| Objective:Root canal therapy is an effective method commonly used in the treatment of pulp and periapical disease. After two hundred years of development, especially after the1980s of the rapid modernization of root canal therapy, at present, root canal therapy has become an internationally recognized, widely indications, operating specifications, requirements clear and efficacy constant treatment of which the clinical success rate is over95%.Single-visit root canal therapy was firstly reported in1901, in which root canal preparation, root canal disinfection rinse and root canal obturation is completed in one visit.Its application is limited in clinical practice due to a higher incidence of postoperative pain.In the process of root canal therapy, including interappointment or12h to several days after treatment, patients often appear teeth pain, swelling and other acute inflammatory reaction phenomenon which is known as endodontic pain (EIP) or endodontic interappointment emergencies (EIE)of which the occurrence rate is3%to50%. The occurring of endodontic interappointment emergencies can be prevented and reduced. During the operation, strictly aseptic,from the start of work on the determination of the length of root canal to prevent root canal preparation and root canal filling material beyond the apical foramen, to avoid bacteria, dentin debris and other infectious substances into the periapical tissues. Coupled with the application of large taper nickel-titanium instruments, ultrasound swished,etc, infections material into the periapical tissue is further reduced during root canal treatment,and also reduced the incidence of pain.The traditional root canal therapy ensures that there is a thorough disinfection before root canal filling, which is still the commonly used treatment of many clinicians.But it needs patient visits for many times, increasethe burden on the time and energy of the patient. Single-visit root canal therapy saves time for the patient and the doctor, it is easily to be accepted by patients, and has promising clinical efficacy. With the continuous development of dental instruments, today’s single visit root canal therapy already has a good effect. Many doctors worry about the high incidence of EIE without using. In this study, patients were randomized to single-visit root canal therapy or multiple-visit root canal therapy, incidence of inter-appointment pain was compared between them to explore the feasibility of single-visit root canal therapy, it provide a reference for clinicians to select the single visit root canal therapy.Method:Select patients172cases who need root canal therapy in the clinical treatment, then they were randomly divided into four groups. Group A, C for the experimental group; GroupB, D for the control group.Group A:46cases.To prepare teeth with crown-down techninque by engine-driven rotary ProTaper nickel-titanium instruments, then finish root canal filling in one time with Vitapex and gutta percha point. Group B:45cases.To prepare Teeth with crown-down techninque by engine-driven rotary ProTaper nickel-titanium instruments, intracanal medicament for seven days and then root canal filling with Vitapex and gutta percha point. Group C:41cases.To prepare Teeth withcrown-down techninque by engine-driven rotary ProTaper nickel-titanium instruments, then finish root canal filling in one time with Endomethasone ivory and gutta percha point. Group D:40cases. To prepare Teeth with crown-down techninque by engine-driven rotary ProTaper nickel-titanium instruments,ntracanal medicament for seven days and then root canal filling with endomethasone ivory and gutta percha point. The root canal filling uses cold gutta-percha lateral condensation method in the four groups. On postoperative day2(48h) and day7, patients were followed up on postoperative pain. Four groups of patients for treatment in accordance with different root canal treatment, The appointment patients in the postoperative day1(24h)、day7and day15follow-up referral, then detailed records after teeth emergency situation.Results:1. The occurrence of EIE in each group.A group:46cases, there are five cases occurred postoperative emergency on the second day after root canal therapy, the incidence of postoperative emergency is10.7%.There are two cases occurred postoperative emergency on the second day after root canal therapy, the incidence of postoperative emergency is4.3%.B group:45cases, there are two cases occurred postoperative emergency on the second day after root canal therapy, the incidence of postoperative emergency is4.4%. There are one cases occurred postoperative emergency on the seventh day after root canal therapy, the incidence of postoperative emergency is2.2%.C group:41cases, there are three cases occurred postoperative emergency on the second day after root canal therapy, the incidence of postoperative emergency is7.3%. there are one cases occurred postoperative emergency on the seventh day after root canal therapy, the incidence of postoperative emergency is2.4%.D group:40cases, there are two cases occurred postoperative emergency on the second day after root canal therapy, the incidence of postoperative emergency is2.5%. there are one cases occurred postoperative emergency on the seventh day after root canal therapy, the incidence of postoperative emergency is2.5%. There is no significant difference on the incidence of postoperative emergency between experimental group (A) and the control group (group B)(P>0.05). There is no significant difference on the incidence of postoperative emergency between experimental group (C) and the control group (groupD)(P>0.05).2.Pain after root canal filling in each group:by rank sum test, between experimental group (A) and the control group (group B), between experimental group (C) and the control group (groupD),there was significant difference in occurring rate of pain after root canal filling at the next day after the operation(P <0.05).There was no significant difference in occurring rate of pain after root canal filling at the seventh day after the operation,(P>0.05).Conclusion and Suggestion:1Conclusion:Conclusion1. The results of group A and group B were statistically analyzed, the difference was not statistically significant (P<0.05), indicating that using Vitapex as paste in the single-visit root canal therapy will not will not cause more occurrence of postoperative emergency than multiple-visit root canal therapy.Conclusion2. The results of group C and group D were statistically analyzed, the difference was not statistically significant (P<0.05), indicating that using Endomethasone ivory as paste in the single-visit root canal therapy will not cause more occurrence of postoperative emergency than multiple-visit root canal therapy.Conclusion3. The results of group A and group C were statistically analyzed, the difference was not statistically significant (P<0.05), indicating that in the single-visit root canal therapy choosing Vitapex or Endomethasone ivory as paste will not significantly affect the occurrence of postoperative emergencyConclusion4. Between group A and group B, between group C and groupD,there was significant difference in occurring rate of pain after root canal filling at the next day after the operation(P<0.05), indicating that single-visit root canal therapy has higher incidence of postoperative pain than multiple-visit root canal therapy.2Suggestion:Multiple-root canal therapy has higher incidence of postoperative pain, but for EIE, there was no difference between the two. Long as each step strictly according with the rules to operate, single-visit root canal therapy is for the majority of clinical cases, and doctors do not have to adopt single-visit root canal therapy because of worrying too much about EIE. As single-visit therapy reduces the times of visit, it may be a preferred choice in clinic. |
PDF Full Text Request