BACKGROUND: Teeth are often cut by high-speed turbine engine which drill and friction also will irritate the dental nucleus and periapex directly and cause pain. Eutectic mixture of local anesthetics (EMLA) was reported in dental caries treatment for pain released.OBJECTIVE: To observe the analgesia effect and influence on electra vital force of EMLA when used for dental caries preparation. DESIGN: Self matched-pairs control randomly observation.SETTING: Department of Dentistry, the Stomatological College, the Fourth Military Medical University of Chinese PLA. PARTICIPANTS: Fifty patients including 28 males and 22 females were selected from the Department of Dentistry, the Stomatological College, the Fourth Military Medical University of Chinese PLA from January 2000 to January 2001. Their ages ranged from 18 to 55 years, and the mean age was 36 years. Inclusion criteria: ① Patients whose suffered from teeth only had a superficial hole and needed to be filled. The patients should have 2 teeth that need therapy at the same time and the 2 teeth should in different quadrant regions of the mouth; ② Patients without allergy history of local anesthetics; ③ Patients had signed in the informed consent; patients without cardiovascular diseases or dental ulcer. The experiment was in accordance with the ethics standards, and all patients provided the informed consent.METHODS: ① Grouping and intervention: Assigned to groups with self matched-pairs control method randomly by the side of coin to decide the experiment and teeth; the teeth for experiment were smeared with 2 g of EMLA (Astra AB, Sweden) on the surface of tooth and the bilateral periodontal mucous membrane with cotton bud, after 5 minutes smearing to treat the teeth. The control teeth were not smeared the EMLA to treat. ② Visual analogue scales (VAS) scores and electra vital force: The electra vital force (SYBLONENDO USA) of teeth was measured after 5 minutes, and the VAS score was recorded to evaluate the pain of teeth when incised and ground and compare it with that of control group.MAIN OUTCOME MEASURES: VAS scores and electra vital force.RESULTS: Fifty patients were included in the final analysis. ① VAS scores: The average VAS scores of teeth during treatment after smeared with ELMA were 2.54±0.84. While that of teeth not smeared with EMLA was 7.42±0.51 (P < 0.01). ② Electra vital force: The average value of electra vital force before smeared with EMLA was 45.76±1.56 while that after smeared with EMLA was 64.34±2.28 (P < 0.01).CONCLUSION:EMLA can improve the electra vital force of teeth and has analgesia effect during the dental caries treatment.%背景:牙体病治疗时高速涡轮机常直接刺激牙髓和根尖周组织引起疼痛,已有应用油/水乳化胶涂抹对其镇痛的报道.目的:观察应用油/水乳化胶用于牙体病牙齿制备治疗过程中的镇痛以及对牙齿电活力的影响.设计:自身配对随机对照观察.对象:选择2000-01/2001-01在第四军医大学口腔医学院牙体病科就诊的50例牙病患者,男28例,女22例,年龄18～55岁,平均36岁.纳入标准:①患牙均为浅洞需进行补牙治疗者,同时有两颗牙齿需要治疗,并且两颗患牙位置需要相隔4个牙位以上者或上下患牙.②无局麻药过敏史者.③无心血管疾病及口腔溃疡者.实验经过医院伦理委员会批准许可,患者对实验及治疗项目知情同意.方法:①分组及干预: 采用自身牙齿配对随机对照实验, 即随机抛硬币法将每位患者两颗牙齿分为实验牙和对照牙,实验牙齿冲洗干净,吹干,用棉签将2 g 油/水乳化胶(瑞典,Astra AB)涂于牙齿表面及两侧牙周黏膜,牙齿两侧用棉球阻塞防止唾液浸入.涂抹油/水乳化胶后5 min开始给予补牙治疗,对照牙不进行油/水乳化胶涂抹,直接治疗.②疼痛视觉模拟评分值和电活力测定:采用疼痛视觉模拟评分法评价实验牙及对照牙磨切时疼痛情况,在油/水乳化胶处理牙齿前及处理5 min后分别应用美国产SYBLONENDO电活力仪检测实验牙电活力.主要观察指标:疼痛视觉模拟评分评分及电活力检测结果.结果:患者50例均进入结果分析.①疼痛视觉模拟评分评分结果:对照牙治疗时平均疼痛视觉模拟评分分值明高于实验牙,差异有统计学意义[(7.42±0.51)分,(2.54 ±0.84)分,P < 0.01].②牙电活力:油/水乳化胶处理前实验牙电活力平均值低于处理后,差异有统计学意义[(45.76±1.56)分,(64.34±2.28)分,P < 0.01].结论:油/水乳化胶涂抹可提高牙齿电活力,对牙体病牙齿制备时有镇痛作用.
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