根管治疗期间急症的发生程度与相关因素分析

目的分析根管治疗期间急症（EIAE）发生率、急性发作指数（FUI）及相关因素。方法按纳入标准选取204例在湖南旺旺医院口腔科就诊需行根管治疗的患牙,随机分成两组,A组101例患牙采用双敞法制备根管;B组103例患牙采用根向深入法制备根管。记录相关数据,如患者年龄、性别、牙位、患牙治疗前状况（包括牙髓及根尖周状况、治疗前疼痛、窦道）及根管器械制备后1周内出现的症状。结果 204例患牙EIAE的发生率为13.24%（27/204）,FUI值为3.51±1.36。双敞法组EIAE的发生率（21.78%）明显高于根向深入法组（4.85%）,二者差异有统计学意义（P〈0.01）。双敞法组FUI值（5.53±1.09）明显高于根向深入法组（1.79±0.76）（P〈0.01）。根尖X线透射阴影阳性患者EIAE的发生率和FUI值明显高于根尖X线正常者（P〈0.05）;治疗前有疼痛和无窦道患者EIAE的发生率和FUI值明显高于无症状者（P〈0.05）;EIAE的发生率与患者的年龄、性别和牙位无显著相关性（P〉0.05）。结论根向深入法制备根管能显著降低EIAE的发生率及急性发作程度,根尖X线透射阴影阳性、治疗前疼痛和根尖无窦道的患牙能增加EIAE的发生率及急性发作程度。

A clinical evaluation of endodontic interappointment emergencies：incidence, severity and related factors

Objective The present study was performed to investigate the incidence, severity and related factors of endodontic interappointment emergencies （EIAE） and flare up index （FUI）. Mothods Two hundred and four patients attending for endodontic therapy in Hunan Wantwant Hospital were randomly assigned to either double flared technique or crown down technique procedure group. In group A, 101 teeth were instrumented with double flared technique;In group B, 103 teeth were instrumented with crown down technique. The related factors were recorded, including age, gender, tooth position, pulpal and periapical status, pre-operative pain, sinus and the symptoms occurred 1 week after root canal instrumentation. Results The incidence of EIAE observed in 204 teeth was 13.24%. Twenty two endodontic EIAE （21.78%） were recorded in double flared technique group compared to 5（4.85%） EIAE in crown down technique group. The EIAE incidence in double flared technique group was significantly higher than that in crown down technique group （P0.01）. FUI in double flared technique group （5.53±1.09）was significantly higher than that in crown down technique group （1.79±0.76）（P0.05）; The incidence and FUI value in EIAE patients with periapical radioluceney or pre-operative pain or without sinus were significantly higher than those with normal periapical radiograph, no pre-operative pain and with sinus （P0.05）. There was no significant interrelationship of the EIAE and the patient＇s age, gender and tooth position （P0.05）. Conclusion Crown down technique has been shown to be a safe and effective alternative to double flared technique. The presences of a periapical lesion and the pre-operative pain or without sinus were the most important predictors of EIAE during root canal therapy.