Incidence of periapical lesions and clinical symptoms after pulpectomy--a clinical and radiographic evaluation of 1- versus 2-session treatment. Incidence of postoperative pain after one-appointment endodontic treatment of asymptomatic pulpal necross in single-rooted teeth. Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. A comparative study of the single-visit and the multiple-visit edodontic procedure. Flare-ups incidence and severity after using calcium hydroxide as intracanal dressing. Postoperative pain after endodontic retreatment: single- versus two-visit treatment. Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms. Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions. Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a Nigerian teaching hospital. Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital. Postobturation pain after single- and multiple-visit endodontic therapy. A prospective study. Postoperative pain after 1- and 2-visit root canal therapy.
Outcome of pulpectomy in 2 treatment sessions with calcium hydroxide as an intracanal dressing was compared to a procedure comprising instrumentation and root-filling in 1 session.
                Subjects with a vital pulp condition (N = 256) were recruited to a randomized clinical trial. Outcome parameters included radiographic signs of apical periodontitis and painful symptoms at clinical follow-ups 1 week and 1-3 years after treatment.
                Of 244 subjects available for final recall, 17 presented with periapical radiolucency. Lesions were evenly distributed among the 2 treatment groups. Postoperative pain recorded 1 week after permanent filling was significantly associated with overfilling (P = .001), with no difference between treatment groups. There was no association with presence of overfilling and radiographic lesion at end point of recall.
                Study confirms that pulpectomy may be carried out at a high rate of success if due attention is given to aseptic operating procedures, proper instrumentation and filling. Under these conditions an interappointment dressing with calcium hydroxide does not seem to influence outcome. nan This study was performed to evaluate radiographic healing of teeth with apical periodontitis, treated in one visit or in two visits (a) with or (b) without calcium hydroxide as an intracanal disinfecting medicament. The patients were assigned one of the three treatment groups by the throwing of a die. The Periapical Index (PAI) Scoring Method was used to compare differences in periapical status from the beginning of treatment to a 52-wk follow-up evaluation. Overall, the periapical status of the treated teeth improved significantly after 52 wk (p < 0.0001). A PAI score of 1 or 2 was considered as representing a "good" periapical status while 3, 4, or 5 was a "bad" status. When base line PAI scores were controlled for, the calcium hydroxide group showed the most improvement in PAI score (3, 4, or 5 to 1 or 2), followed by the one-step group (74% vs. 64%). The teeth that were left empty between visits had clearly inferior healing results. Power statistics were conducted to determine the numbers required for significant differences between the groups, and it was shown that large experimental groups on the order of hundreds of patients would be required to show significant differences. nan Acute pain and swelling following endodontic treatment are a challenge for both the patient and the dentist. According to previous studies, the incidence of flare-ups increases after endodontic treatment of teeth with necrotic pulps. Calcium hydroxide is currently used as a multi-purpose drug in root canal therapy. The aim of this study was to evaluate the incidence and severity of flare-ups after treatment of pulpless teeth using calcium hydroxide as an intracanal dressing. Sixty patients with single-root necrotic teeth participated in this study. These patients were randomly divided into three groups of 20. The patients were treated in Group A in a single-visit approach, in group B with a two-visit approach without any intracanal dressing and group C with a two-visit approach using calcium hydroxide as an intracanal dressing for one week. All of the patients were followed for 72 hours after each treatment session. The information about the incidence and severity of pain and swelling was recorded in tables, using a modified Visual Analogue Scale for pain severity measurement and a scale with four degrees for measuring the severity of swelling. The data were analyzed by chi-square test and GENMODE procedure. 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.
                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.
                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).
                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. The purpose of the present study is to evaluate the healing of periapical lesions of teeth with positive and negative canal cultures at the time of obturation, and to evaluate the periapical healing of teeth treated in one visit (without) or in two visits with an interappointment dressing of calcium hydroxide.
                Thirty-nine patients received root-canal treatment. In the first visit, teeth were instrumented, and 18 of these teeth were filled (after microbiological sampling) with calcium hydroxide in sterile saline. The other 21 teeth were obturated with gutta-percha and AH-26 sealer after microbiological sampling. Four weeks later, the teeth with calcium hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer. Healing of periapical radiolucency was recorded over a period up to 4.5 years.
                In both the treatment groups, the size of the periapical lesions reduced significantly during the follow-up period. Complete radiographic healing was observed in 81% of the cases in the one-visit group, and in 71% of the cases in the two-visit group. The probability of success increased continuously over time for both treatment groups. Seven out of eight cases (87.5%) that showed a positive root-canal culture at the time of obturation healed. The number of colony forming units (CFU) in six out of eight positive canals was <10(2) CFU mL(-1).
                Within the limitations of this study, no significant differences in healing of periapical radiolucency was observed between teeth that were treated in one visit (without) and two visits with inclusion of calcium hydroxide for 4 weeks. The presence of a positive bacterial culture (CFU<10(2)) at the time of filling did not influence the outcome of treatment. This prospective clinical study explored the influence of calcium hydroxide as an interappointment dressing on the healing of periapical lesions associated with pulpless teeth that had not been endodontically treated previously. This was achieved by comparing the prognosis after a two-visit root canal treatment with that following a one-visit treatment.
                Seventy-three patients were recruited having one tooth with an endodontically induced lesion. Of these patients, 67 could be re-examined. Calcium hydroxide was placed in the instrumented root canals of 31 teeth for at least one week and the treatment finished at the second visit. Thirty-six teeth were root canal treated at one visit. The criteria for success were the absence of signs and symptoms indicating an acute phase of periapical periodontitis and radiographically a periodontal ligament space of normal width. Methods for event time analysis were used to evaluate and compare the prognosis of both treatment approaches.
                The probability that complete periapical healing will take place increased continuously with the length of the observation period. In both treatment groups the likelihood that the root canal treatment yields a success within an observation time of five years exceeded 90%. A statistically significant difference between the two treatment groups could not be detected.
                From a microbiological perspective, one-visit root canal treatment created favourable environmental conditions for periapical repair similar to the two-visit therapy when calcium hydroxide was used as antimicrobial dressing. One-visit root canal treatment is an acceptable alternative to two-visit treatment for pulpless teeth associated with an endodontically induced lesion. BACKGROUND: Until 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. METHODS: Data 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. RESULTS: Ten 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. CONCLUSION: The 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. This prospective study was conducted to determine the flare up rate related to root canal treatment of asymptomatic non vital maxillary central incisor teeth performed in one and two appointments and the relationship, if any between pain and number of treatment visits.
                The frequency of postobturation pain and swelling was recorded and evaluated over an observation period of 1 week in a 120 consecutive patients undergoing root canal treatment. The patients were assigned randomly into one of two groups of 60 patients each. The canals of all teeth were prepared and filled using the step-back preparation and lateral condensation filling techniques. The data were analyzed statistically using Mann-Whitney test.
                Eight of the 120 patients were excluded from the analysis as they failed to attend for postoperative reviews. Out of the 112 patients involved in the study 90 patients had no pain, 9 patients had slight pain, 8 patients had moderate pain, and 5 patients had severe pain after 2 days. After 7 days 104 patients had no pain, 4 patients had slight pain, 3 patients had moderate pain and 1 patient had severe pain.
                No statistically significant difference in the incidence and degree of postoperative pain was found between one and two visit Endodontic procedures. The rate of post obturation flare up in asymptomatic Endodontically treated non vital maxillary centarl incisors was 11.6 and 3.6% after 2 and 7 days, respectively. This prospective study was conducted to determine whether there is any significant difference in the incidence of postobturation pain after single- and multiple-visit root canal treatment (RCT).
                The frequency of postobturation pain was recorded and evaluated over an observation period of 30 days in 291 of 300 consecutive patients receiving RCT. The patients were assigned randomly and consecutively into either single- or multiple-visit groups. The canals of all teeth were prepared and filled by a single operator using the step-back and lateral condensation techniques. The data were analysed statistically to determine the relationship, if any, between the pain experienced and pulpal vitality, tooth type, pre-operative pain, and the sex and age of the patient.
                Nine of the 300 patients were excluded from the analysis as they failed to attend for postoperative reviews. A significantly higher incidence (P < 0.01) of postobturation pain was found in the multiple-visit group (38%) than in the single-visit group (27%) within 24 h of obturation. The incidence of pain decreased thereafter, with all patients being sysmptom free at the end of the observation period. No significant correlation was found between postobturation pain and any other factor, with the exception that teeth which had nonvital pulp prior to treatment were associated with a significantly greater (P < 0.005) incidence of postobutration pain.
                Pain was significantly higher in the multiple-visit RCT group and significantly associated with the treatment of the nonvital pulp. The factors that influence postoperative pain after root canal treatment are not completely understood. The purpose of this prospective clinical study was to evaluate postoperative pain after root canal therapy performed in 1 appointment versus 2 appointments.
                Seventy-two patients requiring root canal therapy on permanent molars were included in this study. Patients were randomly assigned to either the 1-appointment or the 2-appointment group. Both vital and nonvital teeth were included. The standardized protocol for all teeth involved local anesthesia, isolation and access, engine-driven rotary nickel-titanium canal instrumentation to a minimum size #5 (.028 mm).04 taper Profile with step-back flaring, and irrigation with 2.5% NaOCl. Teeth in group 1 (n = 39) were obturated at the first appointment by using laterally condensed gutta-percha and Roth 811 sealer. Teeth in group 2 (n = 33) were closed with a sterile dry cotton pellet and Cavit restoration and were obturated at a second appointment 7 to 14 days later. A modified Visual Analogue Scale was used to measure preoperative pain and pain at 6, 12, 24, and 48 hours after the first appointment. Statistical analysis was performed to compare groups at each interval by using an independent-samples t test with Bonferroni adjustment.
                There was no statistically significant difference between groups at preoperative intervals or at any of the 4 postoperative intervals (P <.01).
                There was no difference in postoperative pain between patients treated in 1 appointment and patients treated in 2 appointments. The majority of patients in both groups reported no pain or only minimal pain within 24 to 48 hours of treatment.
No difference exists in the effectiveness of RoCT, in terms of radiological success, between single- and multiple-visit RoCT. Most short- and long-term complications are also similar in terms of frequency, although patients undergoing a single visit may experience a slightly higher frequency of swelling and are significatively more likely to take painkillers.