Acta odontologica Scandinavica · 2012
Cross-sectional evaluation of post-operative pain and flare-ups in endodontic treatments using a type of rotary instruments.
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Tanalp Jale, Sunay Hakki, Bayirli Gündüz
Аннотация
AIM: The purpose of this clinical study was to evaluate the general incidence of post-operative pain and flare-ups in patients who were endodontically treated by two endodontics specialists using rotary instruments (Hero 642, Micro Mega, France) with the same treatment protocol.
METHODS: Records of 382 teeth belonging to 268 patients treated by two endodontics specialists during a 6-month period were kept and evaluated. Post-operative pain between treatment visits was categorized using a pre-established scoring system. Ninety-five patients were males, whereas 173 were females.
RESULTS: Pulpal necrosis without periapical pathosis was determined as the most common indication for endodontic treatment (21.7%) followed by irreversible pulpitis and re-treatment without periapical lesions (18.3%, 18.3%, respectively). The general prevalence of post-operative pain and flare-ups was determined as 8.1%, whereas cases that could be classified as real flare-ups which were severe and required an unscheduled visit (scores 2 and 3) comprised 3.4% of the cases. No statistically significant correlation was determined between gender and post-operative pain and flare-up (p = 0.05). There was a significant correlation between number of appointments and the presence of pain and flare-ups. Teeth undergoing multiple visits had a higher risk of developing post-operative pain and flare-ups compared to those with single appointments with a statistical significance (p = 0.03).
CONCLUSIONS: Teeth with pre-operative pain were more prone to developing post-operative pain and discomfort with a statistically significant difference (p = 0.02). While no significant correlation was determined between tooth vitality and pain and flare-ups (p = 0.5), a statistically significant relationship existed between the presence of a periapical pathosis and post-operative pain and flare-ups. Cases with a periapical lesion had a higher risk of developing pain and flare-ups compared to those with no periapical involvement (p = 0.0001). Future studies may focus on the influence of rotary instrumentation systems in more specific groups of cases. Meanwhile; microbiological as well as psychological aspects of flare-ups are topics that warrant further investigation.
METHODS: Records of 382 teeth belonging to 268 patients treated by two endodontics specialists during a 6-month period were kept and evaluated. Post-operative pain between treatment visits was categorized using a pre-established scoring system. Ninety-five patients were males, whereas 173 were females.
RESULTS: Pulpal necrosis without periapical pathosis was determined as the most common indication for endodontic treatment (21.7%) followed by irreversible pulpitis and re-treatment without periapical lesions (18.3%, 18.3%, respectively). The general prevalence of post-operative pain and flare-ups was determined as 8.1%, whereas cases that could be classified as real flare-ups which were severe and required an unscheduled visit (scores 2 and 3) comprised 3.4% of the cases. No statistically significant correlation was determined between gender and post-operative pain and flare-up (p = 0.05). There was a significant correlation between number of appointments and the presence of pain and flare-ups. Teeth undergoing multiple visits had a higher risk of developing post-operative pain and flare-ups compared to those with single appointments with a statistical significance (p = 0.03).
CONCLUSIONS: Teeth with pre-operative pain were more prone to developing post-operative pain and discomfort with a statistically significant difference (p = 0.02). While no significant correlation was determined between tooth vitality and pain and flare-ups (p = 0.5), a statistically significant relationship existed between the presence of a periapical pathosis and post-operative pain and flare-ups. Cases with a periapical lesion had a higher risk of developing pain and flare-ups compared to those with no periapical involvement (p = 0.0001). Future studies may focus on the influence of rotary instrumentation systems in more specific groups of cases. Meanwhile; microbiological as well as psychological aspects of flare-ups are topics that warrant further investigation.