Résumé
Background: Endodontic emergency during root canal treatment (flare up) is a common occurrence in multi-visit root canal treatment (RCT) and it may be associated with many factors. The occurrence however can affect the prognosis of the tooth and the patient –clinician relationship.
Aim: To determine the incidence and risk factors associated with occurrence of flare up in a multi visit RCT.
Methodology: Patients planned for multi-visit (RCT) were recruited for the research. Standard protocol was followed in all cases. After the first visit, the patients were followed up for possible development of flare up. Patients’ demographics, presence or absence of preoperative pain, status of the pulp and occurrence of flare up were among the data collected. Data was analyzed using SPSS version 20 with level of significance set at P <0.05.
Result: A total of 106 root treated teeth were analyzed in patients aged 17 to 73years with a mean of 33±13.2 and male to female ratio of 1:1.5. Incidence of flare up was 8.5%. Prior to treatment, 47% of the cases had pain, 61.3% had apical radioluscency and 83% had pulpal necrosis. Majority (7, 77.8%) of the flare up occurred after the first visit (p=0.000). Only pre-treatment pain had a statistical significant relationship with occurrence of flare up (p=0.009).
Conclusion: Incidence of flare up was 8.5% and the major risk factor was preoperative pain. First visit in a multi visit RCT is an important stage which if well handled, can reduce the incidence of flare up.
Keywords: flare up, risk factors, preoperative pain, incidence.
Résumé
Contexte: L’urgence endodontique pendant le traitement du canal radiculaire (embrasement) est un phénomène courant rare dans multi visiteTCR et peut être associé à de nombreux facteurs. Cependant l’occurrence peut affecter le pronostic de la dent et la relation patient-clinicien.
Objectif: Pour déterminer l’incidence et les facteurs derisquesassociés à l’apparition de l’embrasement dans une multi visite TCR.
Méthodologie: Les patients prévus pour le traitement multi visite du canal radiculaire (TCR) ont été recrutés pour la recherche. Après la première visite TCR faite sous un protocole guidée pour TCR, les patients ont été suivis pour le développement possible d’embrasement. La démographiedes patients, la présence ou l’absence de douleur préopératoire, l’état de la pulpe et l’occurrence d’embrasementétaient parmi d’autres données recueillies. Les données ont été analysées à l’aide du logiciel SPSS version 20. Avec un niveau de signifiance fixé à p <0.05.
Résultat: Un total de 106 dents traitées ont été analysées chez les patients âgés de 17 à 73 ans avec une moyenne de 33 ± 13,2 ans et ratio hommes-femmes de 1: 1,5. L’incidence de l’embrasement était à 8,5%. Traitement préalable, 47% des cas eu des douleurs, 61,3% avaient la radioluscencie apical et 83% avaient une nécrose pulpaire. La majorité (77.8%) des embrasements a eu lieu après la première visite (p = 0,000). Seule la douleur prétraitement avait une relation statistiquement significative avec l’embrasement(p = 0,009).
Conclusion: Le facteur de risque majeur trouvé en association avec embrasement était la douleur préopératoire. La première visite dans un traitement multi visite du canal radiculaire est une étape importante qui, si bien géré, peut réduire l’incidence d’embrasement.
Mots-clés: embrasement, facteurs de risque, douleur préopératoire, incidence
Correspondence: Dr. Shakeerah O. Gbadebo, Deparment of Restorative Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail:olaaris2k1@yahoo.com
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