Effects of sodium hypochlorite solution concentration and irrigation temperature on pain level in patients undergoing root canal treatment for mandibular molars with irreversible pulpitis
Objective To analyze the influence of sodium hypochlorite solution concentration and irrigation temperature on pain level in patients undergoing root canal treatment for mandibular molars with irreversible pulpitis. Methods A retrospective analysis was conducted on 98 patients who received root canal treatment for mandibular molars in Linping Hospital,Second Affiliated Hospital of Zhejiang University. A total of 32 patients who received root canal treatment with 30℃ 1.0％ sodium hypochlorite solution irrigation from December 2020 to November 2021 were included in group A,and 32 patients who adopted root canal treatment with 30℃ 2.5％ sodium hypochlorite solution irrigation between December 2021 and November 2022 were enrolled in group B,and 34 patients who used root canal treatment and were irrigated with 55℃ 2.5％ sodium hypochlorite solution from November 2022 to December 2023 were included in group C. The periodontal status,inflammatory factors[tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),high-sensitivity C-reactive protein (hs-CRP)],pain perception[Visual Analog Scale (VAS)]and adverse reactions were compared among the three groups. Results After treatment,the gingival index,periodontal appearance index,and bleeding index of patients in group B were (1.41±0.37) points,(1.19±0.35) points,and (1.40±0.37) points,respectively,which were better than those in group A (all P<0.01). After treatment,the gingival index,periodontal appearance index,and bleeding index of patients in group C were (0.95±0.20) points,(0.88±0.21) points,and (1.16±0.25) points,respectively,which were better than those in group B (all P<0.01). After treatment,the levels of TNF-α,IL-6,and hs CRP in group B were (4.78±1.15) ng/L,(3.29±0.71) ng/L,and (10.26±1.32) mg/L,respectively,all lower than those in group A (all P<0.01),while the levels of TNF-α,IL-6,and hs-CRP in group C were (4.09±0.96) ng/L,(3.16±0.53) ng/L,and (10.09±1.27) mg/L,respectively,all lower than those in group B,all P<0.01). After treatment,the VAS score of group B patients was (2.13±0.42) points,which was lower than that of group A (2.89±0.46) points (t=6.902,P<0.001);while the VAS score of group C was (1.85±0.31) points,which was lower than that of group B (t=3.094,P=0.003). There was no significant difference in the total incidence of adverse reactions such as sneezing between Group A,Group B and Group C (Hc=0.790,P>0.05). Concentration (1.0％) and temperature (30℃) were independent risk factors for the degree of pain in patients with irreversible pulpitis undergoing mandibular root canal treatment (P<0.05). Conclusion 55℃ 2.5％ sodium hypochlorite solution can effectively improve the periodontal status,reduce the levels of inflammatory factors,and relieve the pain in patients undergoing root canal treatment for mandibular molars with irreversible pulpitis,and has good safety.
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