A prospective randomized trial comparing periapical instrumentation to intracanal instrumentation in cases of asymptomatic pulpal-periapical lesions
| Autor: | Bennett H. Sideman, Donald R. Morse, Ira B. Spritzer, Robert D. Lefkowitz, M. Lawrence Furst, Robert M. Belott |
|---|---|
| Rok vydání: | 1987 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Dentistry Asymptomatic Pathology and Forensic Medicine law.invention Random Allocation Randomized controlled trial law Dental Pulp Necrosis Medicine Severe pain Edema Humans Instrumentation (computer programming) Prospective Studies Prospective cohort study Child General Dentistry Aged Clinical Trials as Topic Pain Postoperative Mild pain business.industry Incidence (epidemiology) Periapical Diseases Significant difference Surgery Root Canal Therapy Female medicine.symptom business |
| Zdroj: | Oral surgery, oral medicine, and oral pathology. 64(6) |
| ISSN: | 0030-4220 |
| Popis: | To clarify the divergent viewpoints with respect to method of instrumentation in asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL), this prospective study was undertaken. The subjects were 106 patients with quiescent cases of PN/PL. Alternately, 53 had periapical instrumentation and 53 had intracanal instrumentation. Prophylactic antibiotics were not administered but the patients were told to take an antibiotic at the first sign of swelling. Flare-ups, non-flare-up-associated swelling and pain, and cases in which there were no postoperative problems were evaluated at 1-day, at 1 week, and at 2 months. A 6.6% incidence of flare-up was found with no statistically significant difference between periapical instrumentation (7.5%) and intracanal instrumentation (5.7%). A 27.4% incidence of swelling was found with no statistically significant difference between periapical instrumentation (24.5%) and intracanal instrumentation (30.2%). A 43.4% incidence of pain was found, with no statistically significant difference between periapical instrumentation (39.6%) and intracanal instrumentation (47.2%). When moderate pain and severe pain were combined, the incidence was 21.7%, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (28.3%). An incidence of patients having no postoperative problems of 41.5% was found, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (35.8%). When flare-ups were combined with swelling, the incidence was 34.0%, with no statistically significant difference between periapical instrumentation (32.1%) and intracanal instrumentation (35.8%). When flare-ups were combined with pain, the incidence was 50.0%, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (52.8%). When flare-ups were combined with both swelling and pain, the incidence was 77.4%, with no statistically significant difference between periapical instrumentation (71.7%) and intracanal instrumentation (83.0%). When non-flare-up-associated mild pain was combined with the category of no postoperative problems, the incidence was 63.2%, with no statistically significant difference between periapical instrumentation (71.7%) and intracanal instrumentation (54.7%). A sign test analysis of the nine previous categories showed that periapical instrumentation was significantly better than intracanal instrumentation (8/9; p < 0.001). A review of similar cases showed that patients with whom periapical instrumentation was used had significantly better periapical healing than patients in whom the apex could not be negotiated. Hence, for patients with PN/PL without symptoms, it appears that periapical instrumentation is preferable to intracanal instrumentation. |
| Databáze: | OpenAIRE |
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