A Clinical Study Of Endodontic Interappointment Emergencies

Objectives. Pain and swelling are the common acute symptoms following a root canal treatment appointment. The severe instance is called endodontic interappointment emergency(EIE). The purpose of this study was to observe the occurrence of EIE and to evaluate the effects of some treatment measures on preventing EIE. Study design. The data of 544 teeth of 363 patients were collected from the clinical cases treated by some postgraduates. They are divided into 3 groups. Thirty hundred and ninety-two cases in the routine group were treated according to the routine procedures of the root canal therapy. Ninety-one cases in the medicament group took dexamethasone tablets after the root canal instrumentation. Root canals of sixty-one cases in the drainage group were prepared at the first visit and had been left open for two or three days. The related factors were recorded, including age, gender, tooth type, pulpal/ periapical diagnosis, the length of instrumentation and the symptoms occurred after instrumentation. The incidences and FUI value of EIE were statistically analyzed. Results. The outcome of the routine group showed that theincidence of EIE was 19.1%, and that the incidence of swelling was 6.4%. The incidence and degree were significantly higher in overinstrumented teeth than the other (p<0.05). EIE was not significantly related to the patients' age and gender. The anterior teeth had more incidence of EIE and higher FUI value than the posterior teeth, but the results were not statistically significant. The incidence of EIE and FUI coincided with the severity of the pathosis of the pulpal and periapical tissue. Compared with those in the routine group, cases in the medicament group had less severe EIE (p <0.05). But the incidence of EIE was not statistically significant between these two groups. Although drainage reduced the occurrence of EIE, there was no significantly difference between the cases in the drainage group and those in the routine group. Conclusions. The incidence of EIE was 19%. EIE was not related to the patients' age and gender. The results suggested that EIE was probably related to tooth type and pulpal/periapical diagnosis. The occurrence of EIE was significantly related to overinstrumentation. Taking dexamethasone could remit the symptoms of EIE. Drainage could reduce the occurrence of EIE after the root canal treatment of residual roots and crowns.