The choice of single- versus multiple-visit root canal treatment for infected teeth is in dispute. The purpose of this systematic review was to compare the healing rate and post-obturation pain of single- versus multiple-visit root canal treatment for teeth with infected root canals.
An exhaustive literature search combined with specified inclusion criteria was performed to identify randomized or quasi-randomized controlled trials (RCTs or quasi-RCTs), comparing root canal treatment in single and multiple appointments (2 or more visits) in patients with infected root canals.
Ten RCTs were identified and included in this review. Of these, 6 compared the healing rate and 5 compared the prevalence of post-obturation pain in single- and multiple-visit root canal treatment on teeth with infected root canals. No significant difference was observed in the healing rate between single- versus multiple-visit root canal treatment, as well as the incidence of medium-term post-obturation pain. As to the short-term follow up, the prevalence of post-obturation pain was significantly lower in single-visit than in multiple-visit group.
On the basis of current studies, the healing rate of single- and multiple-visit root canal treatment is similar for infected teeth. Patients experience less frequency of short-term post-obturation pain after single-visit than those having multiple-visit root canal treatment.
"Although no significant difference was found in periapical healing between one- or two-visit endodontic treatment of necrotic teeth , some factors such as the patient's health, anxiety, fatigue, and symptoms, in addition to complexity of treatment, should be considered. Su et al. described that the healing rate of single- and multiple-visit root canal treatment is similar for infected teeth . Multiple-visit and single-visit root canal treatment demonstrated almost equal success but most important aspect for success in treatment is indication of each case and then its subsequent treatment, be it multiple or single visit root canal treatment . "
[Show abstract][Hide abstract] ABSTRACT: Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals.
"Pain is a subjective phenomenon and its measurement can be difficult and is affected by individual experiences (4). Several factors influence pain during and after root canal therapy such as gender, age, tooth position, intracanal irrigants, intracanal dressings, root canal fillings, number of appointments, and apical periodontitis (5, 6). "
[Show abstract][Hide abstract] ABSTRACT: Pain experience makes a serious anxiety for both patient and clinician before and after root canal treatment. Pain is a complex psychophysiologic phenomenon.
The aim of this randomized control trial study was to evaluate the analgesic effect of Odontopaste® and a corticosteroid containing compound medicament between root canal therapy appointments.
One hundred and twenty lower first and second mandibular molars with spontaneous pain and sensitivity to percussion were selected and divided into three groups (40 patients per each group). After root canal preparation, patients were entered one of these groups randomly. Root canals in group 1 were dressed with Odontopaste, in group 2 with a compound intracanal medicament, and in group 3 with placebo. Patients determined their pain rate and percussion sensitivity on Heft-parker VAS diagram, before the first appointment and 24 hours and 7 days after that.
Spontaneous pain and Percussion sensitivity score averages of 24 hours after the first appointment in group 1 and group 2 were less than group 3, which indicates statistically significant difference between these groups. There was no statistically significant difference between these groups after 7 days neither on spontaneous pain nor percussion sensitivity.
Odontopaste® and compound intracanal medicaments resulted in statistically significant reduction in postoperative pain and percussion sensitivity after 24 hours, but there was no statistically significant difference after 7 days with placebo.
Jundishapur Journal of Natural Pharmaceutical Products 11/2013; 8(4):169-74.
"When scores obtained by radiographic evaluation were submitted to Mann — Whitney U test, there was no statistically significant difference between teeth in groups I and II at either the baseline, 3, 6, or 12 months evaluation. This finding is in consistent with the results of majority of well controlled clinical studies done. "
[Show abstract][Hide abstract] ABSTRACT: To compare and evaluate the clinical symptoms and radiographic evidence of periapical healing after endodontic treatment of teeth with periapical pathology when completed in one-visit or two-visits with ApexCal paste at 3, 6, and 12 months.
A total of 57 patients requiring root canal treatment on 64 single rooted teeth with periapical pathology preoperatively were included. The teeth were assigned randomly into two groups and treated according to standardized protocol. The teeth in group I (n = 34) were obturated at the first visit, while those in group II (n = 30) were medicated with ApexCal paste, and obturated in a second visit 7 days later. Patients were recalled at intervals of 3, 6, and 12 months to evaluate the treated teeth both clinically and radiographically for periapical healing.
Mann - Whitney U test showed no difference between groups I and II. Wilcoxon signed rank test showed significant decrease in mean periapical index (PAI) scores within both groups during 12 months evaluation. The level of significance used was P < 0.05.
Both groups exhibited equally favorable healing at 12 months, with no statistically significant differences between groups I and II.
Journal of Conservative Dentistry 03/2013; 16(6):484-488. DOI:10.4103/0972-0707.120933
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