降低咬合对急性牙髓炎一次性根管治疗术后疼痛影响的研究

目的探讨降低咬合对急性牙髓炎一次性根管治疗术后疼痛的影响。方法选择2012年1—8月汕头市金平区中医医院口腔科门诊收治的下颌磨牙急性牙髓炎患者44例（共44颗患牙），按就诊顺序随机分为试验组和对照组，每组22例（22颗患牙）。试验组患牙在行一次性根管治疗术后作降低咬合处理，使其在正中、侧方咬合位均无咬合接触；对照组患牙在行一次性根管治疗术后不作降低咬合处理。记录两组患者术后疼痛发生情况，并在术后7d内每天1次记录疼痛的视觉模拟评分（visual analogue scale／score，VAS）分值。比较两组患者术后疼痛发生率及疼痛VAS分值的差异。结果试验组患者术后疼痛发生率为36_36％，对照组为40．91％，两组患者的术后疼痛发生率差异无统计学意义（P〉0．05）。两组患者术后7d内的疼痛VAS分值比较，实验组均比对照组略低，但差异并无统计学意义（P〉0．05）。两组患者中发生术后疼痛者7d内的疼痛VAS分值比较，试验组均比对照组低，且差异均有统计学意义（P〈0．05）。结论单纯降低咬合对急性牙髓炎一次性根管治疗术后疼痛发生率无明显影响，但对于会发生术后疼痛的患者，可以减轻其疼痛的程度。

The effect of occlusal reduction on the postoperative pain level after one-visit endodontic treatment for acute pulpitis.

Objective To discuss the effect of occlusal reduction on the postoperative pain level after one-visit endodontic treatment for acute pulpitis. Methods Totally 44 cases of acute pulpitis of mandibular molar were selected and divided into the experiment and control groups. The experiment group included 22 cases receiving total occlusal reduction in both centric and lateral occlusion after the root canal therapy. The control group included 22 cases without reduced occlusion. The rate of pain response and VAS （Visual Analogue Scale/Score） , which was evaluated 7 days, 1 time per day, were recorded after operation. A comparison of the pain response and VAS results was done between the two groups. Results There was no statistically significance between the groups regarding the rate of pain response after operation （the experiment group 36.36%, the control group 40.91%, P 〉 0. 05）. The VAS of the experiment group was slightly lower than the control group, the difference having statistical significance （P 〈 0.05）. Conclusion Oeclusal reduction has no effect on the rate of pain response, whereas it might diminish the pain degree following acute pulpitis in one-visit root canal therapy.