Alt ve üst dişlerde tek ve iki seansta yapılacak kanal tedavilerinde postoperatif ağrının değerlendirilmesi
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızın amacı, preoperatif olarak ağrılı, semptomatik, vital, çok köklü dişlerde tedavi ile ilgili faktörlerden olan seans sayısı/kullanılan medikamentin çeşidi ve kök kanallarının şekillendirilmesinde kullanılan farklı sistemlerin, kanal tedavisi sırasında ve kanal tedavisi sonrası meydana gelen postoperatif ağrı ve flare-up üzerine etkisinin incelenmesidir. Prospektif randomize klinik çalışmamıza, 14-60 yaş aralığında bulunan semptomatik akut ağrılı, vital alt ve üst çene çok köklü toplam 90 diş dahil edilmiştir. Çalışmamız tek bir hekim tarafından standart bir protokol dahilinde tamamlanmıştır. Çalışma grupları kök kanalı şekillendirme yöntemlerine göre; Ni-Ti döner alet sistemlerinden ProTaper(Tulsa Dentsply, Tulsa, OK, A.B.D.) ve resiprokal hareket yapan Reciproc(VDW, Münih, Almanya) olmak üzere önce iki gruba daha sonra da seans sayısı/ kullanılan medikamente göre de her grup kendi içerisinde tek seans, kalsiyum hidroksit medikamentli iki seans ve klorheksidin medikamentli iki seans olamak üzere alt gruba ayrılarak kanal tedavisi uygulanmıştır. ProTaper ve Reciproc gruplarına 45'er adet dişe; tek seans, klorheksidin ve kalsiyum hidroksit medikamentli iki seans gruplarında da 30'ar adet dişe kanal tedavisi yapıldı. Kanallar şekillendirildikten sonra hastaların 12, 24 ve 48 saat sonraki postoperatif ağrıları ve kanallar doldurulduktan sonraki başlangıç, 12, 24 ve 48 saat sonraki postobturasyon ağrıları Görsel Analog Skala (VAS) kullanılarak değerlendirildi. Çalışmamızda; tedavi değişkenlerinden olan şekillendirme yöntemi ve seans sayısı/ kullanılan medikamentin postoperatif ağrı şiddeti ve insidansı üzerinde etkisi olmadığı tespit edilmiştir ve istatistiksel olark fark bulunmamıştır (p > 0.05). Hiç bir çalışma grubunda flare-up gözlenmemiştir. Diş tipi ve hastaların cinsiyetinin ağrı üzerinde etkisi olmadığı tespit edilmiştir ve istatistiksel olark fark bulunmamıştır (p > 0.05). Maksiller dişlerde 48. saatteki postoperatif ağrı seviyeleri daha yüksek bulunmuştur(p=0,031). 30-50 yaş grubundaki hastalarda 24. Saatte daha yüksek ağrı vardır ve istatiksel olarak anlamlıdır (p=0,039). Obturasyon sonrası 12. saatteki ağrı ortalaması CHX grubunda, şekillendirmenin Resiproc ile yapıldığı hastalarda ProTaper ile yapılan hastalara kıyasla daha yüksek olduğu bulunmuştur ve istatiksel olarak anlamlıdır (p=0,039). Çalışmamızın sonuçlarına göre, akut ağrılı, semptomatik, vital çok köklü dişlerde farklı şekillendirme yöntemlerinin kullanılmasının, seans sayısının ve kullanılan medikament türünün postoperatif ağrı şiddeti ve insidansı üzerinde etkili bir faktör olmadığı bulunmuştur. Semptomatik, akut ağrılı ve vital dişlerde; uygun anestezi sağlandığında, güvenilir bir yöntem ile kanal boyu tespiti yapılıp kemomekanik şekillendirme tam olarak yapıldığında, asepsi kurallarına uyulduğunda etkin bir şekilde ağrı azalmaktadır. Anahtar Kelimeler: ağrı; postoperatif ağrı; kök kanal şekillendirme yöntemleri; tek seansta kanal tedavisi; çok seansta kanal tedavisi
Evaluation Of Postoperative Pain After 1 And 2 Visit Root Canal Treatment In Mandibular And Maxillary Teeth The aim of the present study was to investigate postoperative pain and flare-ups during and after endodontic treatment of preoperatively painful, symptomatic, multi-rooted with vital teeth and factors related to treatment. These factors are the number of treatment appointments/ used medicaments type and different instrumentation systems. In this prospective randomized clinical study, ninety patients aged 14-60 years requiring RCT on symptomatic, painful, vital, multi-rooted teeth teeth with vital pulps preoperatively were included. The teeth were randomly assigned to two groups (n = 45) according to the instrumentation system used: ProTaper Universal(Tulsa Dentsply, Tulsa, OK, USA) continuous rotary system or Reciproc(VDW, Münih, Germany) reciprocating systems. Then in each group its own assigned to three sub-groups (n =30) according to the number of treatment appointments/ medicaments type used: one visit, calcium hydroxide medicated two visit and chlorhexidine medicated two visit. Root canal treatment were performed by one endodontist with a standard treatment protocol. Postoperative pain at 12, 24, 48 hours after root canal preparation and postobturation pain at beginning, 12, 48 hours after root canal filling was evaluated with Vision Analog Scale (VAS). In our study the variables of treatment; root canal instrumentation systems and the number of treatment appointments/ used medicaments had no effect on postoperative pain severity and incidence and there was no statistically significant difference ( p > 0.05). None of the 90 participants reported flare-ups during the period of the study. Tooth type and gender were determined to have no effect on postoperative pain and there was no statistically significant difference (p > 0.05). Postoperative pain at 48 hours was found to be high in the maxillary tooth than mandibular tooth (p=0,031). At 24 hours postoperative pain severity was higher in patients which 30-50 years group and it was statistically significant (p=0,039). The pain mean at 12 hours postobturation pain in the CHX group which prepared with Resiproc system was found to be higher than ProTaper system and it was statistically significant (p=0,039). The result of the present study demonstrates that, different instrumentation techniques and the number of treatment appointments/ used medicaments type seem to have no influence on the postoperative pain severity and incidence of symptomatic with acute pain, multi-rooted vital teeth. The endodontic treatment preoperatively painful, symptomatic and vital teeth; when providing appropriate anesthesia, determining working lengths by a reliable method, completely chemomechanical preparation of the root canal, provide asepsis pain effectively reduce. Keywords: pain; postoperative pain; instrumentation system, single visit root canal treatment; two visit root canal treatment.
Evaluation Of Postoperative Pain After 1 And 2 Visit Root Canal Treatment In Mandibular And Maxillary Teeth The aim of the present study was to investigate postoperative pain and flare-ups during and after endodontic treatment of preoperatively painful, symptomatic, multi-rooted with vital teeth and factors related to treatment. These factors are the number of treatment appointments/ used medicaments type and different instrumentation systems. In this prospective randomized clinical study, ninety patients aged 14-60 years requiring RCT on symptomatic, painful, vital, multi-rooted teeth teeth with vital pulps preoperatively were included. The teeth were randomly assigned to two groups (n = 45) according to the instrumentation system used: ProTaper Universal(Tulsa Dentsply, Tulsa, OK, USA) continuous rotary system or Reciproc(VDW, Münih, Germany) reciprocating systems. Then in each group its own assigned to three sub-groups (n =30) according to the number of treatment appointments/ medicaments type used: one visit, calcium hydroxide medicated two visit and chlorhexidine medicated two visit. Root canal treatment were performed by one endodontist with a standard treatment protocol. Postoperative pain at 12, 24, 48 hours after root canal preparation and postobturation pain at beginning, 12, 48 hours after root canal filling was evaluated with Vision Analog Scale (VAS). In our study the variables of treatment; root canal instrumentation systems and the number of treatment appointments/ used medicaments had no effect on postoperative pain severity and incidence and there was no statistically significant difference ( p > 0.05). None of the 90 participants reported flare-ups during the period of the study. Tooth type and gender were determined to have no effect on postoperative pain and there was no statistically significant difference (p > 0.05). Postoperative pain at 48 hours was found to be high in the maxillary tooth than mandibular tooth (p=0,031). At 24 hours postoperative pain severity was higher in patients which 30-50 years group and it was statistically significant (p=0,039). The pain mean at 12 hours postobturation pain in the CHX group which prepared with Resiproc system was found to be higher than ProTaper system and it was statistically significant (p=0,039). The result of the present study demonstrates that, different instrumentation techniques and the number of treatment appointments/ used medicaments type seem to have no influence on the postoperative pain severity and incidence of symptomatic with acute pain, multi-rooted vital teeth. The endodontic treatment preoperatively painful, symptomatic and vital teeth; when providing appropriate anesthesia, determining working lengths by a reliable method, completely chemomechanical preparation of the root canal, provide asepsis pain effectively reduce. Keywords: pain; postoperative pain; instrumentation system, single visit root canal treatment; two visit root canal treatment.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry, Ağrı, Ağrı, Ağrı-postoperatif, Pain-postoperative, Dental restorasyon, Dental restoration, Dişler, Teeth, Kök kanal dolgu materyalleri, Root canal filling materials, Kök kanal tedavisi, Root canal therapy
