不同根管预备方法对老年人根管再治疗术后疼痛的影响

目的：对比ProTaper镍钛系统冠向下预备法和采用不锈钢手用锉逐步后退技术两种根管预备方法对老年人根管再治疗术后疼痛的影响。方法：选择106颗首次根管治疗失败再治疗患牙随机分为实验组与对照组，实验组使用ProTaper Universal再治疗器械（D1、 D2、 D3）去除根管内充填物后， ProTaper（F1、 F2、 F3）进行根管预备，对照组采用不锈钢手用锉去除牙胶后以逐步后退法预备根管，观察两组术后1h、6h、12h、24h、48h、7d VAS自评分值,24h与7d临床评定的疼痛发生率。结果：两组术后疼痛在6h出现,12h达到峰值，此后呈下降趋势，7d时已完全缓解；实验组在疼痛发生期间（6、12、24、48h 4个时间点）VAS自评分值均低于对照组，差异有统计学意义（P值分别为0.000、0.000、0.000、0.004， P〈0.05）；24h临床评定疼痛发生率实验组为11.1%，对照组为34.6%，差异有统计学意义（P=0.042， P〈0.05）；7d时临床评定疼痛发生率实验组为1.85%，对照组为3.85%，差异无统计学意义（P=0.807， P〈0.05）。结论：两种根管预备方法均会引起再治疗术后疼痛，使用ProTaper镍钛系统能有效降低老年人根管再治疗术后疼痛的发生。

Effects of different root canal preparation techniques on postoperative pain of elderly retreated patients

Objective：To assess effects of root canal preparation via Protaper Nickel-Titanium system using crown-down technique and stainless steel hand files with step-back technique on postoperative pain of endodontic retreatment in elderly patients. Methods：A total of 106 molars for retreatment were randomly divided into experimental group and control group. Molars in experimental group were treated with ProTper Universal instruments, while stainless steel instruments were used in the control group. Visual analogue scale （VAS） was used to measure pain 1h, 6h, 12h, 24h, 48h, 7 days after endodontic retreatment, and clinical pain assessment 24h and 7d after endodontic retreatment were also performed in both groups. Results：VAS analysis showed that postoperative pain occured after 6h, peaked after 12h and completely disappeared after 7d. The values of VAS in experimental group were lower than the other group, and the difference was statistically significant （P〈0.05）. The value of clinical pain assessment after 24h of experimental group was 11.1% while the control group 34.6%, and the difference was also statistically significant （P〈0.05）, while no significant differences were found on day 7 （P=0.807, P〈0.05）. The value of clinical pain assessment was 1.85% and 3.85%, respectively. Conclusion： Both methods of endodontic retreatment may cause？postoperative pain, however, it can be effectively alleviated via ProTaper Universal instruments treatment.