Two-visit Root Canal Treatment Research Articles

The evaluation of effective rate and pain intensity of root canal treatment in primary teeth-a retrospective study.

Two-visit root canal treatment for children reduce the time of visits and the by-chair time in comparison with the three-visit root canal treatment. However, it is not clear whether two-visit root canal treatment increase the risk of complications. This study aimed to evaluate the clinical effects and post-operative pain intensity after the root canal treatment between two-visit and three-visit groups in primary molars from children.106 patients were screened for eligibility, of which 74 went back to the preservation visit. Therefore, 74 primary molars from 74 children that diagnosed with chronic pulp and periodontal tissue diseases in the clinics of pediatric dentistry were retrospectively analyzed, in which 37 in the two-visit group and 37 in the three-visit group. The total effective rate and postoperative pain intensity were assessed after treatment and all statistical data were carried out with SPSS software.The average age of children in the two-visit and three-visit groups was 6.4 and 7.0, respectively, with no significant difference (p = 0.056). The two-visit group consisted of 59.5% male and 40.5% female children, while the three-visit group consisted of 56.8% male children and 43.2% female children (p = 0.813). Two months after treatment, the total effective rate in the three-visit group was 97.30%, a little higher than that in the two-visit group (94.59%), but with no significant difference (p = 0.201). Besides, there was also no significant difference in pain intensity between the two-visit and three-visit groups (p = 0.692). Therefore, there were no significant difference of total effective rate and pain intensity in root canal treatment between the two-visit and three-visit groups in primary molars from children.

Single-visit versus Two-visit Root Canal Treatment of Permanent First Molars in 9-14 Years Old Children

Single-visit versus Two-visit Root Canal Treatment of Permanent First Molars in 9-14 Years Old Children

Comparison of postoperative pain following single-visit and two-visit root canal therapy in controlled diabetic patients with irreversible pulpitis: A randomized control trial.

Aim:The aim of this study was to evaluate and compare the prevalence of postoperative pain after single- and two-visit endodontic therapy in controlled Type 2 diabetic and nondiabetic individuals in multirooted teeth with irreversible pulpitis.Materials and Methods:Ninety patients with irreversible pulpitis (30 controlled diabetics and 60 nondiabetics), between 18 and 60 years were included in the study. After obtaining initial pain scores, patients were randomly allocated to single-visit or two-visit root canal treatment (RCT) groups to receive standardized treatment. After the first visit, patients were given visual analog scale form to mark pain intensity at 1 h, 6 h, 12 h, 24 h, 48 h, 72 h, and 1 week. The compiled data collected were statistically analyzed using 20 SPSS software.Results:In both groups, for patients undergoing single-visit and multi-visit RCT, pain intensity was highest on 1st day of treatment and dropped afterward. A comparison of pain between single-visit and two-visit patients revealed no significant difference in pain scores for the respective time intervals. Intergroup comparison between controlled diabetics and nondiabetics showed no significant difference in pain reported between both groups.Conclusion:According to the results of this study, being diabetic or nondiabetic, no difference in pain perception was seen between single- and multiple-visit endodontics suggesting that single-visit as well as two-visit endodontic treatment can be done in controlled diabetic patients.

Acute Pain Rate of Single Versus Two-visit Root Canal Treatment of Teeth With Necrotic Pulps

Acute Pain Rate of Single Versus Two-visit Root Canal Treatment of Teeth With Necrotic Pulps

Outcome of One and Two Visit Root Canal Treatment of Irreversible Pulpitis

Objective: The present prospective comparative clinical trial was undertaken to compare the outcomes of single and two-visit root canal treatment of irreversible pulpitis.
 Methodology: This prospective study was conducted in the Department of Conservative Dentistry and Endodontics of Dhaka Dental College on patients who presented with pain due to irreversible pulpitis. Patients with single-rooted teeth with uncomplicated canal and full-formed apex having irreversible pulpitis were included. However, pregnant women or patients under treatment of antibiotics, cortiosteiods or suffering from any systemic diseases or immuno-compromised patients or patients having teeth with calcified canal or periodontal disease were excluded. A total of 80 patients who met the eligibility criteria were consecutively included and were randomly assigned to either one-visit (n = 40) or two-visit (n = 40) treatment groups. Data were kept on pulp vitality status, the presence or absence of pre-operative pain and degree of post obturation pain at 6, 12, 24, 48 hours and 1 week postoperatively. The outcome variable was intensity of pain which was measured using a visual analogue scale (VAS) as 0 = no pain, 1 = slight pain or discomfort, 2 = moderate pain relieved by analgesic, 3 = moderate to severe pain not completely relieved by analgesics and 4 = severe pain or swelling not relieved by analgesics and required unscheduled visit.
 Result: Forty percent of the patients in the two-visit group did not have any pain (measured in terms of visual analogue scale) at 12 hours compared to 25% in the single visit group, although the difference did not turn significant (p = 0.580). Likewise the proportion of patients without pain in the two-visit group was considerably higher (52.5%) at 24 hours than that in the single-visit group (45%) (p = 0.852). Improvement in pain sensation was reported to be significantly higher in the two-visit group (as 95% of the patients did not complain any pain) at 48 hours than that in the single-visit group (80% of the patients did not complain any pain) (p = 0.015). None of the patients of either group complained of pain one week postoperatively.
 Conclusion: Compared to single-visit, two-visit root canal treatment showed better results in terms of intensity of post-obturation pain at 12, 24 and 48 hours after root canal treatment for irreversible pulpitis.
 Ibrahim Card Med J 2015; 5 (1&2): 45-48

Trial suggests no difference between single-visit and two-visit root canal treatment

Randomised controlled trial. Patients over the age of 16 with radiographic evidence of apical periodontitis and a diagnosis of pulpal necrosis confirmed by negative response to hot and cold tests were randomised to receive either a one or two visit root canal treatment (RoCT). Clinical and radiographic evaluation was undertaken at two years by masked examiners. Two hundred and eighty-seven patients (300 teeth) were randomised. One hundred and fifty-five teeth were allocated to the single visit group and 145 to two-visit treatment. Eighteen teeth were lost to follow up, nine from each group. At two years there were no significant differences between the groups, with 96.57% (141 of 146 teeth) in the single-visit group being classified as healed compared with 88.97% (121 of 136 teeth) in the two-visit group. This study provided evidence that a meticulously instrumented single-visit root canal treatment can be as successful as a two-visit treatment. There was no significant difference in radiographic evidence of periapical healing between single-visit and two-visit root canal treatment.

One-Visit Versus Two-Visit Root Canal Treatment: Effectiveness in the Removal of Endotoxins and Cultivable Bacteria

IntroductionThis clinical study was conducted to compare the effectiveness of 1-visit versus 2-visit root canal treatment in removing endotoxins and cultivable bacteria from primarily infected root canals. MethodsForty-eight primarily infected root canals were selected and randomly divided into 4 groups: G1, 1% NaOCl; G2, 2% chlorhexidine (CHX) gel; G3, 1% NaOCl + Ca(OH)2; and G4, 2% CHX gel + Ca(OH)2 (all, n = 12). G1 and G2 involved 1-visit treatment, whereas G3 and G4 involved 2-visit treatment with the placement of Ca(OH)2 medication for 14 days. Samples were collected before and after root canal procedures. A chromogenic LAL assay test was used to quantify endotoxins. Culture techniques were used to determine bacterial counts. ResultsEndotoxins and cultivable bacteria were detected in 100% of the initial samples. All treatment protocols were effective in reducing bacterial load from infected root canals: G1 (1% NaOCl, 99.97%), G2 (2% CHX gel, 99.75%), G3 (1% NaOCl + Ca(OH)2, 99.90%), and G4 (2% CHX gel + Ca(OH)2, 96.81%), respectively (P < .05). No differences were found in bacterial load reduction when comparing 1-visit and 2-visit treatment groups, irrespective of the irrigant tested (P > .05). Higher median percentage values of endotoxin reduction were achieved in the 2-visit treatment groups (G3, 98.01% and G4, 96.81%) compared with 1-visit treatment groups (G1, 86.33% and G2, 84.77%) (all P < .05). ConclusionsBoth 1-visit and 2-visit root canal treatment protocols were effective in reducing bacteria and endotoxins, but they were not able to eliminate them in all root canals analyzed. Furthermore, 2-visit root canal treatment protocols were more effective in reducing endotoxins than 1-visit root canal treatment protocols.

Success Rate of Single- versus Two-visit Root Canal Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial

IntroductionThe aim of this study was to evaluate the outcome of single- versus 2-visit root canal treatment of teeth with apical periodontitis after a 2-year follow-up period. MethodsThree hundred maxillary and mandibular nonvital teeth with apical periodontitis were treated in either a single visit or 2 visits. The main inclusion criteria were radiographic evidence of apical periodontitis (minimum size ≥2.0 × 2.0 mm) and a diagnosis of pulpal necrosis confirmed by a negative response to hot and cold tests. Radiographically, all teeth showed small and irregular periapical radiolucencies before treatment. The canals were enlarged with LightSpeedLSX (Discus Dental, Culver City, CA) root canal instruments to a final apical preparation size #60 for anterior and premolar teeth and size #45 to #55 for molars. The EndoVac negative-pressure irrigation system (Discus Dental) was used for disinfecting irrigation, and all canals were filled by lateral compaction of gutta-percha and Sealapex sealer (SybronEndo, Orange, CA). The healing results were clinically and radiographically evaluated 2 years postoperatively. ResultsOf the 300 teeth treated, 18 were lost to follow-up, 9 in the 2-visit group and 9 in the 1-visit group. Of the 282 teeth studied, the randomization procedure had allocated 146 teeth to 1-visit treatment and 136 teeth to 2-visit treatment. Teeth with symptoms of persisting periapical inflammation were scored as not healed. Teeth with a reduced periapical rarefaction were judged as uncertain. Teeth with complete restitution of the periodontal contours were judged as healed. In the 1-visit group, 141 of 146 teeth (96.57%) were classified as healed as compared with 121 (88.97%) of 136 teeth in the 2-visit group. Eleven cases were classified as uncertain in the 2-visit group (8.08%) compared with 4 (2.73%) in the 1-visit group. Two of 10 teeth in the 2-visit group presented with pain before the 2-year follow-up and were classified as not healed. The hypothesis tests were conducted at the 0.05 level of significance. Statistical analysis of the healing results did not show any significant difference between the groups (P = .05). ConclusionsSeveral factors play an important role in the decision-making process of 1- versus 2-visit endodontics. Among these are objective factors like preoperative diagnosis, the ability to obtain infection control, root canal anatomy, procedural complications, and subjective factors like patients' signs and symptoms. This study provided evidence that with a treatment protocol with instrumentation to predefined larger apical instrumentation sizes and irrigation with a negative apical pressure system can lead to healing in cases of apical periodontitis, which is a significant finding compared with more dated studies that showed average healing of apical periodontitis cases. With the given sample size, there was no statistically significant difference between the 2 treatment modalities.

Incidence of post-operative pain after single visit and multiple visit root canal treatment: A randomized controlled trial

Aim:To compare the incidence and intensity of post-obturation pain after single or multi visit root canal treatment on single rooted teeth in a randomized controlled trial.Materials and Methods:Two hundred patients requiring root canal treatment on permanent single rooted teeth (both vital and non vital) were included. The patients were assigned randomly into two groups of 100 patients each. The teeth in Group1 (n = 100) were obturated at the first visit, whilst those in Group 2 (n = 100) were obturated in a second visit 7 days later. A modified Heft Parker visual analog scale was used to measure pre-operative pain and post-obturation pain at 6, 12, 24 and 48 hours after obturation. Independent-sample T-tests was used for statistical analysis.Results:Twelve patients were excluded from the study as they failed to follow the scheduled revisit. Data were obtained from the remaining 188 patients. There was no statistically significant difference in the incidence and intensity of post-obturation pain experienced by two groups.Conclusions:The incidence and intensity of post-obturation pain experience following one- or two-visit root canal treatment on teeth with a single canal were not significantly different.

Comparison of post‐obturation pain experience following one‐visit and two‐visit root canal treatment on teeth with vital pulps: a randomized controlled trial

To compare the incidence and intensity of post-obturation pain after one- or two-visit root canal treatment (RCT) on anterior teeth with vital pulps and a single root and canal in a randomized controlled trial. One hundred patients requiring RCT on permanent anterior teeth with vital pulps preoperatively were included. The patients were assigned randomly into two groups of 50 patients each. After local anaesthesia, isolation, access and pulp extirpation, the canals of all teeth were prepared using engine-driven rotary ProTaper nickel-titanium instruments in a crown-down technique and irrigated with 2.5% NaOCl. The teeth in group 1 (n = 50) were filled with AH Plus sealer and gutta-percha using a lateral compaction technique at the first visit, whilst those in group 2 (n = 50) were medicated with a calcium hydroxide paste, a sterile dry cotton pellet and Caviton and scheduled for a second visit 7 days later. A modified verbal descriptor scale was used to measure preoperative pain and post-obturation pain at 6, 24, 48 h and 1 week after operation. Chi-square tests and independent-sample T-tests were used to compare the incidence and intensity of post-obturation pain of two groups at each interval. Eleven patients were excluded from the study as they failed to follow the scheduled revisit or their selected teeth had more than one root canal. Data were obtained from the remaining 89 patients. Forty-three patients were undergoing one-visit treatment (group 1) and 46 undergoing two-visit treatment (group 2). Most patients in both groups reported no pain or only slight pain within each post-obturation interval, only one in group 1 and one in group 2 had flare-ups and slight swelling. There was no statistically significant difference in the incidence and intensity of post-obturation pain experienced by two groups. The incidence and intensity of post-obturation pain experience following one- or two-visit RCT on teeth with vital pulps and a single canal were not significantly different.

Postobturation pain and associated factors in adolescent patients undergoing one- and two-visit root canal treatment

Objectives This prospective study evaluated the frequency and intensity of postobturation pain and associated factors in adolescents undergoing one- and two-visit root canal treatment. Methods 121 patients aged 11–18 years presenting with molars with pulp necrosis were assigned randomly into two treatment groups: one- and two-visit (including interappointment dressing with calcium hydroxide paste). The canals of all teeth were prepared using a preflaring (2/3 middle-cervical) and step-back (1/3 apical) preparation techniques and filled with laterally compacted gutta-percha and sealer. Postobturation pain was recorded on a visual analogue scale (VAS) of 0–5. Data were statistically analyzed using multivariate logistic regression. Results The frequencies of postobturation pain were 10.5% (6/57) in the one-visit group and 23.0% (14/61) in the two-visit group. There were no statistically significant differences between the groups ( p = 0.07). The intensity of the pain was similar in both groups, particularly flare-ups, with a prevalence of 1.75% in the one-visit group and 1.65% in the two-visit group. Postobturation pain was significantly associated with the presence of preoperative pain ( p = 0.04; OR = 3.54; CI 95% = 1.02–12.30) and a positive culture at the time of obturation ( p = 0.00; OR = 9.43; CI 95% = 2.93–30.35). Conclusions Postobturation pain was more present in the two-visit group, but was not statistically significant. The intensity of postobturation pain was similar. Effective microbiological control and the presence of preoperative pain may influence the postobturation pain in adolescents.

Postoperative pain after endodontic retreatment: Single- versus two-visit treatment

Objective The purpose of this clinical study was to determine the effect of 1- or 2-visit root canal treatment on the postoperative pain in the retreatment cases. Study design Two hundred eighteen cases that required retreatment were included in the study. Obturated and unfilled canal space and the status of periapical tissues were evaluated according to the PAI index. The patients were subcategorized in regard to the presence or the absence of preoperative pain. Approximately half of each category was treated in 1 appointment. After removing the previous root canal obturation materials and biomechanic preparation of root canals, the teeth in the 1-visit group were obturated at the first appointment by using AH 26 sealer and laterally compacted gutta-percha, and those in the 2-visit group were medicated with calcium hydroxide–chlorhexidine combination and then closed with a temporary filling material. One week after the initial appointment, patients were asked about the occurrence of postoperative pain. The level of discomfort was rated as no pain, mild pain, moderate pain, or severe pain (flare-up). Data were statistically analyzed using the chi-squared and Fischer exact tests. Results Eight patients from the 1-visit group and 2 patients from the 2-visit group had flare-ups. There was a statistical difference between the groups ( P < .05). Two-visit root canal treatment was more effective in completely eliminating pain than 1-visit treatment of previously symptomatic teeth ( P < .05). Conclusions Two-visit endodontic treatment with intracanal medication was found to be effective in reducing postoperative pain of previously symptomatic teeth and decreased the number of flare-ups in all retreatment cases.

Prevalence of and factors affecting postpreparation pain in patients undergoing two-visit root canal treatment.

This longitudinal, prospective study (i) investigated the prevalence of postpreparation pain during root canal treatment and (ii) evaluated the influence of factors affecting the pain experience. Twenty practitioners, comprising general dental practitioners, MSc graduates and endodontists, participated in this study. The patient sample (n=272) was derived from consecutive patients attending the practitioners' surgeries for a two-visit root canal treatment on a single tooth. Demographic, medical history, preoperative and intraoperative data as well as pain experience on days 1 and 2 after root canal preparation were recorded. Intensity of pain experienced was recorded on a visual analogue scale (VAS) of 0-5. The data were analysed using logistic regression models. The prevalence of postpreparation pain within 48 h after treatment was 64.7% (n=176), but less than 10% of patients experienced severe pain (VAS 4 or 5) on either day 1 or day 2. The presence of preoperative pain (OR=2.841, P<0.001), tooth type (OR=2.008, P=0.009), systemic steroid therapy for other medical reasons (OR=0.181, P=0.023) and preoperative swelling (OR=2.433, P=0.040) were the only factors to significantly influence postpreparation pain experience. The prevalence of postpreparation pain was high, and the important prognostic determinants were presence of preoperative pain, tooth type, systemic steroid therapy and preoperative swelling.