Single-visit Root Canal Treatment Research Articles

Diclofenac Transdermal Patch versus Oral Diclofenac on Post Endodontic Pain and Quality of Life- A Randomised Clinical Trial.

To compare the effect of pre-treatment transdermal and oral diclofenac on post-endodontic pain level and oral health-related quality of life (OHRQOL) in patients with symptomatic irreversible pulpitis with apical periodontitis in mandibular molars following single visit root canal treatment. This parallel-arm, randomised, double-blinded clinical trial is reported according to the Consoli-dated Standards of Reporting Trials (CONSORT) 2020 guidelines. The protocol was approved by the Institu-tional Ethical Committee on 30th March 2021 (MADC/IEC-I/029/2021) and registered at the clinical trial reg-istry of India (CTRI/2021/12/038696). Adult patients fulfilling the eligibility criteria were randomised into two groups. Group DTP received a diclofenac transdermal patch 100 mg, and Group DOT received a diclofenac oral tablet 100 mg one hour before root canal treatment. Pain scores were checked at baseline, 2, 4, 6, 8, 24, 48, and 72 hours after the treatment. OHRQOL was assessed at baseline and one week after the treatment. Both groups were associated with a significantly lower incidence of post-operative pain and im-proved OHRQOL. At 2 hours, the pain level was significantly lower with an oral diclofenac tablet, and at 24 hours, the pain level was significantly lower with a diclofenac transdermal patch. Regarding OHRQOL, there was no significant difference between the two groups. Within the limitations of this study, the diclofenac transdermal patch had lesser post-operative pain at 24 hours, whereas the oral diclofenac tablet had lesser pain at 2 hours.

Evaluation of Different Root Canal Sealers on Post Operative Pain in Single Visit RCT – A Comparative Study

ABSTRACT Aim: To evaluate and compare three different root canal sealers (Endo-Sequence BC, Bio Root RCS and Zinc Oxide Eugenol) on post operative pain in single visit root canal therapies. Material and Methodology: 60 subjects with age ranging from 18-60 years were randomly selected depending upon the inclusion criteria. The subjects were then divided into three groups with 20 patients in each. In all the patients’ single visit root canal treatment was done followed by obturation using different sealers. In Group I Endo- Sequence sealer was used, in Group II Bio-Root RCS and in Group III Zinc Oxide Eugenol sealers were used respectively. Results: statistically significant results were obtained on comparing the efficacy of three groups with Group I proving to be much effect among the three. Conclusion: within the limitation of the study it can be concluded that though all the sealers were effective in reducing post-operative pain, patients with Endo Sequence BC sealers evaluated statistically significant results.

Assessment of Bacterial Load and Post-Endodontic Pain after One-Visit Root Canal Treatment Using Two Types of Endodontic Access Openings: A Randomized Controlled Clinical Trial.

The need for controlling bacteria and pain during root canal therapy is undeniable. This clinical trial aimed to assess whether there is a difference in colony-forming unit (CFU) reduction after instrumentation and post-endodontic pain after root canal treatment (RCT) using a traditional endodontic cavity (TEC) versus a conservative endodontic cavity (CEC). This clinical study was conducted on 89 patients designated for a single-visit RCT. Patients were allocated randomly (TEC n = 45 and CEC n = 44). The access opening was gained accordingly in each group by a single operator. A pre-instrumentation sample of root canal dentin was collected using an endodontic file; the second sample was collected similarly, right after shaping and cleaning the root canal. The CFU was calculated based on the samples collected. The pain level was recorded preoperatively and at 1, 7, and 21 days postoperatively utilizing a visual analog scale (VAS). There were no statistically significant differences in the CFU reduction between the TEC and CEC groups (p > 0.05). Additionally, there were no statistically significant differences found in postoperative pain levels between the TEC and CEC at 1, 7, and 21 days (p > 0.05). Despite the limitations of this study, both the CEC and TEC demonstrate a decrease in bacteria within the root canals and alleviate postoperative pain with no difference between them.

The effect of ibuprofen sustained release oral premedication on intraoperative and postoperative pain: A randomised clinical trial.

The aim of this study was to assess the effect of ibuprofen sustained release (SR) oral premedication on the efficacy of buccal infiltration (BI) with intraoperative and postoperative pain after single-visit root canal treatment. Sixty patients diagnosed with symptomatic irreversible pulpitis and apical periodontitis in mandibular molar were divided into two groups. Group SR received ibuprofen SR 800 mg and group PL received placebo capsule 1 h before 3.6 mL articaine BI injection. Pain was recorded using a modified visual analogue scale and postoperatively at intervals 6, 24 and 48 h. Group SR showed a significantly higher anaesthetic success rate (73.3%) compared to group PL (46.7%) (p < 0.05). Intraoperative and postoperative pain was significantly higher in group PL compared to group SR (p < 0.05). Premedication of ibuprofen SR improved the efficacy of primary BI in mandibular molars with symptomatic irreversible pulpitis and decreased postoperative pain at 6 and 48 h.

Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial.

To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.

Postoperative Pain Following Single-visit Root Canal Treatment with Reciproc Blue and HyFlex EDM Instrumentation; A Prospective Randomized Clinical Trial

Postoperative Pain Following Single-visit Root Canal Treatment with Reciproc Blue and HyFlex EDM Instrumentation; A Prospective Randomized Clinical Trial

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment.

Post-operative pain after endodontic treatment is a common occurrence, and its prevalence is mostly high immediately after treatment, decreasing in one day and reportedly reaching minimal levels 7 days after treatment. This research focuses on the final flushing of the root canal with different irrigating solutions to reduce its occurrence. Aim: To compare and evaluate the effect of delivering three intracanal irrigants - saline at room temperature, saline at 2.5oC, and intracanal dexamethasone as final irrigant on postoperative pain after a single visit endodontics. This randomized double-blinded parallel clinical trial was conducted on patients requiring a single appointment root canal treatment, with a pain level of 4 or higher on the visual analogue scale (VAS). According to the final irrigating solution, all patients were randomly allocated into three groups of 15 each: 0.9% physiological saline (Group 1), 2.5oC cold saline (Group 2), and 2ml Dexamethasone (Group 3). Patients were instructed to complete VAS to determine their post-operative scores at 6hrs, 12hrs, and 24hrs following the treatment. In all groups, mean VAS scores decreased significantly from baseline to 6hr and 12hr, with lower scores at 24 hours. Post-hoc analysis revealed no significant distinction in the mean VAS scores between 12 hours to 24 hours. Lower pain scores are observed in the dexamethasone group, followed by cryotherapy which performed better than saline at room temperature. Final flushing with dexamethasone solution and cryotherapy is effective, safe, and a well-tolerated strategy to minimize postoperative pain after single visit endodontics. Key words:Intracanal cryotherapy, Cold saline, Dexamethasone, Postoperative pain, Visual analogue scale.

Outcome of single-visit root canal treatment with or without MTAD: A randomized controlled clinical trial.

This study aimed to investigate 2-year changes in periapical trabecular patterns in single-rooted teeth with apical periodontitis using fractal analysis and periapical index (PAI) after root canal treatment performed with or without BioPure MTAD solution. In this randomized clinical trial, 100 patients were selected and randomized to either the BioPure MTAD or the control groups. Initial periapical radiographs were obtained for each participant before and 2 years after root canal treatment. The region of interest in the periapical lesion around the root apex was selected from the paired periapical radiographs, and then, the fractal dimension (FD) was calculated. With regards to the classification of periapical status, PAI was labelled as "healed" (PAI ≤ 2) or "unhealed" (PAI ≥ 3). After 24 months, 28 patients did not comply with the follow-up and the data of 72 patients were compared. When the initial and the follow-up PAI scores were compared, the decrease was statistically significant in 33 of 37 teeth (89.2%) and 32 of 35 teeth (91.4%) in the BioPure MTAD and control group, respectively. In both groups, statistically significant increases were observed in FD values after 2 years in all patients (p < .001). No significant difference was found between the two groups amongst decreased PAI scores and increased FD values. Root canal treatments with or without BioPure MTAD irrigation contributed to periapical healing in single-visit root canal treatment. Two years after root canal treatment, the extent of the periapical trabecular bone radiographically increased, as the FD and PAI data revealed.

Effect of Ultrasonic Irrigation Combined with Epoxy Resin Paste in Single Visit Root Canal Treatment in Chronic Pulpitis.

To determine the clinical efficacy of ultrasonic irrigation combined with epoxy resin-based sealer in single visit root canal treatment of chronic pulpitis. Randomised controlled trial. Place and Duration of the Study: Department of Stomatology, Hefei BOE Hospital, Hefei, China, from March 2019 to December 2021. Ninety patients with chronic pulpitis, comprising 104 affected teeth, were enrolled. Using a random number table, they were divided into Group A (n = 30, 35 teeth), Group B (n = 30, 35 teeth), and the control group (n = 30, 34 teeth). All underwent single visit root canal treatment. Group A received ultrasonic irrigation followed by sealing with epoxy resin-based paste; Group B had conventional syringe irrigation followed by the same sealing; the control group had syringe irrigation and closure with zinc oxide-eugenol paste. Pain during treatment, posttreatment clinical outcomes, and differences in inflammatory markers (IL-4, IL-6, hs-CRP), and quality of life (QOL) scores pre- and posttreatment over two months were observed. After the treatment, improvement rates for Groups A, B, and the control group were 91.4%, 65.7%, and 61.7%, respectively. Pain occurrence rates were 6.7%, 30.0%, and 36.7%, respectively. Group A outperformed both Group B and the control group in improvement and pain incidence with statistical significance (p<0.016). Posttreatment, Group A had lower IL-4, IL-6, hs-CRP levels than Groups B and the control group (p<0.05), and had higher scores for sleep, mood, and appetite (p<0.05). Ultrasonic irrigation combined with epoxy resin-based paste yields better results for chronic pulpitis treatment, reducing postoperative pain, mitigating inflammation levels, and enhancing quality of life. Chronic pulpitis, Ultrasonic irrigation, Epoxy resin paste, Root canal treatment, Therapeutic effect.

Efficacy of pre-operative submucosal injection of dexamethasone and triamcinolone acetonide on post-operative pain following endodontic treatment of teeth with irreversible pulpitis: A randomised clinical trial

Post-endodontic pain is a challenge to clinicians. In this context the evidence for use of preoperative medication is not consistent. The study's objective is to assess the effects of dexamethasone and triamcinolone acetonide administered submucosally in single doses on postoperative pain following single-visit root canal treatment for teeth with symptomatic irreversible pulpitis. Thirty patients were randomly allocated in three groups. Group I received saline (control), Group II received dexamethasone (8mg) and Group III received triamcinolone acetonide (40mg) before endodontic treatment was initiated. Root canal treatment was performed in a single appointment for all the participants. Post-operative pain was assessed using Heft-Parker visual analogue scale (HP VAS). Comparison of HP VAS scores was done using Kruskal Wallis Test and Mann Whitney Test. There was no significant difference in the mean HP VAS scores between 3 groups at pre-op period (P=0.74). At 6,12 and 24h post-operative period the mean HP VAS scores in Group 2 and 3 was significantly lesser as compared to Group 1. Corticosteroid preoperative dosages led to a reduction in post endodontic pain after single visit root canal treatment of teeth with symptomatic irreversible pulpitis.

Does single-visit root canal treatment of permanent teeth provide more benefit than a multiple-visit approach?

Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE Ovid, Embase Ovid. Randomised controlled trials and quasi-randomised controlled trials were included. Participants aged ≥ 10 with a permanent tooth possessing a completely formed apex and without resorption; Intervention: Root canal treatment (RoCT) carried out in a single visit; Comparison: RoCT carried out over multiple visits; Outcome: Primary outcome was treatment success (retention of tooth or radiographic evidence of healing), with secondary outcomes investigating post-operative symptoms (pain, swelling, sinus tract formation). Standard Cochrane methods to assess internal validity were used. The Robins 1 tool (for quasi randomised controlled trials) or risk of bias (RoB) 1 tool (for randomised controlled trials) were used to assess RoB whereby a judgement was assigned as 'low', 'high' or 'unclear'. GRADE (GRADEpro GDT software) was used to assess certainty of evidence for each outcome. The certainty of evidence was defined as high, moderate, low or very low, having no downgrade, downgrade of one level, downgrade of two levels and downgrade of three or more levels, respectively. Of the various subgroups investigated to determine their relevance, only pretreatment conditions (vital teeth versus necrotic teeth) and endodontic technique (manual versus mechanical instrumentation) were available for subgroup analysis. The Cochrane's test for heterogeneity and I2 test were used to assess the variation in treatment effects. A random-effects model was used to combine risk ratio (RR) for dichotomous data and mean difference (MD) for continuous data. Sensitivity analysis was performed for each outcome, excluding studies at overall high or unclear RoB. Forty-seven studies were included in the meta-analysis and internal validity assessment, with 5693 teeth analysed. Ten studies were found to have a low RoB, 17 with a high RoB and 20 with an unclear RoB. No evidence was identified suggesting a difference between treatment carried out in a single visit compared to a multiple visits approach for the primary outcome measure, but there was very low certainty about the findings (RR 0.46, 95% confidence interval (CI) 0.09 to 2.50; I 2 = 0%; 2 studies, 402 teeth). No evidence was identified suggesting a difference between treatment carried out in a single visit compared to multiple visits with regards to radiological failure (RR 0.93, 95% CI: 0.81 to 1.07; I 2 = 0%; 13 studies, 1505 teeth; moderate-certainty evidence), participants reporting pain up to 72 h post obturation (RR 0.97, 95% CI: 0.81 to 1.16; I 2 = 70%; 12 studies, 1329 teeth; low-certainty evidence), pain for 72 h post obturation (MD 0.26, 95% CI: -4.76 to 5.29; I 2 = 98%; 12 studies, 1258 teeth; low-certainty evidence) or pain at 1 week post obturation (RR 1.05, 95% CI: 0.67 to 1.67; I2 = 61%; 9 studies, 1139 teeth; very low-certainty evidence). Similarly, no evidence was identified to prove that there was a difference between treatment carried out in a single visit compared to multiple visits with regards to swelling or flare-up (RR 0.56 95% CI: 0.16-1.92; I 2 = 0%; 6 studies; 605 teeth; very low-certainty evidence), analgesic use (RR 1.25 95% CI: 0.75-2.09; I 2 = 36%; 6 studies, 540 teeth; very low-certainty evidence) and sinus tract or fistula presence (RR 1.00, 95% CI: 0.24-4.28; I 2 = 0%; 5 studies, 650 teeth; very low-certainty evidence). Interestingly, however, there was evidence to show that more participants reported pain after 1 week following RoCT completed in a single visit, compared to those in multiple visit groups (RR 1.55, 95% CI: 1.14-2.09; I 2 = 18%; 5 studies, 638 teeth; moderate-certainty evidence). Subgroup analysis showed there was an increase in post-treatment pain after 1 week for RoCT carried out in a single visit on vital teeth (RR 2.16, 95% CI: 1.39-3.36; I 2 = 0%; 2 studies, 316 teeth), and with the use of mechanical instrumentation (RR 1.80, 95% CI: 1.10-2.92; I 2 = 56%; 2 studies, 278 teeth). The current evidence shows that RoCT carried out in a single visit is no more effective than RoCT carried out over multiple visits; after 12 months, there is no difference in pain or complications with either approach. However, single visit RoCT has been shown to have increased post-operative pain after 1 week compared to RoCT completed over multiple visits.

Post-Operative Quality of Life after Single-Visit Root Canal Treatment Employing Three Different Instrumentation Techniques-An Institutional Randomized Clinical Trial.

Root canal treatment (RCT) eliminates damaged pulpal tissue and protects the tooth from recurrent microbial invasion. Post-endodontic pain (PEP) is a frequently encountered complication of root canal therapy. It can have an impact on patients' quality of life (QoL) and their subjective perception of treatment options. Thus, a self-assessment questionnaire was used to evaluate and compare the influence of manual, rotary, and reciprocating file shaping procedures on immediate post-operative quality of life (POQoL) involving single-visit root canal therapy. It was a double-blinded, randomized, controlled clinical trial. A total of 120 participants were randomly assigned sequentially to three groups comprising 40 patients in each group: Group A: Hand K file (positive control); Group B: ProTaper Next file system; and Group C: WaveOne Gold. Post-operative pain was evaluated using a 4-point visual analog scale (VAS) after 12 h, 24 h, 48 h, 72 h, and 1 week. The highest post-operative pain was with manual instrumentation using hand K files, and the lowest was with reciprocating and rotating instrumentations. No significant difference was noted between the parameters of quality of life assessed, suggesting the filing system or technique had a similar effect.

Comparative analysis of reduction in pain scores after single visit root canal treatment using endodontic irrigation protocols, namely, Conventional needle irrigation, PUI, PIPS and SWEEPS: A randomized control trial.

To assess the effects of different irrigation activation systems on postoperative pain using a Visual Analog Scale (VAS), using new laser irrigation activation system shock wave-enhanced emission photoacoustic streaming (SWEEPS), photon-induced photoacoustic streaming (PIPS), passive ultrasonic irrigation activation techniques, compared with the conventional irrigation (CI) method. Sixty patients suffering from symptomatic irreversible pulpitis in maxillary or mandibular molars were enrolled and randomly assigned to four different irrigation activation groups (n = 15) after chemomechanical root canal preparation. Preoperative and postoperative pain scores were recorded using VAS. The data were collected and subjected to statistical analysis using IBM SPSS 20.0 software at a level of significance being 0.05. We observed that mean pain scores decreased with time in all patients in all groups. The decrease in pain score was found to be statistically significant (P < 0.05) among both the genders in Group 3 (PIPS) and Group 4 (SWEEPS). Postoperatively, pain scores decreased significantly using Group 4 (SWEEPS), followed by Group 3 (PIPS), Group 2 (ultrasonic activation), and Group 1 (conventional needle irrigation). No significant relation was observed statistically between pain scores and age groups among all groups, except for preoperative score in Group 3 and age groups. Postoperative scores were lower in laser-activated irrigation systems as compared to the other activation systems. The highest pain scores were observed in case of CI method, at pre- and post-operative periods.

Evaluation of postoperative pain with new heat-treated rotary and reciprocating nickel-titanium files: A randomized controlled clinical trial.

A special heat-treated endodontic file (TruNatomy) was recently introduced with the claim of superior flexibility to enhance dentin preservation. The aim of the present study was to assess postoperative pain in single-visit root canal treatment with this newly introduced file, comparing it with other contemporary reciprocating and rotary file systems. One hundred seventy patients with acute irreversible pulpitis in maxillary premolars were randomly assigned to four experimental file systems: TruNatomy, HyFlex EDM, EdgeFile, and ProTaper Gold. Pre- and postoperative pain scores were assessed with 10-point visual analog scale. Data were statistically analyzed using Kruskal-Wallis test. TruNatomy file system had significantly the highest postoperative pain incidence (53.8%), while the EdgeFile system had significantly the least postoperative pain incidence (24%) and 24-h pain score. The present study demonstrated that the reciprocating multiple-file system, EdgeFile, had significantly reduced postoperative pain incidence compared to other heat-treated rotary nickel-titanium file systems.

Efficiency of diode laser in control of post-endodontic pain: a randomized controlled trial

ObjectivesAs post-endodontic pain control is one of the main targeted addressed in endodontics, our aim was delignated to compare two different methods for low-level laser application utilizing diode laser: low-level laser therapy (LLLT) and laser-activated irrigation (LAI) in the control of post-endodontic pain.Materials and subjectsA total of 180 patients received single-visit root canal treatment; they were randomly allocated into 3 equal groups. Group I received LAI, group II received LLLT, and group III served as control with normal root canal treatment and mock laser intervention (ML group). Postoperative pain was recorded using visual analogue scale (VAS) after 24, 48, and 72 h. Data were tabulated and statistically analyzed.ResultsAt 24 h, there was a statistically significant difference between median pain scores in the three groups (P value < 0.001) with ML group scored highest score followed by LAI and then LLLT group. At 48 h, there was a statistically significant difference between the three groups (P value < 0.001), with ML group scoring highest median pain scores while LLLT and LAI showed statistical insignificant scores. At 72 h, there was no statistically significant difference between the 3 groups (P value = 0.179).ConclusionLLLT is superior to LAI and ML group in the control of immediate postoperative pain after 24 h while after 48 h both LAI and LLLT were equally effective, but they still showed significant differences when compared to ML group.Clinical relevanceDiode laser can be used by clinicians as it decreases the post-endodontic pain in patients with symptomatic apical periodontitis undergoing endodontic treatment.

Frequency of pain in Teeth with irreversible pulpitis after single visit root canal treatment using cryotherapy

ABSTRACT&#x0D; Objective: &#x0D; To determine the frequency of pain in teeth with irreversible pulpitis after single visit root canal treatment using intra-canal cryotherapy.&#x0D; Study design: &#x0D; Quasi experimental&#x0D; Place and duration of study: &#x0D; Department of Operative Dentistry, Armed forces institute of Dentistry Rawalpindi from 1st June 2017 to 31st December 2017.&#x0D; Material and Methods: &#x0D; Total of 140 patients from 20 to 65 years were equally divided into two groups Group A in which Cryotherapy was used and Group B was control group. After anesthetizing the tooth &amp; application of Rubber Dam, Root canal preparation was done with Protaper next series and copious irrigation of 5.25% sodium hypochlorite and 17% EDTA solution. In group A patients the final irrigation was done with Normal saline at a temperature of 2.5°C. In the control group, final irrigation was performed with normal saline at room temperature. Obturation was done with cold lateral condensation and permanent restoration was done with composite. Patients were contacted by telephone after 24 Hours and were asked whether they experienced any pain.&#x0D; Results: &#x0D; Mean age was 39.26+12.61 years. There were 82 (58.6) male and 58 (41.4) female patients. Comparison of cryotherapy group and controls was done in terms of post-operative pain. After 24 Hours 80% of the patients in group A has no pain while in control group 61.4% were pain free.&#x0D; Conclusion: &#x0D; Key words: Root canal treatment, cryotherapy, irreversible pulpitis, postoperative pain

Single-Visit Root Canal Treatment: A Systematic Review and Meta-Analysis

Background: Root canal treatment (RCT) is a specialized and one of the most demanded procedures in the public oral health-care sector. Multiple-visit endodontic treatment is considered a conventional method for treating the affected teeth; however, the procedure requires a considerable amount of time to complete the treatment. The recent era is showing an escalating preference of the endodontists as well as the patients toward the single-visit RCT over multiple visits due to some advantages such as the low risk of leakages usually caused by the temporary seal. To the best of our knowledge in this systematic review and meta-analysis, we aim to evaluate the effectiveness of single-visit RCT over multiple-visit RCT in terms of the rate of flare-ups and postoperative pain in both vital and nonvital teeth. Methods: We performed an electronic search through PubMed, MEDLINE Database, Cochrane Central Register of Controlled Trials, Scopus Database, Web of Science, and LILACS Database. A systematic review was performed using the Cochrane handbook and PRISMA statement. The meta-analysis presented in this study was done by applying the random effects model in RevMan 5.4. Results: A total of 106 articles were referred. Out of these, forty articles were selected for analysis in the database, and 22 were excluded because of the absence and irrelevance of required parameters. A total of ten studies were selected for meta-analysis after the complete screening and analysis. The comparison was done between the incidence of postoperative pain among vital and nonvital teeth. The difference in postoperative pain after 24 and 48 h of single-visit RCT among studied groups was found to be nonsignificant with P = 0.49 and 0.20, respectively. Moreover, the majority of studies have shown that there was no difference in the occurrence of pain whether patients were treated through the single visit or multi-visit RCT. Conclusion: Based on the evidence, single-visit RCT appeared to be a safe treatment mode when considered for flare-ups. However, within the limitation of this study, it is also concluded that the incidence of postoperative pain is seen within 24 h of treatment which was found to reduce with the passage of time.

Incidence of Postoperative Pain after Single Visit Root Canal Treatment using XP-endo Shaper, 2Shape and ProTaper Gold Rotary Systems: A Prospective Randomized Clinical Trial.

To evaluate the incidence of postoperative pain, treatment time and analgesic intake after single visit endodontic treatment of mandibular molars using XP-endo Shaper, 2Shape and ProTaper Gold rotary systems. 150 patients with irreversible pulpitis were scheduled for single visit root canal treatment. Teeth were randomly assigned to one of the three groups: ProTaper Gold (PTG; Dentsply Tulsa Dental Specialties, Johnson City, TN), 2Shape (2S; Micro-Mega, Besancon, Cedex, France) and XP-endo Shaper (XPES; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Preoperative and postoperative pain was rated by the patients at the beginning of treatment and after 24, 48, 72 hours and 7 days on Heft Parker's visual analog scale (HP-VAS). Highest mean postoperative pain score was recorded in PTG (P<0.05), followed by 2S and XPES respectively at all time intervals. XPES exhibited maximum reduction from preoperative pain at 24 (48.67%) and 48 hours (96.90 %) with no pain at 72 hours. Treatment time was significantly least in XPES (P<0.05) followed by 2S and PTG; but no significant difference in analgesic intake was noted. XPES exhibited least postoperative pain at all time intervals and treatment time, followed by 2S and PTG rotary systems respectively. (EEJ-2022-04-053).

Single visit root canal treatment versus pulpotomy in management of pulpitis

AimTo clinically and radiographically evaluate single visit root canal treatment (RCT) and pulpotomy in management of mature teeth with irreversible pulpitis.Patients and methodsTwenty-four patients diagnosed with irreversible pulpitis in their mature permanent mandibular molars, were selected and randomly divided into two equal groups according to the treatment protocol either single visit RCT or pulpotomy. For single visit RCT group, ProTaper NEXT rotary system was used for canal preparation and obturation was done using cold lateral condensation technique. While in pulpotomy group, after coronal pulp amputation and hemostasis, Biodentine was used as the pulpotomy agent. The clinical examination of tested groups was performed immediately after completing the procedure (baseline), 3, 6, 9, and 12 months posttreatment. While the radiographic examination using cone-beam computed tomography was carried out at baseline and 12 months postoperatively. Statistical analysis was performed by χ2 test for clinical evaluation criteria and t test for radiographic data.ResultsSingle visit RCT had clinical success rate of 91.67%, while pulpotomy group showed 83.33% success rate. Radiographically, both groups showed normal width of periodontal ligament membrane space and normal bone density after follow-up. There was no statistically significant difference between two groups (P > 0.05).ConclusionsSingle visit RCT and pulpotomy had high success rate in management of mature permanent teeth diagnosed with irreversible pulpitis. Pulpotomy can be considered as an alternative treatment option.

Revelation of Outcome of Single visit V/s Multiple visit Endodontic Therapy

Abstract Aim: This study aims to investigate whether there is a substantial difference between single- and multiple-visit root canal treatment (RCT) in regard to the incidence and intensity of postendodontic pain and flare-up. Materials and Methods: The following databases were searched and evaluated “Cochrane Database of Systematic Reviews, Web of Science, PubMed, and Scopus databases” for studies published from January 2000 to August 2021. The articles were chosen using the PRISMA protocol. The review includes 22 articles. Results: The other studies assessed either the incidence or the intensity, while three studies compared both. The majority of studies irrigated with sodium hypochlorite and used both hand-driven and rotary equipment. Thirteen trials made use of an intracanal medicament. Conclusion: The systematic review demonstrated that there was no significant difference in the incidence or the intensity of the pain as measured between single-visit RCT and multiple-visit RCT. The incidence of postendodontic pain or a flare-up is not independently determined by the number of visits required for root canal therapy.