Single-visit Endodontic Therapy Research Articles

Evaluation of postoperative pain using warm versus room temperature sodium hypochlorite as an irrigant in mandibular molars with irreversible pulpitis: A randomized controlled trial.

The study evaluates and compare the effect of 3% warm NaOCl with NaOCl at room temperature in root canal irrigation on postoperative pain. In this randomized controlled trial, mandibular molars with symptomatic irreversible pulpitis in healthy 18-year-old patients and above were included. The sample consisted of 56 patients evaluating the postoperative pain, allocated randomly into 2 groups of 3% NaOCl at two different temperatures, i.e. at room temperature and at 60°C. Endodontic treatment was initiated for each group and instrumentation was done using MTwo rotary files. The final irrigation was performed according to the groups assigned. For each included tooth, preoperative and postoperative pain scores at 6, 12, 24, 48, and 72 h were collected through the Heft Parker Visual Analog Scale. Statistical analysis was performed using independent t-test, Chi-square test, Mann-Whitney U-test, and Friedman test followed by Wilcoxon test. The mean percentage reduction in pain scores was significantly higher among the warm NaOCl group as compared to the control group at different time intervals (P < 0.001). The mean number of analgesics taken was significantly lower among the warm NaOCl group as compared to the control group (P < 0.001). The warm NaOCl group recorded less postoperative pain than the control group during the first 72 h following single-visit endodontic therapy.

Comparative Evaluation of Periapical Healing Outcome Following Non Surgical Endodontic Treatment in Single-visit versus Multiplevisit in Type 2 Diabetes Mellitus Patients: A Randomised Clinical Study

Introduction: Apical periodontitis is very common in those with diabetes mellitus. Diabetes alters immunity, which impacts how periapical tissue heals. The decision between one-visit and multiple-visit root canal therapy is currently up for debate. Aim: To compare periapical healing following single-visit endodontic therapy and multiple-visit endodontic therapy in type 2 diabetic patients by clinical assessment. Materials and Methods: The present randomised singleblinded clinical trial was conducted in the Department of Conservative Dentistry and Endodontics, KM Shah Dental College and Hospital, Vadodara, Gujarat, India, from December 2017 to October 2019. A total of 46 patients having type 2 diabetes, indicated for root canal treatment participated in the study and were randomly split into two groups: group I: Single-visit endodontic treatment and group II: Multiple-visit endodontic treatment. Thereafter, endodontic treatment was carried out on all the patients and the patients were recalled for evaluation at 1-week, 3-month and 6-month time intervals. The clinical assessment was done based on the absence of pain, swelling and sinus tract formation. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Results showed that the success rate based on clinical assessment at one week for a single-visit and multi-visit group was 56.52% for both the groups and at three months 90.47% and 86.36%, respectively. At six months, the single-visit group reported 100% success, while the multi-visit group reported 95% success. However, the difference between the groups was not statistically significant. Conclusion: Within the limitation of the study, it was concluded that clinically, a higher success rate was found after six months in patients having type 2 diabetes mellitus who were treated in a single-visit, which was not statistically significant.

Comparative Evaluation of Postoperative Pain Following Single Visit and Two Visit Endodontic Therapy in Non-vital Teeth

Management of postoperative pain is a challenge for clinicians providing root canal therapy and a primary concern for patients as it directly affects their quality of life. Traditionally, multiple-visit endodontic treatment has been employed. In modern endodontics, single-visit endodontic therapy is becoming popular. Objectives: To compare frequency of postoperative pain following single and two-visit endodontic therapy in non-vital teeth. Methods: Randomized Controlled Trial was conducted at Operative Dentistry Department, Islamic International Dental Hospital, Islamabad. Each patient was assigned to group A or B with 140 participants in each group. Access, cleaning, and shaping were performed on the first visit. At the first visit, teeth in group A were obturated using guttapercha, whereas Group B was obturated after one week. Patients were instructed to mark the severity of pain at intervals of 6 hours, 24 hours, and 7 days after treatment. Results: 280 patients were divided into two groups of 140 each. Overall mean age and standard deviation was 27.35 + 7.18. At 6 hours, 123 group A and 119 group B patients experienced pain. 113 patients in group A and 105 patients in group B reported pain at 24 hours. On the 7th day, the number of patients in groups A and B that had pain was 8 and 7 respectively. P-value was not statistically significant. Conclusion: This study found no difference in the incidence of postoperative pain in non-vital teeth, irrespective of the number of endodontic treatment visits.

Effect of Prednisolone Premedication on Postoperative Pain after Single Visit Endodontic Therapy: A Randomized Controlled Trial part (XIII)

This study was designated to evaluate the effect of Prednisolone as premedication in controlling post-endodontic pain after single visit treatment of acute irreversible pulpitis using in a randomized controlled trial. 40 Mandibular Molar teeth were treated using Revo S system, Patients were asked To sign a printed consent and obligated the patient to fill the pain diary 6,12,24 hours after root canal treatment. The patients were randomly divided into 2 groups: experimental group (A): prednisolone 40 mg and control group (B): placebo. The pain was measured using VAS measurement, a triple blind randomized study used to minimize bias and to allow sufficient comparison between groups. The outcome of this study showed that Prednisolone resulted in statistically significant reduction in post endodontic pain at 6, 12 hours post operatively which was considered as large and moderate effect size respectively. At 24 hours postoperatively; Prednisolone group didn’t seem to differ significantly from placebo group with small effect size and this is may be due to prednisolone half life is from 3 hours to 4 hours. So, in absence of contraindications for corticosteroid administration, the use of single-dose prednisolone appears to be a safe and effective method to reduce postoperative pain. It is possible that these favorable results might help to prevent post-endodontic pain.

Comparison of the effect on postoperative pain between instrumentation with and without connected electronic apex locator: a randomized clinical trial

Background: The aim of the present study was to evaluate the postoperative pain between root canal instrumentation with unconnected electronic apex locator and instrumentation with connected electronic apex locator. Methods: Forty-two patients were randomly divided into two groups (n=21). Group 1 was treated using the traditional endodontic motor with unconnected electronic apex locator (EAL) and group 2 was treated using the endodontic motor with connected EAL. All teeth were treated in single-visit endodontic therapy. Postoperative pain levels at 6, 24, 48, 72 h and 1 week were recorded by patients. The data were collected and analyzed using the χ2, and Mann-Whitney U tests with significance at 0.05. Results: Postoperative pain levels were significantly reduced by half at 6 hours in both experimental groups; however, no significant differences were found in postoperative pain levels between the two groups at all considered times. The postoperative pain levels using a percussion test were reduced on day 7 in both groups, and there was no significant difference in this variable between two groups. Conclusions: Both groups have a similar effect on reduction of the postoperative pain for endodontic patients undergoing root canal.

Anesthetic efficacy of anterior middle superior alveolar injection in single-visit endodontic therapy: an in vivo study.

To evaluate and compare the anesthetic efficacy of anterior middle superior alveolar (AMSA) injection in single-visit endodontic therapy, an in vivo study. Teeth in the maxillary anterior segment (N= 60) requiring single-visit endodontic (SVE) therapy were selected. A conventional syringe with 26-guage needle containing 1.5ml lignocaine with 1:80,000 epinephrine was used for the AMSA injection. The SVE therapy was performed using standard protocol. Profoundness of anesthesia during therapy was evaluated at 15-, 30-, 60-, and 90-min intervals using pain rating score and marked on visual analogue scale. In patients who reported pain/ineffectiveness of anesthesia during the course of endodontic therapy, additional supplemental anesthesia (buccal/labial infiltration) was administered. Depending on effectiveness of anesthesia with the AMSA injection alone or the need for additional supplementary injections, patients were divided as: group I-only AMSA and group II-AMSA with one or two supplemental anesthesia. The AMSA injection was effective in 91.67% of the patients undergoing the SVE therapy and the duration of anesthesia for the AMSA injection alone was adequate until the completion of the SVE therapy. Supplementary injections were required in 8.33% of cases at 15-min interval to achieve profound anesthesia. The AMSA injection technique could be used as an alternative to the conventional infiltration technique for anesthetizing teeth in maxillary anterior segment during the SVE therapy. The AMSA injection provides profound pulpal anesthesia of teeth in maxillary anterior segment during endodontic therapy.

Outcome of Single- vs Multiple-visit Endodontic Therapy of Nonvital Teeth: A Meta-analysis.

Endodontic therapy is a specialized procedure more demanded by patients within public oral health care in the country. Then, single-visit endodontic therapy may offer advantages to the health care services, to the professionals, and to the patients by reducing access barriers. A meta-analysis was done and the variables evaluated were periapical repair, microbiological control, and postobturation pain in randomized clinical trials (RCTs) involving endodontic treatment of nonvital teeth at single- or multiple visits. About 17 RCTs were included. There were no differences found in periapical repair or microbiological control in single- and multiple-visit therapy. Single-visit endodontic therapy resulted in 21% less postobturation pain (relative risks = 0.79; 95%, confidence interval: 0.66-0.94). There was less postobturation pain in the single-visit endodontic therapy group. In the public dental care, this analysis favors the adoption of this one therapy because it will be possible to increase the patient access and the supply of this therapy. It is possible to get a better cost-effectiveness for the patients and the health care service. This is very important because the reduction of the cost to the patient allows it to become a complete treatment. The health service, in turn, is able to be better used, with a greater supply of this service.

Comparative evaluation of the efficacy of two modes of delivery of Piroxicam (Dolonex(®)) for the management of postendodontic pain: A randomized control trial.

Background:Alleviating pain is of utmost importance when treating patients with endodontic pain.Aim:To compare and evaluate the efficacy of two modes of delivery of pretreatment Piroxicam (Dolonex®, Pfizer) for the management of postendodontic pain.Materials and Methods:Sixty-six patients with symptomatic irreversible pulpitis were randomly divided into three groups of 22 subjects Group I - control group, no pharmacological intervention, Group II - patients received pretreatment oral Piroxicam (40 mg), Group III - patients received pretreatment intraligamentary injections totaling 0.4 mL of Piroxicam. Single visit endodontic therapy was performed by a single endodontist. Visual analogue scale was used to record pain before treatment and 4, 8, 12, 24, and 48 h postoperatively. Mann–Whitney U-test and Kruskal–Wallis tests were used to analyze the data.Results:The patients in Groups II and III perceived less postendodontic pain as compared to Group I (P < 0.05), at all the time intervals. At 12, 24, and 48 h, pain experience in patients of Group III was significantly less.Conclusions:Intraligamentary mode of delivery of Piroxicam was more efficacious.

Periapical healing outcome following single visit endodontic treatment in patients with type 2 diabetes mellitus.

BackgroundThe prevalence of apical periodontitis in diabetes mellitus patients is high. The altered immunity in diabetes affects the healing process of periapical tissue. Single visit endodontic treatment has shown to increase the periapical healing rate with better patient compliance. Hence the present study aims at evaluating the clinical and radiographic healing outcome of single visit endodontic treatment, in type 2 diabetes mellitus patients with periapical disease.Material and MethodsEighty patients with periapical disease were divided into 2 groups of 40 each: Group I, Control subjects and Group II, Type 2 diabetics. Glycosylated hemoglobin levels were assessed preoperatively and at follow up intervals in diabetics. Pre-operative assessment of periapical status was done using CPDR (Clinical periapical diagnosis of root), QLDR (Qualitative radiographic diagnosis of tooth) and QTDR (Quantitative radiographic diagnosis of tooth) criteria. Postoperative healing was evaluated following single-visit endodontic treatment by Strindberg criteria.ResultsGroup 2 subjects had chronic and exacerbating lesions with significantly larger lesions (p=0.029). 100 % clinical healing outcome in diabetic group was seen in two months. Group 2 showed 85% success in one year on radiographic evaluation. Poor controlled diabetics showed failure compared to fair and good controlled.ConclusionsType 2 diabetics had chronic and larger sized lesions when compared to control subjects. The periapical lesions in patients with poor diabetic control showed failure. The clinical and radiographic healing outcome of single visit endodontic therapy was delayed in diabetic patients. Key words:Apical periodontitis, diabetes mellitus type 2, endodontics, periapical lesion, strindberg criteria.

Clinical effectiveness of palifermin in prevention and treatment of oral mucositis in children with acute lymphoblastic leukaemia: a case–control study

The aim of this study was to evaluate the efficacy of palifermin, an N-terminal truncated version of endogenous keratinocyte growth factor, in the control of oral mucositis during antiblastic therapy. Twenty patients undergoing allogeneic stem-cell transplantation for acute lymphoblastic leukaemia were treated with palifermin, and compared to a control group with the same number of subjects and similar inclusion criteria. Statistical analysis were performed to compare the outcomes in the treatment vs. control groups. In the treatment group, we found a statistically significant reduction in the duration of parenteral nutrition (P=0.002), duration of mucositis (P=0.003) and the average grade of mucositis (P=0.03). The statistical analysis showed that the drug was able to decrease the severity of mucositis. These data, although preliminary, suggest that palifermin could be a valid therapeutic adjuvant to improve the quality of life of patients suffering from leukaemia.

EVALUATION OF THE EFFICIENCY OF INTRALIGAMENTARY DICLOFENAC SODIUM IN REDUCING POST OPERATIVE ENDODONTIC PAIN IN PATIENTS WITH IRREVERSIBLE PULPITIS

Management of pain is th e key to success in endodontic treatment. Diclofenac Sodium is the most commonly prescribed and most effective when administered to patients with irreversible pulpitis. The primary mechanism responsible for its anti - inflammatory and analge sic action is due to the suppression of the cyclo - oxegenase pathway by inhibition of prostaglandin synthesis. However, the traditional oral route is less commonly preferre d as gastrointestinal complaints are more pronounced. In this study 52 patien ts with irreversible pulpitis are randomly divided into 2 groups. The active group is given intraligamentary injection totaling 0.4ml of Diclofenac Sodium while the placebo group received the same amount of Lidocaine. Single visit endodontic therapy is performed by the same endodontist. Visual analogue scale will be used to score pain before treatment and 4,8,12,2 4,48 hrs postoperatively. The prime focus of this randomized double blinded study was to evaluate the analgesic effic acy of Diclofenac Sodium through the intraligamentary route in reducing post treatment endodontic pain. Prophylactic intraligamentary injection of 0.4ml of 30 mg of Diclofenac Sodium was found to be highly effective in reducing post - endodontic pai n of vital teeth with irreversible pulpitis during the first 48 h. It was much more effective than a

Retraction: Effectiveness of single‐ versus multiple‐visit endodontic treatment of two mandibular central incisors from the same patient

The aim of this report is to describe the treatment of two mandibular incisors of the same patient with apical periodontitis following dental trauma. Tooth 31 was treated by single-visit endodontic therapy while tooth 41 was treated by multiple-visit endodontic therapy. A 16-month postoperative radiograph was taken and showed repair.

Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a Nigerian teaching hospital

BackgroundUntil recently the most accepted technique of doing root canal treatment stresses multiple visit procedure. Most schools also concentrated upon teaching the multi-visit concept. However, it has now been reported that the procedure of single visit treatment is advocated by at least 70% of schools in all geographical areas. It was therefore the aims of the present study to find the incidence of post-obturation flare-ups following single and multiple visit endodontic treatment procedures, and to establish the relationship between pre-operative and post-obturation pain in patients referred for endodontic therapy in a Nigerian teaching Hospital.MethodsData collected included pulp vitality status, the presence or absence of pre-operative, inter-appointment and post-obturation pain. Pain was recorded as none, slight, or moderate/severe. Flare-ups were defined as either patient's report of pain not controlled with over the counter medication or as increasing swelling. The patients were recalled at three specific post-obturation periods, 1st, 7th and 30th day. The presence or absence of pain, or the appropriate degree of pain was recorded for each recall visits and the interval between visits. The compiled data were analysed using chi-square where applicable. P level ≤ 0.05 was taken as significant.ResultsTen endodontic flare-ups (8.1%) were recorded in the multiple visit group compared to 19 (18.3%) flare-ups for the single visit group, P = 0.02. For both single and multiple visit procedures, there were statistically significant correlations between pre-operative and post-obturation pain (P = 0.002 and P = 0.0004 respectively). Teeth with vital pulps reported the lowest frequency of post-obturation pain (48.8%), while those with nonvital pulps were found to have the highest frequency of post-obturation pain (50.3%), P = 0.9.ConclusionThe present study reported higher incidences of post-obturation pain and flare-ups following the single visit procedures. However, single visit endodontic therapy has been shown to be a safe and effective alternative to multiple visit treatment, especially in communities where patients default after the first appointment at which pain is relieved.

Successful single-visit endodontics during operation desert shield

This article reports on the incidence of success following single-visit endodontic therapy. Non-surgical endodontic therapy was performed on 210 teeth in 167 patients who were rapidly deployed during the initial stages of Operation Desert Shield. Upon their return, 97 patients were recalled for follow-up evaluation. This study evaluated 102 teeth. The recall rate was 58% with a success rate of 89%.

Single visit endodontic therapy in asymptomatic pulpless maxilllary anterior teeth

A clinical study was carried out to evaluate the post operative seaquelae following single visit endodontic therapy in 32 asymptomatic pulpless maxillaryjanterior teeth. The single visit endodontic therapy was found to be successful and there was no incidence of post-operative discomfort in majority of the cases. Antibiotics and analgesics were administered only in case of discomfort and it reduced the severity of the discomfort considerably.

Use of ultrasonics in single-visit endodontic therapy

Two cases are presented in which a single-visitendodontic procedure was performed using ultrasonics and sodium hypochlorite as an irrigant. We recommend that clinical studies be performed to demonstrate the significance of ultrasonics in single-visit endodontic therapy.

The incidence of failure following single-visit endodontic therapy

The purpose of this study was to evaluate the incidence of failure following single-visit endodontic therapy. The study involved 1,140 teeth in 918 patients. One-year recall evaluations were performed on 925 or 81.8% of the teeth. The endodontic failure rate was found to be 5.2%. No significant difference was found between the tooth groups (anterior and posterior, maxillary and mandibular); however, significant differences were found among the problem code groups (teeth with pulpal pathosis, teeth with periapical extension of pulpal disease, endodontic periapical extension of pulpal disease, endodontic retreatments, and intentional devitalization cases). Also, the incidence of failure was higher in those teeth with periapical extension of pulpal disease which had no prior access opening.

Incidence of postoperative pain following the use of different sealers in immediate root canal filling

A clinical investigation was conducted to compare the incidence and type of postoperative pain in singlevisit endodontic therapy when different root canal sealers were utilized (lodoform, Oxpara, Endomethasone, and AH26). There was no statistical significance between the presence and type of postoperative discomfort and the type of sealer utilized. A clinical investigation was conducted to compare the incidence and type of postoperative pain in singlevisit endodontic therapy when different root canal sealers were utilized (lodoform, Oxpara, Endomethasone, and AH26). There was no statistical significance between the presence and type of postoperative discomfort and the type of sealer utilized.

Single-Visit Endodontic Therapy: A Preliminary Clinical Study

A clinical investigation was conducted to compare the incidence and severity of postoperative pain in single-visit and multiple-visit conventional endodontic therapy. Although the single-visit patients seemed to experience more discomfort than did the multiple-visit patients after the first postobturation day, the differences were not statistically significant. When the total number of pain days was considered, there were no significant differences between the two groups. Thus, single-visit endodontic therapy appears at least equal in desirability to multiple-visit therapy from the point of view of painfulness to the patient.