Evaluation of postoperative pain after endodontic treatment with foraminal enlargement and obturation using two auxiliary chemical protocols

Aim This prospective randomized clinical study examined the influence of two different auxiliary chemical substances on postoperative pain in 301 single-visit endodontic treatments, with enlargement of the apical foramen and extrusion of cement into the periapical region. Material and method The two auxiliary chemicals used were 2% chlorhexidine (2% CHX gel; n = 145) and 5.25% sodium hypochlorite (5.25% NaOCl; n = 156). The incidence of postoperative pain and discomfort was assessed at 24 hours and expressed as percentages. The Fisher exact test and the Chi-square test were used to compare variation in postoperative pain. The variables analyzed were previous pain, pulp status, age, and number of root canals. Result In teeth with previous pain instrumented with 2% CHX gel, the incidence of postoperative pain was 22.22% (6/27) versus 11.11% (3/22) in teeth instrumented with 5.25% NaOCl. In teeth without previous pain instrumented with 2% CHX gel, the incidence of postoperative pain was 8.5% (6/118) versus 2.33% (3/129) in teeth instrumented with 5.25% NaOCl, with no statistically significant difference between the groups. Results showed that previous pain had a significant influence on postoperative status (p < 0.001). After 24 hours postoperatively, 93.7% (282/301) of the teeth had no pain and 6.3% (19/301) had some level of pain, and used one or two doses of medication. Conclusion Based on the results, it can be concluded that the auxiliary chemical substances had no influence on postoperative pain.

目的 本前瞻性随机临床研究探讨了两种不同辅助化学制剂对301例单次就诊牙髓治疗术后疼痛的影响，该类治疗涉及根尖孔扩大及根管充填材料挤压至根尖周区域的操作。
材料与方法 本次研究所采用的两种辅助化学制剂分别为2%氯己定（2% chlorhexidine，2% CHX凝胶；n=145）与5.25%次氯酸钠（5.25% sodium hypochlorite，5.25% NaOCl；n=156）。分别于术后24小时评估术后疼痛与不适的发生率，并以百分比形式呈现结果。采用费希尔精确检验（Fisher exact test）与卡方检验（Chi-square test）比较两组术后疼痛的发生差异。本次分析的变量包括既往疼痛史、牙髓状态、患者年龄及根管数目。
结果 对于存在既往疼痛史的患牙，使用2% CHX凝胶组的术后疼痛发生率为22.22%（6/27），而使用5.25% NaOCl组为11.11%（3/22）；对于无既往疼痛史的患牙，2% CHX凝胶组的术后疼痛发生率为8.5%（6/118），5.25% NaOCl组为2.33%（3/129），两组间差异无统计学意义。结果显示，既往疼痛史对术后疼痛状态具有显著影响（p<0.001）。术后24小时，93.7%（282/301）的患牙无疼痛症状，6.3%（19/301）存在不同程度疼痛并使用了1~2剂镇痛药物。
结论 基于上述研究结果，可得出结论：本次研究使用的辅助化学制剂对术后疼痛无显著影响。