Combined prednisone and partial root canal therapy for acute irreversible pulpitis in third molars:a randomized controlled trial / 中华急诊医学杂志

ABSTRACT

Objective To study the effect of oral prednisone combined with partial root canal therapy on acute irreversible pulpitis pain in third molars. Methods A total of 131 patients with acute irreversible pulpitis of the third molar treated in the emergency department from September 2016 to December 2017 in Shaoxing People's Hospital were selected and been divided into experimental group and control group according to the principle of prospective, random, and contrast. 66 patients in the experimental group received combination prednisone and partial root canal therapy, and 65 patients in the control group received partial root canal therapy. The VAS scores at each time point during treatment, the doses of analgesics and anesthetics used during treatment, the number of return visits within 72 hours after treatment, and treatment comfort were analyzed and compared. And the SPSS 19.0 statistical software was used to compare two sets of biological quantitative data using t-test or rank sum test. Count data were compared using Chi-square test and exact Fisher test. Results After 24 hours of intervention, the VAS scores of both groups decreased, and the VAS scores of the experimental group decreased more signifi cantly. The VAS scores of the experimental group were lower than those of the control group, and the proportion of patients with a VAS score of <5 was higher than that of the control group. In the group,the difference was statistically signifi cant (P<0.05). In addition, the dose of acetaminophen, codeine and other analgesic drugs was lower in the experimental group than in the control group, with a signifi cant difference (P<0.05); The dose of anesthetic 2% lidocaine solution was slightly less in the experimental group than in the control group. There was no signifi cant difference between the two groups (P>0.05);The proportion of return visit patients in the experimental group was lower than that in the control group, and the difference was statistically signifi cant (P<0.05). In the end, the scores and total scores of each dimension of the GCQ scale in the experimental group were higher than those in the control group, and the difference was statistically signifi cant (P<0.05). Conclusion Corticosteroid prednisone can effectively relieve the pain symptoms of irreversible pulpitis in a short period of time and improve the patient's treatment comfort. It can be used as a simple and quick alternative to partial root canal treatment to help clinical planning of endodontic treatment under the best analgesic conditions.