Avaliação da dor pós-operatória do tratamento endodôntico em pacientes com diabetes mellitus tipo 2 – um ensaio clínico controlado

Abstract

This controlled, parallel and blind clinical trial aimed to evaluate the occurrence of postoperative pain in patients with type 2 Diabetes mellitus (DM) after endodontic treatment. At baseline, glycated hemoglobin (HbA1c) was investigated and patients in the experimental group had a medical history of diabetes mellitus and HbA1c ≥ 6.5. The research was developed in three stages: consutation for baseline collection, endodontic treatment in a single session and collection of the outcome. The sample consisted of 80 adults, 40 with DM in the experimental group and 40 without DM in the control group. In the instrumentation protocol, the WaveOne® Gold system was used by two operators, then root canal filling with gutta percha and resin cement AHPlus® was performed, followed by the temporary restoration of the dental element. Postoperative pain assessment was carried out by a team member, blind to the groups, at intervals of 6,12,24 and 72 hours after endodontic treatment, using the discrete numeric scale (NRS 0-10). In the first hours in the DM group, 19 patients (47.5%) experienced pain, while in the control group 24 patients (60%) reported pain (p=0.429). In 12 hours, 11 (27.5%) of the experimental group and 19 (47.5%) of the group without DM experienced pain (p=0.165). After 24 hours, this amount was 9 (22.5%) individuals with DM, 11 (27.5%) in the control group (p=0.930). After 72 hours, 5 patients (12.5%) from each group reported pain (p=0.186). No significant differences were found regarding pain intensity between groups at 6 hours (p=0.139), 12 hours (0.169), 24 hours (0.387) and 72 hours (0.687). However, in the regression analyses, the chance of postoperative pain was lower in patients with DM (OR=0.19; 95%CI=0.04-0.77) regardless of sex, age, preoperative pain, group dental status, type of treatment and presence of extravasation. It is concluded that individuals with type 2 Diabetes mellitus may experience less postoperative pain during endodontic treatment when compared to patients without diabetes.