01 October 2021

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Single versus multiple visit: which is the best endodontic approach with necrotic teeth?

Alessandra Abbà

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Endodontic postoperative pain is an unpleasant sensation that occurs after root canal treatment. Endodontic postoperative pain occurs in 3 to 58% of the cases- depending on many individual variables- and is caused by a chemical or mechanical injury to periradicular tisses, for example a Sodium hypoclorite (NaOCl) or a root canal sealer leak.

In necrotic teeth with infected canals, the incidence of pain increases. In these cases the aim of the therapy is to create a bacteria-free environment and it could be achieved through an endododontic treatment carried out in in single visit or multiple visit. Performing the endodontic treatment in multiple visit could give the clinician the possibility to exploit the antibacterial power of the medication, on the other hands the chance of endodontic postoperative pain with single visit seem to decrease. However this has always been object of dispute. 

So the aim of this study is to determine the frequency of endodontic postoperative pain of single versus multiple visit  root canal treatment of necrotic teeth with infected root canals.

Materials and Methods
This randomized controlled study was conducted from January to June 2016 at Medical University in Islamabad. Necrotic, single rooted teeth of both upper and lower arch were included. The 60 patient selected were randomly divided into two groups: in group 1 the endodontic treatments were carried out in single visit, while in goup 2 in multiple visit  with the placement of a intra canal medication and the obturation carried out 5 days later.
Patients were recalled within 48 hours after obturation to record the endodontic postoperative pain score using visual analogue scale.

Results
no significant difference in post-operative pain were registered in the two groups (p=0.8). The frequency and the intensity of endodontic postoperative pain showed similar values.  

Conclusions
Treatment of necrotic teeth in single visit  or multiple visit  could be carried out in safety in both cases. Nonetheless single visit  approach has several advantages like saving time, cost-effectiveness and better patient acceptance. 

For additional information: Comparison of frequency of post-obturation pain of single versus multiple visit root canal treatment of necrotic teeth with infected root canals. A Randomized Controlled Trial