活髓牙经镍钛机动与手用器械根管预备后疼痛发生比较

目的分别运用K3镍钛机动器械和手用器械进行活髓牙根管预备，比较和分析根管预备后疼痛的发生情况。方法选择因临床上修复需要接受选择性去髓术的82例患者共161颗活髓牙为研究对象，分别采用K3镍钛机动器械（机动组，n=84）和不锈钢K型根管锉手用器械（手扩组，n=77）进行根管预备。1周后复诊，双盲法记录疼痛发生情况，Georgopoulou标准分级评定疼痛反应；分析和比较两组根管预备后疼痛发生率及疼痛反应程度。结果机动组和手扩组根管预备后疼痛发生率分别为29．76％和55．84％，II～III级疼痛发生率分别为5．95％和18．18％，组间比较差异均有统计学意义（P〈0．01和P〈0．05）。根管预备后疼痛发生与牙位的关系分析显示，手扩组根管预备后磨牙Ⅱ～Ⅲ级疼痛发生率显著高于前牙和前磨牙（P〈0．01）。结论采用K3镍钛机动器械进行活髓牙根管预备高效安全，术后疼痛发生率较低且反应程度较轻。

Comparison of postoperative pain after vital pulp root canal preparation with nickel-titanium rotary instrument and hand-used instrument

Objective To compare the post-operative pain after vital pulp root canal preparation with K3 nickel-titanium rotary instrument and hand-used instrument. Methods One hundred and sixty-one vital teeth from 82 patients who received selected pulpectomy were enrolled, and root canal preparation was performed with K3 nickel-titanium rotary instrument (rotary instrument group, n=84) or stainless hand K-files (hand-used instrument group, n=77). Patients revisited one week later, the incidence and degree of post-operative pain after root canal preparation were recorded and compared between two groups. Results The incidences of post-operative pain after root canal preparation in rotary instrument group and hand-used instrument group were 29.76% and 55.84%, respectively, and the incidences of Ⅱ Ⅲ grade pain were 5.95% and 18.18%, respectively, with significant differences between two groups (P<0.01 and P<0.05). In hand-used instrument group, the incidence of Ⅱ-Ⅲ grade pain of molar teeth was significantly higher than those of anterior teeth and premolar teeth after root canal preparation (P<0.01). Conclusion Vital pulp root canal preparation with K3 nickel-titanium rotary instrument is efficient and safe, with low incidence and mild postoperative pain.