两种根管消毒药物对根管预备后疼痛影响.doc

两种根管消毒药物对根管预备后疼痛影响【摘要】 目的 评价氢氧化钙樟脑酚糊剂和0.12%葡萄糖酸氯已定溶液作为根管消毒药物对根管预备后疼痛的影响。方法 158例无疼痛症状的患牙随机分为氢氧化钙樟脑酚糊剂组(79例)和0.12%葡萄糖酸氯已定溶液组(79例)。病例中包括有根尖骨组织破坏和无根尖骨组织破坏两种情况以及初次进行根管治疗和根管再治疗者。观察并比较各组根管治疗期间痛的发生情况。结果 氢氧化钙樟脑酚糊剂封药后84.8%的病例无疼痛发生,无根尖激惹现象发生;氯已定封药后83.5%无疼痛发生,6.3%的病例出现根尖激惹现象。两者之间无统计学差异。其他各比较因素之间也无统计学差异。结论 氢氧化钙樟脑酚糊剂和0.12%葡萄糖酸氯已定溶液均可作为临床常规根管消毒药物使用,能有效降低根管预备后疼痛的发生。 【关键词】 根管治疗; 氢氧化钙糊剂; 氯已定溶液; 根管预备后疼痛; 根尖激惹 The relationship of intracanal medicaments to postoperative pain LI Zhengquan,LI Jun,GAO Yuan,The Third Peoples Hospital of Shenzhen,Shenzhen 518020,China 【Abstract】 Objective To evaluate the incidence of postoperative pain after intracanal dressings with either a calcium hydroxide/camphorated paramonochlorophenol or 0.12%chlorhexidine solution.Methods 158 asymptomatic teeth had their canals dressed with either CH or CHX.The incidence of different intensity levels of postoperative pain was registered for the period between appointments.Results Data revealed that 84.2%of the total number of cases treated with either medicament showed absence of any level of pain.No case medicated with CH and five cases(6.3%)medicated with CHX were categorized as flareups.There were no statistically significant differences between all possible comparisons involving the two medicaments in treatment/retreatment cases and teeth with/without apical periodontitis lesions.Conclusion The low incidence of postoperative pain after the use of both medications,coupled to their antimicrobial effectiveness,gives support to using one or the other in routine treatment/retreatment. 【Key words】 Endodontic treatment;Calcium hydroxide;Chlorhexidine;Postoperative pain;flareups DOI:10.3760/cma.j.issn2010.01.18 作者单位:518020广东省深圳市第三人民医院口腔科 在临床上进行根管治疗过程中,根管预备后疼痛的发生率大约为10%~30%?[1]?,大多数情况下患者可以耐受或通过药物治疗得以缓解,但也有部分患者出现严重疼痛或伴有肿胀而必需非预约就诊进行应急处理,称为根尖激惹(flareups)。由于致病微生物是造成根管预备后疼痛的主要原因,因此选择有效、刺激性小的根管消毒药物来抑制或杀灭细菌是降低其发生率的重要环节。本实验采用0.12%葡萄糖酸氯已定溶液和氢氧化钙樟脑酚糊剂治疗感染根管,对根管预备后疼痛的发生情况进行了比较观察。 1 资料与方法