探讨两种超前口服药物对不可复性牙髓炎下牙槽神经阻滞效果的影响。

收集2016年2月至2018年6月在徐州医科大学附属宿迁医院口腔科或泗阳大众医院口腔科门诊接受治疗的34例不可复性牙髓炎患者为研究对象。随机分为布洛芬组16例和强的松龙组18例，分别于一次性根管治疗前60 min口服布洛芬和强的松龙，记录下牙槽神经阻滞情况，对患者进行疼痛和焦虑评分，评判不同口服药物对神经阻滞的效果。采用χ²检验比较布洛芬组与强的松龙组间性别、6 h内饮食情况、磨牙位置以及阻滞情况的差异。采用成组t检验比较2组患者年龄和疼痛、焦虑评分的差异。

布洛芬组与强的松龙组患者性别、年龄、初始疼痛评分、6 h内饮食情况、磨牙位置、Corah牙焦虑评分比较，差异均无统计学意义（P均>0.05）。2组使用利多卡因下牙槽神经阻滞成功率相当（62.5% vs 61.1%），差异无统计学意义（χ²=0.409，P=0.523），对麻醉不成功者，阿替卡因补充麻醉成功率分别为33.3%和57.1%，差异具有统计学意义（P=0.045）。术后24 h随访疼痛评分，布洛芬组高于强的松龙组［（4.01±1.45）分vs（2.83±1.07）分］，差异具有统计学意义（t=7.078，P=0.008）。

超前口服强的松龙操作简单，患者易于接受，对下牙槽神经麻醉效果有增强作用,且术后疼痛缓解维持时间长,降低患者的疼痛敏感性，值得在临床中进一步推广应用。

To investigate the effects of two advanced oral drugs on the alveolar nerve block in patients with irreversible pulpitis.

From February 2016 to June 2018, 34 patients with irreducible pulpitis who received treatment at the Department of Stomatology of Suqian Hospital Affiliated to Xuzhou Medical University or the Department of Stomatology of Siyang Dazhong Hospital were collected as research subjects. The patients were randomly divided into either an ibuprofen group (n=16) or a prednisone group (n=18). The two groups of patients were given oral ibuprofen and prednisone 60 min before one-time root canal treatment, respectively. The conditions of alveolar nerve block were recorded. The gender, diet, molar position, and nerve block were compared between the two groups by chi-square test. The t-test was used to compare age and pain and anxiety scores between the two groups.

There were no statistically significant differences between the two groups in terms of gender, age, initial pain score, diet within 6 h, molar position, and Corah anxiety score (P>0.05).The success rate of lower alveolar nerve block using lidocaine was similar between the two groups (62.5% vs 61.1%, χ²=0.409, P=0.523). For unsuccessful anesthesia, the success rates of supplemental anesthesia with articaine were 33.3% and 57.1%, respectively, in the ibuprofen group and prednisone group, and the difference was statistically significant (P=0.045).The pain score at the postoperative 24 h follow-up was significantly higher in the ibuprofen group than in the prednisone group [(4.01±1.45) vs (2.83±1.07), t=7.078, P=0.008].

Oral prednisone before root canal treatment is simple and easy to accept, which can enhance the effect of lower alveolar nerve anesthesia, result in longer postoperative pain relief, and reduce the patient's pain sensitivity, so it is worthy of further promotion and application in clinical practice.