■本研究旨在评估无症状单根下颌牙伴根尖牙周炎患者根尖孔扩大对炎症标志物和疼痛的影响。
■根据纳入和排除标准,该研究包括60名患者。在开始根管治疗(RCT)之前,从肘前窝获得血液样本以评估炎症标志物,C反应蛋白(CRP),和红细胞沉降率(ESR)。完成入口开放并完成初始灌溉。使用电子顶点定位器确定工作长度(WL),并用X射线照片进行验证。在对照组中,保持确定的WL,而在实验组,WL设置到根尖孔。两组均根据初始根尖文件进行生物力学准备,直至F2或F3,然后根据主根尖文件大小进行最终灌溉和闭塞。患者在术后24、48和72h时接受视觉模拟量表记录疼痛感觉。72小时后,患者被召回进行随访,再次从肘前窝取血以评估炎症标志物。
使用Studentt检验对在有或没有椎间孔扩大的RCT之前和之后炎性标志物减少的结果进行统计学分析。通过单向“方差分析”和Tukey事后检验对疼痛进行统计学检查,以进行组间疼痛比较。显著性水平设定为P<0.05。使用社会科学统计软件包(SPSS)第23版Windows(SPSSInc.,芝加哥,IL,美国)。由于对照组在RCT前后的疼痛为零,由于总体疼痛评分为零,因此不需要统计分析.
■对照组CRP和ESR的P值分别为0.02和0.03,这表明它是显著的,而实验组的ESR和CRP的P值分别为0.0002和0.0008,这表明它是高度显著的。结果表明,与对照组相比,实验组在减少炎症标志物方面更有效。对照组在RCT后24、48、72h疼痛为零。其中RCT是用根尖椎间孔扩大进行的,24h结束时出现轻度疼痛,48h结束时逐渐减轻,72h结束时无疼痛报告。
■在有根尖扩大的RCT中炎性标志物的减少比没有根尖扩大的RCT更有效。根尖扩大的RCT在治疗后立即引起患者轻度疼痛,随着时间的推移逐渐减少。
UNASSIGNED: This study aims to assess the effect of apical foraminal enlargement on inflammatory markers and pain in patients with asymptomatic single-rooted mandibular teeth with apical periodontitis.
UNASSIGNED: The study included 60 patients based on inclusion and exclusion criteria. Before beginning root canal treatment (RCT), a blood sample was obtained from the antecubital fossa to evaluate the inflammatory markers, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Access opening was done and initial irrigation was done. Working length (WL) was determined with an electronic apex locator and verified with a radiograph. In the control group, the determined WL was maintained, while in the experimental group, the WL was set till the apical foramen. Biomechanical preparation was done in both groups till F2 or F3 based on the initial apical file, followed by final irrigation and obturation based on the master apical file size. Patients were given a Visual Analog Scale to record pain sensations at 24, 48, and 72 h postoperative. After 72 h, patients were recalled for follow-up appointments, and blood was taken from the antecubital fossa again to evaluate inflammatory markers.
UNASSIGNED: The resultant findings for the reduction in inflammatory markers before and after RCT with or without foraminal enlargement were statistically analyzed using the Student\'s t-test. The pain was statistically examined with one-way \"analysis of variance\" and Tukey\'s post hoc test for inter-group comparison of pain. The level of significance was set at P < 0.05. The statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 23 for Windows (SPSS Inc., Chicago, IL, USA). As pain in the control groups is zero before and after RCT, statistical analysis is not required as the overall pain score is zero.
UNASSIGNED: The P values of the CRP and ESR of the control group were 0.02 and 0.03, respectively, which indicates it is significant whereas the P values of the ESR and CRP of the experimental group were 0.0002 and 0.0008 which indicates it is highly significant. Results indicate that the experimental group is more effective compared to the control group in reducing inflammatory markers. Pain in the control group after RCT was zero at the end of 24, 48, and 72 h. In the experimental group, where RCT was done with apical foraminal enlargement, mild pain was present at the end of 24 h which gradually decreased at the end of 48 h and no pain was reported at the end of 72 h.
UNASSIGNED: Reduction in inflammatory markers was more effective in RCT with apical enlargement than without apical enlargement. RCT with apical enlargement caused mild pain in the patients immediately after treatment which gradually decreased over time.