观察到,随着随访时间从6小时增加到72小时,所有仪器系统的VAS评分均下降。随访6小时术后疼痛最大,随访72小时术后疼痛最小。然而,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM的下降幅度较小,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM术后疼痛增加。
结论:在Reciproc的所有牙髓手术随访中,术后疼痛较少,OneShape®,ProtaperGold,和HyFlex®EDM比对照组。OneShape®和HyFlex®EDM组的VAS评分高于Reciproc和ProtaperGold组,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM仪器的术后疼痛增加。
BACKGROUND: Despite substantial breakthroughs in instrumentation systems and pharmaceutical interventions, pain following endodontic therapy remains a serious concern. The effect of the type of endodontic instrumentation system in post-operative pain after endodontic therapy has been a matter of debate.
OBJECTIVE: To evaluate different endodontic instrumentation systems, namely Reciproc (GmbH, Munich), OneShape® (MicroMega, France), Protaper Gold (Dentsply Sirona, USA), and Hyflex® EDM (Coltène/Whaledent Inc., USA) file systems, regarding post-operative pain after endodontic therapy Methods and materials: The endodontic department treated healthy patients aged 20 to 50 years who were experiencing symptoms of irreparable pulpitis in one or more maxillary molars or mandibular molars. Five hundred was the determined size of the sample. The
study participants were divided into five categories, each comprising 100 participants. These categories were: Category 1: Reciproc instrumentation system. Category 2: OneShape® instrumentation system. Category 3: ProtaperGold instrumentation system. Category 4: HyFlex® EDM instrumentation system. Category 5: Control (stainless steel K-files). Following endodontic therapy, these scores were recorded at 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours using the VAS scale.
RESULTS: The visual analog scale (VAS) score (mean±SD) in the control group was 0.73± 0.40 (<0.001). The VAS score in the Reciproc group was 0.43± 0.05 (<0.001). The VAS score in the OneShape® group was 0.36±0.09 (<0.001). The VAS score in the Protaper Gold group was 0.41 ±0.08 (<0.001). The VAS score in the HyFlex® EDM group was 0.55 ±0.02 (<0.001). The VAS score in all instrumentation techniques at 72 hours follow-up was lesser in comparison to a control group with meaningful statistical significance (<0.001). However, the post-operative pain among the Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM instrumentation systems was not different clinically when compared among themselves. However, VAS values were greater in OneShape® and HyFlex® EDM compared to Reciproc and Protaper Gold, showing increased post-operative pain in OneShape and HyFlex® EDM compared to Reciproc and Protaper Gold. It was also observed that there was a decline in the VAS score in all instrumentation systems as the follow-up period increased from 6 hours to 72 hours, with maximum post-operative pain at 6 hours of follow-up and minimum post-operative pain at 72 hours of follow-up. However, the decline was lesser in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold, with increased post-operative pain in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold.
CONCLUSIONS: Post-operative pain at all follow-ups of endodontic procedures was less in Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM than in the control group. VAS scores were higher in the OneShape® and HyFlex® EDM groups compared to the Reciproc and Protaper Gold groups, indicating increased post-operative pain with OneShape® and HyFlex® EDM instruments in comparison to Reciproc and Protaper Gold.