Evaluation of postoperative pain after endodontic treatment with foraminal enlargement and obturation using two auxiliary chemical protocols
Avaliação da dor pós-operatória de tratamentos endodônticos realizados com ampliação e obturação foraminal utilizando dois protocolos de substâncias químicas auxiliares
Bourreau, Marcelle Louise Sposito; Soares, Adriana de Jesus; Souza Filho, F.J.
Abstract
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.
Keywords
Resumo
Objetivo: Este estudo clínico prospectivo randomizado analisou a influência de duas substâncias químicas auxiliares, com diferentes potenciais de toxicidade, na dor pós-operatória observada em 301 tratamentos endodônticos concluídos em uma única sessão, com ampliação do forame apical e sobre-extensão de cimento para o periápice. Material e método: Foram usados gel de clorexidina a 2% (CHX 2% gel; n = 145) e hipoclorito de sódio a 5,25% (NaOCl 5,25%; n = 156). A incidência de dor pós-operatória e desconforto foi avaliada em 24 horas, e foi expressa em porcentagem. O teste exato de Fischer e o teste de Qui Quadrado foram utilizados para comparar a variação da dor pós-operatória. Os fatores analisados foram dor prévia, estado pulpar, idade e número de canais radiculares. Resultado: Nos dentes com dor prévia e instrumentados com CHX 2% gel, a incidência de dor pós-operatória foi 22.22% (6/27), contra 11.11% (3/22) nos dentes instrumentados com NaOCl 5,25%. Nos dentes sem dor prévia e instrumentados com CHX 2% gel, a incidência de dor pós-operatória foi 5.08% (6/118), contra 2.33% (3/129) nos dentes instrumentados com NaOCl 5,25%, sem diferenças estatisticamente significativas entre os grupos. Os resultados mostraram que a dor prévia exerceu uma influência significativa no estado pós-operatório (p < 0,001). Após 24 horas, 93,7% (282/301) dos dentes não apresentaram dor, ao passo que 6,3% (19/301) tiveram algum nível de dor pós-operatória e fizeram uso de uma ou duas doses da medicação. Conclusão: Diante dos resultados, podemos concluir que a substância química auxiliar não está associada à dor pós-operatória.
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References
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