Clinical Observation On The Postoperative Pain Degree Of One-time And Two-time Root Canal Treatment

Objective:The patients with chronic pulpitis and periapical periodontitis were divided into one treatment group and two treatment groups for root canal therapy by using machine nickel-titanium file expanding system and B&L hot gutta-percha filling system.The degree of pain after root canal therapy was analyzed.The periapical index was used to evaluate the recovery of apical tissue in the two groups for half a year.Data support was provided to doctors on the degree of pain of patients after root canal therapy.Preoperative explanation was made to patients to avoid doctor-patient contradiction.Methods:100 patients diagnosed as chronic pulpitis,chronic periapical periodontitis and meeting the inclusion criteria were randomly divided into one-time treatment group and two-time treatment group,46 in one-time treatment group and 54 in two-time treatment group.The basic information of patients was registered and the patients were examined by dental specialty clinic.The anatomical shape of root and the degree of dental lesion PAI were preliminarily analyzed by X-ray.(Periapical Index,periapical index).Data of age,sex,dental position,disease type and treatment times were collected.Instruct patients to use VAS(Visual Analogue Scale)to evaluate pain before root canal therapy.Doctors perform root canal therapy according to the grouping.X-ray was taken again after operation to determine the filling condition of the affected teeth.The first treatment group was completed under local anesthesia,so only VAS and pain duration of patients in the second treatment group were recorded.Wong-Baker facial expression pain scale was used to evaluate the pain degree of patients in the second treatment group when B&L heat carrier cut off gum.Patients in the first treatment group and the second treatment group were reexamined in the clinic 24 hours and 3 days afterroot canal filling.Simplified McGill pain questionnaire survey and doctor evaluation were conducted.The VAS values of 12 hours,24 hours,48 hours,3 days,7 days and 30 days after operation were inquired.Six months after operation,X-ray films were taken to evaluate the PAI of the two groups.SPSS 23.0 software was used to analyze the pain value,PAI index and five factors of two groups after root canal filling.Results: 1.In the second treatment group,54 cases suffered from tooth pain,33 cases had no pain,accounting for 61.11%;19 cases had mild pain,accounting for 35.19%;2cases had moderate pain,accounting for 3.70%.The average duration of pain was 2.07 days in the clinic and 2.09 days in VAS.2.In the second treatment group,Wong-Baker=0,21 cases had no pain,accounting for 38.89%;Wong-Baker=2,14 cases had some pain,accounting for 25.93%;Wong-Baker=4,10 cases had mild pain,accounting for 18.51%;24 cases had mild pain,accounting for 44.44%;Wong-Baker=6,9 cases had obvious pain,accounting for 16.67%.3.There was no significant difference in VAS pain value between the primary group and the secondary group within 12 hours,24 hours,48 hours,3 days,7 days and 30 days after root canal filling(P > 0.05).4.There was no significant difference in PRI sensory score,PRI emotional score and total PRI score between the first and second treatment groups 24 hours and 3 days after operation(P > 0.05).5.There was no significant difference between the first treatment group and the second treatment group 24 hours and 3 days after operation(P > 0.05).6.Six months after operation,86 patients were re-visited,and the rate of missing follow-up was 14%.There was no significant difference in PAI index between the primary treatment group and the secondary treatment group(P > 0.05).7.There was no significant difference in VAS,simplified McGill PRI,doctor’s evaluation and PAI in the first and second treatment groups of chronic pulpitis(P > 0.05).8.The VAS score of the first treatment group of chronic periapical periodontitis was higher than that of the second treatment group at 12 hours and 24 hours after operation(P <0.05).There was no significant difference in simplified McGill PRI,doctor’s evaluation and PAI of the first treatment group at half a year after operation(P > 0.05).9.At 12 and48 hours after operation,gender had significant effect on pain(P < 0.05),and the paindegree of women was higher than that of men.At 12 and 24 hours after operation,age had a significant effect on pain(P < 0.05),and older patients had a higher degree of pain.Age and sex had no significant effect on postoperative pain at other time points(P >0.05).There was no significant difference in the influence factors of dental position,type of disease and number of treatments on postoperative pain(P > 0.05).Conclusion:There was no significant difference in the degree of post-operative pain between one-time and two-time methods.The degree of post-operative pain in females was higher than that in males,and that in older patients was higher.In one treatment group,root canal therapy was completed under local anesthesia,which avoided the pain between clinics and hot gum filling.Therefore,it is suggested that the patients with chronic pulpitis and chronic periapical periodontitis whose PAI index is below grade 3should complete root canal therapy at one time,and the patients with chronic periapical periodontitis should be followed up for a long time.