Treatment outcomes of single-visit versus multiple-visit non-surgical endodontic therapy: a randomised clinical trial

Abstract

BackgroundClincians have been providing single-visit and multiple-visit endodontic treatments for their patients. This study aims to compare the success rate, prevalence of postoperative pain and chairside time of single-visit and multiple-visit endodontic treatments.MethodPatients who required primary endodontic treatment in a university dental clinic were randomly allocated to two general dentists for single-visit or multiple-visit treatments using the same materials and procedures. Ni-Ti rotary files were used to prepare the root canals, which were subsequently obturated with a core-carrier technique. The chairside time was recorded. The treated teeth were followed up every 6 months on clinically signs and symptoms including pain, tenderness to percussion, sinus tract, mobility and abscess. Periapical radiographs were taken to assess periapical pathology. Successful treatments were neither clinical signs/symptoms noted nor radiographic periapical pathology found postoperatively.ResultsA total of 220 teeth from patients aged 46.4 ± 14.1 were followed up for at least 18 months. The mean (±SD) follow-up period was 29.4 ± 9.3 months. The success rates of single-visit and multiple-visit treatments were 88.9 and 87.4 %, respectively (p = 0.729, effect size odds ratio = 1.156). Maxillary teeth had odds ratios of 3.16 (95 % CI: 1.33 to 7.46; p = 0.009) and absence of preoperative apical periodontitis had odds ratios of 4.35 (95 % CI: 1.43 to 13.24; p = 0.010) were identified from logistic regression as having a higher success rate. The average chairside times of single-visit and multiple-visit treatments were 62.0 and 92.9 min, respectively (mean difference = −30.9, 95 % CI: −39.4 to −22.4, p < 0.001, effect size odds ratio = −0.996). Single-visit and multiple-visit treatment had no significant difference in the prevalence of postoperative pain within 7 days (21 and 12 %, p = 0.055, effect size odds ratio = 2.061) and after at least 18 months (0.9 and 1.0 %, p > 0.999, effect size odds ratio = 0.879).ConclusionsThe success rate and prevalence of postoperative pain of single-visit or multiple-visit treatment had no significant difference. The chairside time for single-visit treatment was shorter than multiple-visit treatment.Trial registrationClinical Trials (WHO) ChiCTR-IOR-15006117 registered on 20 March 2015.

Clinical Evaluation of Single versus Multiple Visits Endodontic Retreatment Outcome: A Randomized Controlled Trial

“…Thus the post-obturatuion pain was fairly recorded in few cases after one day but that it mostly subsided after one week. This was corroborated with several studies, where they reported that the cases recorded post-operative pain was recorded after 24 hours, the majority of patients in both groups reported no pain or only minimal pain, and pain disappeared after one week of treatment (12)(13)(14) .…”

“…Patients experiences less frequency of post-obturation pain after single-visit than those having multiple-visits root canal retreatment. These results corroborated the results of many studies (12)(13)(14)29) .But disagreed with a study reported that the two visits root canal retreatment was more effective in completely eliminating post-operative pain than the single visit technique, however they used variable treatment procedures, and most of cases were treated in two or more appointments (18) .…”

“…Some authors studied the post-obturation pain after single and multiple endodontic treatment, they concluded that there was no difference in the postoperative pain between patients treated in one-visit and patients treated in two appointments. The majority of patients in both groups reported no pain or only minimal pain within 24 to 48hours of treatment (12)(13)(14) .While some researchers presented a higher incidence of post-obturation pain following single visit root canal treatment, they reported higher incidences for post-obturation pain and flare-ups following the single visit procedure (15) .Other studies presented higher incidence of post-obturation pain following two visits root canal treatment (16)(17) .…”

An In Vivo Comparative Evaluation of Postoperative Complications in Single- versus Multiple-Visit Endodontic Therapy: 18-Month Follow-Up

“…observed in all the patients, so this radiographic evaluation cannot be associated with the failure of root canal therapy. 14 According to Prashant et al, however, it is necessary to acknowledge the fact that a period of 6 weeks is too short a period for radiographic evaluation to draw any confirm conclusion regarding the outcome of treatment. The resolution of periapical rarefactions in this study supports the results of the present study.…”

“…Wong et al questioned the persistent apical radiolucency over 20 years as absolute failure. 14 In the current study, postoperative complications like pain, tenderness to percussion, and swelling at 6-week follow-up, and radiographic changes after 18 months follow-up were assessed.…”