(PR111) Evaluation of Incision and Drainage Without Dissection Versus Mock Incision and Drainage

Objective: The purpose of this prospective, randomized single-blind study was to compare incision and drainage (I&D) without dissection) and mock drain placement to simulate incision and drainage and drain placement following endodontic debridement in emergency patients with swellings. The effect of COVID-19 on access to dental care in the population was also assessed.

Methods: Patients completed a COVID-19 impact survey and subsequently underwent root canal debridement followed by I&D or mock I&D. A mock drain was sutured into the attached gingiva anterior to the swelling of all patients. Patients recorded their pain, swelling, and medication usage on the evening of the appointment and three days postoperatively. A second appointment allowed for postoperative journal collection, drain removal, and assessment of healing. Success was defined as having less than mild pain and no use of escape medication. Regression analysis was used to evaluate success and pain.

Results: The mock I&D group reported significantly less pain than the I&D group on postoperative days 1-3. The mock I&D group had greater success than the I&D group on all days postoperatively, and this difference was significant on day 2. Pain decreased significantly and success increased significantly over the days following treatment for both groups. Regarding COVID-19 and its impact, 29% of patients reported delaying treatment due to concerns about COVID-19.

Conclusion: Patients with swellings who had an incision and drainage procedure (without dissection) in addition to endodontic debridement experienced more pain and less success than patients who had only endodontic debridement.