严重感染根管一次法根管治疗术术后疼痛分析

发布时间：2018-03-17 09:21

本文选题：一次法　切入点：根管治疗　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：对需进行牙髓治疗的患牙采用一次法根管治疗，探讨严重感染根管根管治疗术后疼痛情况，为临床应用一次法根管治疗提供依据。方法：根据临床检查、术前拍摄X片并结合患者的症状做出明确诊断后，，收集符合纳入标准的患者（其中活髓和死髓患牙病例各10例）。常规麻醉，上橡皮障，开髓，揭去髓顶，去除冠髓，探查根管，建立髓腔根管直线通路，根管长度电测仪测定根管工作长度，使用K3（0.06锥度）机用镍钛器械配合Crown-down（冠向下）技术进行根管预备、成形，根管预备过程中，每次更换器械均使用5ml2.5%次氯酸钠（SodiumHypochlorite，NaOCl）溶液冲洗根管，并用17%乙二胺四乙酸（EthyleneDiamine Tetraacetic Acid， EDTA）溶液完成最后根管冲洗。使用美松糊剂和相应锥度牙胶尖，采用侧方加压方法完成严密的根管充填，最后进行牙冠部的充填。术后指导患者使用数字评分法（Numeric nating Scale, NRS）评估术后当天至术后一周内每天的疼痛情况并记录于疼痛回访表，在一周后复诊时回收回访表，对术后一周内的疼痛情况进行统计学分析。结果： 1.一次法根管治疗术后第1天的疼痛强度最大（P0.05），有统计学意义，疼痛在一周内呈现逐渐降低并消失的趋势。 2.一次法根管治疗术后7天内，死髓患牙组与活髓患牙组的疼痛发生率无显著性差异，P0.05。 3.一次法根管治疗术后7天内，死髓患牙组与活髓患牙组的疼痛强度无显著性差异，P0.05。结论：死髓患牙和活髓患牙经一次法根管治疗后，术后一周之内疼痛率和疼痛强度无明显差异。临床上为减少患者就诊次数，严重感染根管的患牙可以选用一次法根管治疗，但要排除术前严重的肿痛、根管内活动性渗出和根尖牙槽骨严重破坏的症状。
[Abstract]:Objective: to study the pain after root canal therapy in patients with severe infection, and to provide the basis for clinical application of single root canal therapy. Methods: according to clinical examination, X ray was taken before operation and definite diagnosis was made in combination with the symptoms of the patients. The patients who met the inclusion criteria were collected (including 10 cases of live pulp and 10 cases of dead pulp teeth), routine anesthesia, rubber barrier, pulp opening. Removing the top of the pulp, removing the crown pulp, exploring the root canal, establishing the straight passage of the root canal, measuring the working length of the root canal with the electric measuring instrument of the root canal length, using the K3A0.06 taper) machine to prepare the root canal with the nickel-titanium instrument and Crown-down (down) technique. During the root canal preparation, the root canal was washed with 5 ml 2.5% sodium hypochlorite sodium hypochlorite solution and 17% ethyleneDiamine Tetraacetic acid (EDTAT) solution. The method of lateral compression was used to complete the strict root canal filling, and finally the crown was filled. Numeric nating scale (NRS) was used to evaluate the daily pain status from the day of operation to one week after operation and recorded in the pain return form. The pain was statistically analyzed one week after operation. Results:. 1. The pain intensity was the highest on the first day after the treatment, which was statistically significant, and the pain gradually decreased and disappeared within one week. 2. There was no significant difference in the incidence of pain between the dead pulp teeth group and the living pulp tooth group within 7 days after a single root canal therapy (P 0.05). 3. There was no significant difference in pain intensity between the dead pulp teeth group and the living pulp tooth group within 7 days after a single root canal therapy (P 0.05). Conclusion: there is no significant difference in pain rate and pain intensity between dead and living pulp teeth after one treatment. In order to reduce the number of visits to patients, the teeth with severe infection can be treated with root canal only once. However, the symptoms of severe preoperative swelling and pain, active exudation in the root canal and severe destruction of the apical alveolar bone should be excluded.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.05

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