Clinical Evaluations Of Transitional Treatment Of Pulpitis During Pregnancy

Objective: To observe the effect of transitional treatment for pulpitis in pregnancy on pulpitis therapy,pregnancy status and neonatal health status,and to provide evidence for the decision-making of the clinical treatment plan for pulpitis during pregnancy.Methods: 60 cases of Pulpitis of Pregnancy who were diagnosed in the Department of Endodontics of Affiliated Hospital of Qingdao University from 2015.1-2017.6 have been investigated.In which,age arrangement is 21-35 years old,the mean age was 28 years old.37cases(61.7%)of the first pregnancy,23 cases(38.3%)of the second pregnancy,12 cases(24.0%)during the first trimester(12 weeks before pregnancy),32 cases(53.3%)during the second trimester(13 to 27 weeks of pregnancy),and 16 cases(26.7%)during the third trimester(28 weeks and later).This clinical trial study has been approved by the Hospital Ethics Committee.According to different stages of pregnancy,the patients were divided into the first,second and third trimester.Preoperative learn about the history of the patient was finished,and the cooperation with obstetricians was used to determine whether patients can tolerate dental treatment according to the pregnancy status of the patient,and we performed flexible psychological interventions on the patients and their families,and signed a written informed consent form.All the patients were anesthetized locally using STAsystem combined with Alcaine hydrochloride adrenaline during treatment.The rubber dams were used,and thenopened pulp,took off pulp,given root canal preparation once,filled with vitapex pasta,and filled cavity with 3M glassionomer cement.Then we observe the clinical response throughout the whole pregnancy.Normal obturation of the root canal and crown restoration were conducted after delivery.The Heft-Parker VAS was used to determine the patient's postoperative pain relief in 24 hours.Comparison of the VAS values before and after treatment was used to evaluate the short-termefficacy of the teeth.The evaluation of transitional treatment was finished based on the patient's subjective symptoms,clinical examination,X-ray film after 24 h of oral treatment during pregnancy to the second month after delivery when completing the normal root canal treatment.The patient's pregnancy status,pregnancy outcomes and neonatal gestational age,weight,deformity,neonatal complications after treatment were observed and compared statistically.Data were analyzed by SPSS20.0.T test was used to analyze the differences in VAS before and after treatment,and chisquare test was used to analyze the pregnancy outcomes and neonatal health status of the first,second,third pregnancy.P<0.05 was considered statistically significant.Results: The symptoms of pulpitis were significantly improved 24 h after treatment,35 casesof painlessness,23 cases of mild pain,and 2 cases of moderate pain.Effective treatment(effective =painless + mild pain)in 58 cases,and the effective rate was 96.7%.The difference of VAS before and after treatment was statistically significant(P<0.05).Patients had no discomfort still the end of pregnancy.After clinical examination and X-ray assessment,except for 1 case due to tooth fracture,the remaining teeth can be continued perfect root canal therapy.59 cases of successful treatment,the success rate was 98.3%,1.7% failure rate.The pregnancy status of the patients was good,and they all passed the pregnancy period safely,and no adverse pregnancy outcomes were observed after treatment during different periods of pregnancy.The normal live birth rate is 100%.Neonatal health was good.Significant differences were not found in birth gestational age,body weightmal formations,andneonatal complications between the three groups(P>0.05).Conclusion: Transitional treatment of pulpitis during pregnancy is a safe and effective procedure,which is worthy to be widely used in clinics.(1)The acute symptoms of pain in pregnant womencan be effectively and timely relieved;(2)It is safe for pregnant women and fetuses;(3)The occlusal function of the affected tooth is restored as more as possible;(4)It can prevent the reinfectionandpreparea suitabletoothforthesubsequentnormal RCT after pregnancy period.