The relationship of intracanal medicaments to postoperative pain in endodontics

International Endodontic Journal - Tập 36 Số 12 - Trang 868-875 - 2003
E. H. Ehrmann1, Harold H. Messer1, Geoffrey G. Adams1
1School of Dental Science, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 711 Elizabeth Street, Melbourne, Victoria, 3000, Australia.

Tóm tắt

AbstractAim  To investigate the relationship of postoperative pain to three different medicaments placed in the root canal after a complete biomechanical debridement of the root canal system in patients presenting for emergency relief of pain.Methodology  Two hundred and twenty‐three teeth belonging to 221 patients presenting as emergencies to the Royal Dental Hospital of Melbourne were included in the study. Inclusion was limited to patients with a diagnosis of pulp necrosis and acute apical periodontitis. All teeth underwent conventional root canal treatment, which involved the instrumentation to the apices of each canal at the first visit. Canals were instrumented using a stepback technique and hand‐files along with irrigants using Milton's (1% sodium hypochlorite) solution followed by 15% EDTAC. The canals were dried and one of the following three medicaments was inserted into the canal in random sequence: Group 1: Ledermix paste (Lederle Pharmaceuticals, Division of Cyanamid, Wolfratshausen, Germany); Group 2: calcium hydroxide paste (Calcipulpe, Septodont, France); and Group 3: no dressing.Before dismissal, the preoperative pain experienced on the previous night was recorded using a visual analogue pain scale. Patients were then instructed to record the degree of pain experienced 4 h after treatment and daily for a further 4 days.Results  The mean score pain for all three groups was between 42 and 48 prior to treatment being commenced. After 4 days, the pain score for Group 2 was 10, for Group 3 was 7 and for Group 1 was 4. Mean preoperative pain level was 44.4 (of a maximum 100) for all groups, and declined by 50% (to 22.1) after 24 h. Patients in Group 1 (Ledermix) experienced significantly less (P = 0.04) postoperative pain than those in the other two groups. There was no significant difference between Group 2 (calcium hydroxide) and Group 3 (no dressing).Conclusion  Under the conditions of this study, painful teeth with acute apical periodontitis that had been dressed with Ledermix paste gave rise to less pain than that experienced by patients who had a dressing of calcium hydroxide or no dressing at all. Ledermix is an effective intracanal medicament for the control of postoperative pain associated with acute apical periodontitis, with a rapid onset of pain reduction.

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Tài liệu tham khảo

10.1111/j.1365-2591.1992.tb00748.x

10.1111/j.1600-9657.1988.tb00295.x

10.1016/S0099-2399(84)80042-4

Blitzer MH, 1956, Root Canal Therapy: use of a combination of antibacterial agents, hydrocortisone and hyaluronidase, New York Dental Journal, 22, 503

10.1111/j.1600-9657.1985.tb00652.x

10.1016/S0099-2399(87)80066-3

10.14219/jada.archive.1992.0199

10.1111/j.1834-7819.1964.tb02067.x

10.1016/0022-3913(65)90074-0

10.1111/j.1834-7819.1972.tb04932.x

10.1046/j.1365-2591.1998.00159.x

Feinchneider II, 1961, L'hydrocortisone, précieux adjurent au traitment d'endotontie, Journal of the Canadian Dental Association, 27, 203

10.1111/j.1365-2591.1987.tb00590.x

10.1111/j.1365-2591.1984.tb00396.x

10.1097/00004770-200302000-00009

10.14219/jada.archive.1965.0079

10.1016/0030-4220(86)90044-7

Laws AJ, 1967, Corticosteroid‐antibiotic sedation for endodontic casualty patients, New Zealand Dental Journal, 65, 35

10.1038/sj.bdj.4808469

10.1067/moe.2001.115975

Olsen P, 1964, Clinical experience with a corticoid‐antibiotic preparation in conservative treatment of the pulp, Journal of the Canadian Dental Association, 30, 771

Olsen P, 1966, Further experience with triamcinolone demethylchlortetracycline for conservative endodontic treatment, Journal of the Canadian Dental Association, 32, 522

Rimmer A, 1991, Intracanal medications and antibiotics in the control of interappointment flare‐up, Quintessence International, 22, 997

Schneider DW, 1968, Triamcinolone acetonide‐demethylchlortetracycline HCl treatment in endodontic practice, Journal of Oral Medicine, 23, 51

Schroeder A, 1962, Zur Frage der konservativen und chirugischen Behandlung der Pulpitis, Österreichische Zeitschrift für Stomatologie, 59, 81

Schroeder A, 1965, Corticosteroids in endodontics, Journal of Oral Therapeutics and Pharmacology, 2, 171

Schroeder A, 1981, Endodontics – Science and Practice, 219

Seltzer S, 2000, Pain.

Sinkford JC, 1964, The case against topical use of adrenocorticosteroids in dentistry, Journal of the American Dental Association, 68, 765

10.1111/j.1365-2591.1991.tb00117.x

Stanley H, 1984, Pathways of the Pulp, 851

10.1016/S0099-2399(88)80181-X

10.1111/j.1600-9657.1990.tb00423.x

Van Cura JE, 1970, Corticosteroid‐antibiotic combination in the treatment of acute secondary apical periodontics, Illinois Dental Journal, 39, 307

10.1016/S0099-2399(06)80535-2

10.1016/0030-4220(54)90034-1

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International Endodontic Journal

Tập 36 Số 12

868-875

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