根管治療後の術後疼痛に対する咬合調整の効果。A Randomized Clinical Trial

Effect of Occlusal Adjustment on Postoperative Pain after Root Canal Treatment: A Randomized Clinical Trial.

• Elizângela Cristina Barbosa Vianna
• Fernando José Herkrath
• Izabelly Esteves Bittencourt Martins
• Luana Pontes Barros Lopes
• André Augusto Franco Marques
• Emílio Carlos Sponchiado Júnior

抄録

この前向き無作為化臨床試験の目的は、歯内療法治療後の術後疼痛の有病率に対する咬合調整の影響を分析することであった。歯内療法を適応とする症候性不可逆性歯髄炎と診断された78名の患者を研究に参加させた．参加者は無作為に割り付けられ，2群に分けられた：咬合調整群（OAG）では，歯内療法を行った後に咬合調整を行った．対照群（CG）では、咬合調整を行わずに歯内療法を行った。治療は同一の術者が行った．痛みの発生と強度は、口頭評価尺度（VRS）と数値評価尺度（NRS）の2つの尺度で記録した。痛みの評価は、歯内療法後6時間後、24時間後、72時間後に、実験を盲検化した2人目の検者によって行われた。データはMann-Whitney検定、カイ二乗検定、Fisher's exact検定を用いて分析した。咬合調整群では71.1％が術後疼痛を報告し、対照群では67.5％が疼痛を報告した。6時間後の評価では、咬合調整群で21人、対照群で24人が痛みを訴えた（p=0.672）。24時間評価では18人と19人が痛みを報告し（p=0.991）、72時間評価では8人と4人が痛みを報告した（p=0.219）。咬合調整は、症状性の不可逆性歯髄炎を有する歯内療法的治療を受けた歯の術後疼痛の有病率に影響を与えなかった。

The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.