Single Versus Multiple Visits for Endodontic Treatment of Permanent Teeth: A Cochrane Systematic Review

Dipartimento di Medicina, Chirurgia Odontoiatria, Università degli Studi di Milano, Milan, Italy.
Journal of endodontics (Impact Factor: 3.38). 10/2008; 34(9):1041-7. DOI: 10.1016/j.joen.2008.06.009
Source: PubMed


The Cochrane Collaboration promotes evidence-based healthcare decision making globally through systematic reviews of the effects of healthcare intervention. The purpose of this systematic review was to investigate whether the effectiveness and frequency of short-term and long-term complications are different when endodontic procedure is completed in one or multiple visits. Randomized and quasi-randomized controlled trials enrolling patients undergoing endodontic treatment were identified by searching biomedical databases and hand-searching relevant journals. The following outcomes were considered: tooth extraction as a result of endodontic problems and radiologic failure after 1 year, postoperative discomfort, swelling, analgesic use, or sinus track. Twelve studies were included in the review. No detectable difference was found in the effectiveness of root canal treatment in terms of radiologic success between single and multiple visits. Neither single-visit root canal treatment nor multiple-visit root canal treatment can prevent 100% of short-term and long-term complications. Patients undergoing a single visit might experience a slightly higher frequency of swelling and refer significantly more analgesic use.

Download full-text


Available from: Giovanni Lodi
  • Source
    • "This allows more dentists to consider single-visit endodontic treatment. Figini et al58 suggested that it was becoming more popular to complete the entire endodontic procedure in a single visit, in particular for endodontists and skilled general practitioners. There are a number of advantages to single-visit endodontic treatment. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy) AND (single-visit OR one-visit OR 1-visit). Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of single-visit versus multiple-visit endodontic treatment.
    Full-text · Article · May 2014 · Clinical
  • Source
    • "The prognosis of root canal treatment depends on root canal disinfection (Sjögren et al. 1997) with the additive effect of coronal and apical seal (Ray & Trope 1995). Many studies have shown the importance of intracanal medication during root canal disinfection (Trope et al. 1999, Figini et al. 2008). This study investigated the disinfection potential of five different medicaments. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: To compare the antimicrobial activities of Activ Point (Roeko, Langenau, Germany), Calcium Hydroxide Plus Point (Roeko, Langenau, Germany), calcium hydroxide, 1% chlorhexidine gel and bioactive glass (S53P4) against Enterococcus faecalis and Streptococcus mutans. Methodology: One hundred and twenty extracted single-rooted human teeth were used. After removing the crowns, root canals were prepared by using the Protaper rotary system. Following autoclave sterilization, root canals were incubated at 37 °C with E. faecalis ATCC 29212 and S. mutans RSHM 676 for 1 week. The specimens, which were divided into five treatment groups for each microorganism according to the intracanal medicament used, were tested in 10 experimental runs. In each experimental run, 10 roots were included as treatment, one root as positive control and one root as sterility control. Sterile paper points were utilized to take samples from root canals after the incubation of teeth in thioglycollate medium at 37 °C for 1 week. Samples taken from teeth by sterile paper points were inoculated onto sheep blood agar, and following an overnight incubation, the colonies grown on sheep blood agar were counted and interpreted as colony-forming units. Results were tested statistically by using Kruskal-Wallis and Conover's nonparametric multiple comparison tests. Results: CHX gel (P < 0.001 and P < 0.001), Activ Point (P = 0.003 and P = 0.002) and Ca(OH)₂ (P = 0.010 and P = 0.005) were significantly more effective against E. faecalis than that of Ca(OH)₂ Plus Point and bioactive glass, respectively. On the other hand, compared with Ca(OH)₂ , CHX gel (P < 0.001), and Activ Point (P < 0.001), bioactive glass (P = 0.014) produced significantly lower colony counts of S. mutans. When compared with the positive control, treatment with Ca(OH)₂ Plus Point (P = 0.085 and P = 0.066) did not produce significantly lower colony counts of E. faecalis and S. mutans, respectively. Conclusions: Compared with the medicaments having an antimicrobial effect because of their alkaline pH, the medicaments containing chlorhexidine were effective against both E. faecalis and S. mutans.
    Full-text · Article · Sep 2012 · International Endodontic Journal
  • Source
    • "In a randomized clinical trial, Molander et al. (2007) assessed the 2-year clinical and radiographic outcome of one-and two-visit root canal treatment and found similar healing results. In a systematic review, Figini et al. (2008) investigated whether the effectiveness and frequency of short-term and long-term complications were different when root canal treatment was completed in one or multiple visits. No detectable difference in the effectiveness of root canal treatment in terms of "
    [Show abstract] [Hide abstract]
    ABSTRACT: Mohammadi Z, Dummer PMH. Properties and applications of calcium hydroxide in endodontics and dental traumatology. International Endodontic Journal, 44, 697–730, 2011. Calcium hydroxide has been included within several materials and antimicrobial formulations that are used in a number of treatment modalities in endodontics. These include, inter-appointment intracanal medicaments, pulp-capping agents and root canal sealers. Calcium hydroxide formulations are also used during treatment of root perforations, root fractures and root resorption and have a role in dental traumatology, for example, following tooth avulsion and luxation injuries. The purpose of this paper is to review the properties and clinical applications of calcium hydroxide in endodontics and dental traumatology including its antibacterial activity, antifungal activity, effect on bacterial biofilms, the synergism between calcium hydroxide and other agents, its effects on the properties of dentine, the diffusion of hydroxyl ions through dentine and its toxicity. Pure calcium hydroxide paste has a high pH (approximately 12.5–12.8) and is classified chemically as a strong base. Its main actions are achieved through the ionic dissociation of Ca2+ and OH− ions and their effect on vital tissues, the induction of hard-tissue deposition and the antibacterial properties. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. It has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also an effective anti-endotoxin agent. However, its effect on microbial biofilms is controversial.
    Full-text · Article · May 2011 · International Endodontic Journal
Show more