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Alves-Silva EG, Arruda-Vasconcelos R, Louzada LM, de-Jesus-Soares A, Ferraz CCR, de Almeida JFA, Marciano MA, Steiner-Oliveira C, Bello-Silva MS, Shemesh H, Paula Figueiredo de Almeida Gomes B. The effect of photodynamic therapy on postoperative pain in teeth with primary endodontic infection. Photodiagnosis Photodyn Ther 2021; 37:102700. [PMID: 34954090 DOI: 10.1016/j.pdpdt.2021.102700] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The objective of this study was to investigate the action of photodynamic therapy on pain control after endodontic treatment in asymptomatic teeth with a primary infection, within a single visit. METHODS Sixty (60) single-rooted teeth with pulp necrosis and periapical lesions were selected and randomly divided into two (2) groups (n=30), according to the protocol; a control group (CG) and a group using photodynamic therapy (aPDT). The canals were instrumented with Reciproc files # 25 up to 40 along the entire length of the canal, using 2% chlorhexidine gel as the auxiliary chemical substance, followed by irrigation with sterile saline. The canals were filled with Endomethasone N cement, 0.005% methylene blue, using AsGaAl diode laser, 660 nm wavelength, 100 mW of power and 9 J of energy, using optical fibers with 365 µm in diameter. RESULTS Pain intensity was assessed at 8, 12, 24, 48, 72 hours and 1 week after endodontic treatment using a visual analogue scale. The level of pain was classified as none (0), mild (1-3), moderate (4-7) or severe (8-10). The data were at a significance level of 5%. There was a statistically significant difference (p<0.05) in the periods of 8, 12, 24, 48 and 72 hours between the control group and the aPDT group. After 1 week, there was no statistically significant difference. CONCLUSIONS It is concluded that photodynamic therapy had a significant effect on decreasing post-endodontic treatment pain in teeth with necrotic pulp and asymptomatic periapical lesions.
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Affiliation(s)
- Esdras Gabriel Alves-Silva
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Lidiane Mendes Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Marina Angélica Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Carolina Steiner-Oliveira
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Marina Stella Bello-Silva
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | - Hagay Shemesh
- Department of Endodontology, Academic Centre for Dentistry of Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
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The Comparison of Short-Term Postoperative Pain in Single- versus Multiple-Visit Root Canal Treatment: A Systematic Review and Meta-Analysis Study. Pain Res Manag 2021. [DOI: 10.1155/2021/5574995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Postoperative pain after root canal therapy (RoCT) is an unpleasant experience for patients, and it could be affected by different factors. The times of visits could be one of these factors that were evaluated in various studies. However, there is inconsistent evidence on the relation between postoperative pain and the times of visits. Therefore, the current systematic review aimed to summarize the results of these studies and meta-analyze them. For this purpose, a comprehensive search was conducted in four main databases (Cochrane Database of Systematic Reviews, Web of Science, PubMed, and Scopus databases) for related English articles from 1978 to August 2020. The quality of studies was evaluated using the Delphi checklist. The heterogeneity of studies was determined by I2 statistic, and publication bias was assessed using the funnel plot and the Begg test. The results were presented by using relative ratio (RR) estimates and standard mean difference (SMD) with its 95% confidence intervals (CI) using a random-effects model. Initial searches from mentioned databases identified 1480 papers; of which only 27 of them met the inclusion criteria. In quality assessment, thirteen studies had quality scores of more than 7, two studies had 4 scores, and the rest had 5 scores. Overall, based on the available evidence, the meta-analysis showed that the risk of postoperative pain in single-visit was 1.02 times (CI 95% (0.99, 1.19), I2 = 60.7%,
) higher than that of the multiple-visit treatment. The mean difference of postoperative pain in single-visit was −0.30 (CI 95% (−0.36, −0.25), I2 = 0.94.4,
) compared with the multiple-visit treatment. Based on the results of this meta-analysis, the risk of postoperative pain in single-visit RoCT was higher than that in multiple-visit RoCT with acceptable statistical heterogeneity and moderate quality of the studies.
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Mantri S, Gupta N, Paul B, Dube K, Ghosh S. Incidence of postoperative pain after single-visit and multiple-visit root canal therapy: A randomized controlled trial. J Conserv Dent 2021; 24:348-353. [PMID: 35282580 PMCID: PMC8896126 DOI: 10.4103/jcd.jcd_216_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/04/2022] Open
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Singh A, Kumar A, Nazeer J, Singh R, Singh S. Incidence of postoperative flare-ups after single-visit and multiple-visit endodontic therapy in permanent teeth. J Indian Soc Pedod Prev Dent 2020; 38:79-83. [PMID: 32174633 DOI: 10.4103/jisppd.jisppd_354_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Single- and multiple-visit root canal treatment has been the subject of long-standing debate in the endodontic community, so the purpose of this study was to determine the incidence of postoperative flare-up after single- and multiple-visit endodontic therapy in permanent teeth. MATERIALS AND METHODS A total of 65 children aged >10 years who underwent root canal treatment were randomly categorized equally into two treatment groups: the first group underwent single-visit treatment, and the other group underwent multiple-visit therapy. The visual analog scale was employed to evaluate pain preoperatively and postoperatively after obturation. Recall visits were carried out after 1 week, 1 and 3, 6 and 9 months. The Statistical Package for the Social Sciences version 15.0 was employed for statistical analysis. RESULTS Except at the baseline, at all the other time intervals, the mean pain score in the multiple-visit group was higher as compared to that of the single-visit group; statistically no significant difference was found. CONCLUSION The mean pain score in the single-visit group was lower as compared to that of the multiple-visit group; however, the difference between the two groups was statistically significant (P > 0.05).
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Affiliation(s)
- Anju Singh
- Department of Dentistry, Nalanda Medical College and Hospital, Patna, Bihar, India
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- Department of Conservative Dentistry and Endodontics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Abhas Kumar
- Department of Oral and Maxillofacial Surgery, Patna Dental College and Hospital, Patna, Bihar, India
| | - Jazib Nazeer
- Department of Oral Pathology and Microbiology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Rohit Singh
- Department of Prosthodontics Crown Bridge and Implantology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Supriya Singh
- Private Practice, Department of Oral Medicine and Radiology, Patna, Bihar, India
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Alomaym MAA, Aldohan MFM, Alharbi MJ, Alharbi NA. Single versus Multiple Sitting Endodontic Treatment: Incidence of Postoperative Pain - A Randomized Controlled Trial. J Int Soc Prev Community Dent 2019; 9:172-177. [PMID: 31058068 PMCID: PMC6489520 DOI: 10.4103/jispcd.jispcd_327_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/13/2018] [Indexed: 11/05/2022] Open
Abstract
AIMS AND OBJECTIVES The aim of the study is to assess any considerable differences in the incidence and severity of postobturation pain after single- and multiple-visit root canal treatment. MATERIALS AND METHODS We carried our study on 400 successive patients who needed root canal treatment. They were randomly categorized into two groups of 200 each. First group underwent single-visit treatment and the other group underwent multiple-visit therapy. Visual analog scale was employed to evaluate pain preoperatively and postoperatively at 6, 12, 24, and 48 h after obturation. The Statistical Package for the Social Sciences version 20 was employed for analysis. RESULTS There was a male predominance (235; 60.26%). Of 390 cases, 167 were vital and 223 were nonvital. There was an insignificant difference between the preoperative and postoperative pain levels of vital and nonvital teeth of both the groups at different time intervals. CONCLUSION There was a less incidence of pain in multiple visit group than single-visit one, which was statistically significant.
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Affiliation(s)
- Moayad Ahmed A. Alomaym
- General Practitioner, Ministry of Health, King Fahad Specialist Hospital, Alqassim Region, Saudi Arabia
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Effects of Ibuprofen Compared to Other Premedication Drugs on the Risk and Intensity of Postendodontic Pain: A Systematic Review. Eur Endod J 2018; 3:123-133. [PMID: 32161868 PMCID: PMC7006579 DOI: 10.14744/eej.2018.83803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/12/2018] [Accepted: 08/10/2018] [Indexed: 11/20/2022] Open
Abstract
Objective This systematic review aims to evaluate the effects of ibuprofen compared to other drugs on the risk and intensity of postoperative pain resulting from endodontic treatment in adult patients. Methods A systematic search was carried out through Medline databases (Pubmed, Scopus, Web of Science, Cochrane, Lilacs, and BBO). There was no restriction on the publication year or idiom. The gray literature was explored. The Periodicos Capes Theses Databases and ProQuest Dissertations were also searched, as well as the unpublished and ongoing trials registry and the IADR abstracts (1990-2016). Solely randomized clinical trials that compared the risk or intensity of pain resulting from endodontic treatment in adult patients were included in this systematic review. The risk of bias of the articles was evaluated using the Cochrane Collaboration's tool. A random-effect meta-analysis was conducted for ibuprofen versus placebo and ibuprofen versus other drugs at 6, 8, and 24 hours. The GRADE approach was used to assess the quality of the evidence. Results A total of 1132 studies were identified, and only seven meet the eligibility criteria. No difference between the groups was detected in any of the meta-analysis. An exception was observed when one study was removed from the meta-analysis of pain intensity at 24 hours for ibuprofen versus placebo, favoring ibuprofen (SMD -0.67; 95% CI -1.05 to -0.17). The quality of evidence in all meta-analyses was graded as low or very low. Conclusion Results of the present systematic review indicate that there is no clear evidence supporting that preoperative ibuprofen is better than other drugs in reducing the risk and intensity of postendodontic pain.
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Erdem Hepsenoglu Y, Eyuboglu TF, Özcan M. Postoperative Pain Intensity after Single- versus Two-visit Nonsurgical Endodontic Retreatment: A Randomized Clinical Trial. J Endod 2018; 44:1339-1346. [DOI: 10.1016/j.joen.2018.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 11/15/2022]
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Sevekar SA, Gowda SHN. Postoperative Pain and Flare-Ups: Comparison of Incidence Between Single and Multiple Visit Pulpectomy in Primary Molars. J Clin Diagn Res 2017; 11:ZC09-ZC12. [PMID: 28511499 PMCID: PMC5427425 DOI: 10.7860/jcdr/2017/22662.9377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 11/19/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Endodontic treatment performed in either single- or multiple visit can be followed by numerous short- and long term complications. One of the short term complications include postoperative pain and flare-ups. The ability to predict its prevalence and forewarn the patient may go some way towards enabling coping strategies and help dentist in pain management treatment decisions. AIM To compare the incidence and intensity of postoperative pain and flare-ups between single- and multiple visit pulpectomy in primary molars. Also, to correlate the preoperative status of the pulp to postoperative pain and flare-ups. MATERIALS AND METHODS Eighty primary molars indicated for pulpectomy were included in the study and divided into two groups. Tooth treated and preoperative status of the pulp vitality was recorded. All the conventional steps in pulpectomy were followed. Teeth in Group 1 (single visit pulpectomy) were obturated on the same visit. Teeth in Group 2 (multiple visit pulpectomy) were obturated in the subsequent appointment. The recording of postoperative pain, flare-ups, use of medication were done after 24 hours, seven days and one month. RESULTS Four cases in both the groups reported postoperative pain (10%) at 24 hour recall, p=0.74. One flare-up (2.5%) was recorded in each group p=0.67. None of the patients reported pain at seventh day and one month recall. Postoperative pain was recorded in five non-vital teeth (13.5%) and three vital teeth (6.9%). However, it was statistically not significant p=0.53. CONCLUSION From the perspective of our study there was a low incidence of postoperative pain. The majority of patients in both groups reported no pain or only minimal pain within 24 hours of treatment. There were no differences between single- and multi visit treatment protocols with respect to the incidence of postoperative pain. No significant correlation could be found between pulp vitality and the incidence of postoperative pain.
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Affiliation(s)
- Shrirang Anand Sevekar
- Associate Professor, Department of Paediatric and Preventive Dentistry, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Subhadra Halemane Nagaraj Gowda
- Associate Professor, Department of Paediatric and Preventive Dentistry, YMT Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Abstract
Diseases of the dental pulp often have an infectious origin, and treatments are aimed to control infections of the root canal system. Endodontic treatment principles originally evolved on the basis of trial and error, and only in recent decades have scientific methods been adopted to support clinical strategies. Yet, relevant research on the disease processes, their diagnoses, and efficient treatment are rare in the endodontic literature. Hence, the advancement of biologically based knowledge significant to clinical endodontics has been slow. Therefore, many differences of opinion still prevail in this field of dentistry. This review highlights and analyzes the background of some of the more heavily debated issues in recent years. Specifically, it deals with disagreements regarding the clinical management of pulpal exposures by caries in the adult dentition, definitions of success and failure of endodontic therapy, and causes of and measures to control infections of the root canal system. Clearly, a most apparent gap in the published endodontic literature is the lack of randomized clinical trials that address the more significant controversial matters relating to the management of pulpal wounds, medication, and the number of appointments required for the treatment of infected root canals. However, trials in endodontics require extremely long follow-up periods if valid conclusions are to be generated. Therefore, it is not to be expected that there will be rapid solutions to these issues in the foreseeable future.
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Affiliation(s)
- G. Bergenholtz
- Department of Endodontology and Oral Diagnosis, Faculty of Odontology, The Sahlgrenska Academy at Göteborg University, Box 40530, Göteborg, Sweden
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Manfredi M, Figini L, Gagliani M, Lodi G. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev 2016; 12:CD005296. [PMID: 27905673 PMCID: PMC6463951 DOI: 10.1002/14651858.cd005296.pub3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament). The success of RoCT depends on a number of variables related to the preoperative condition of the tooth, as well as the endodontic procedures. This review updates the previous version published in 2007. OBJECTIVES To determine whether completion of root canal treatment (RoCT) in a single visit or over two or more visits, with or without medication, makes any difference in term of effectiveness or complications. SEARCH METHODS We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 14 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 5), MEDLINE Ovid (1946 to 14 June 2016), and Embase Ovid (1980 to 14 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 14 June 2016. We did not place any restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs of people needing RoCT. We excluded surgical endodontic treatment. The outcomes of interest were tooth extraction for endodontic problems; radiological failure after at least one year, i.e. periapical radiolucency; postoperative pain; swelling or flare-up; painkiller use; sinus track or fistula formation; and complications (composite outcome including any adverse event). DATA COLLECTION AND ANALYSIS We collected data using a specially designed extraction form. We contacted trial authors for further details where these were unclear. We assessed the risk of bias in the studies using the Cochrane tool and we assessed the quality of the body of evidence using GRADE criteria. When valid and relevant data were collected, we undertook a meta-analysis of the data using the random-effects model. For dichotomous outcomes, we calculated risk ratios (RRs) and 95% confidence intervals (CIs). For continuous data, we calculated mean differences (MDs) and 95% CIs. We examined potential sources of heterogeneity. We conducted subgroup analyses for necrotic and vital teeth. MAIN RESULTS We included 25 RCTs in the review, with a total of 3780 participants, of whom we analysed 3751. We judged three studies to be at low risk of bias, 14 at high risk, and eight as unclear.Only one study reported data on tooth extraction due to endodontic problems. This study found no difference between treatment in one visit or treatment over multiple visits (1/117 single-visit participants lost a tooth versus 2/103 multiple-visit participants; odds ratio (OR) 0.44, 95% confidence interval (CI) 0.04 to 4.78; very low-quality evidence).We found no evidence of a difference between single-visit and multiple-visit treatment in terms of radiological failure (risk ratio (RR) 0.91, 95% CI 0.68 to 1.21; 1493 participants, 11 studies, I2 = 18%; low-quality evidence); immediate postoperative pain (dichotomous outcome) (RR 0.99, 95% CI 0.84 to 1.17; 1560 participants, 9 studies, I2 = 33%; moderate-quality evidence); swelling or flare-up incidence (RR 1.36, 95% CI 0.66 to 2.81; 281 participants, 4 studies, I2 = 0%; low-quality evidence); sinus tract or fistula formation (RR 0.98, 95% CI 0.15 to 6.48; 345 participants, 2 studies, I2 = 0%; low-quality evidence); or complications (RR 0.92, 95% CI 0.77 to 1.11; 1686 participants, 10 studies, I2 = 18%; moderate-quality evidence).The studies suggested people undergoing RoCT in a single visit may be more likely to experience pain in the first week than those whose RoCT was over multiple visits (RR 1.50, 95% CI 0.99 to 2.28; 1383 participants, 8 studies, I2 = 54%), though the quality of the evidence for this finding is low.Moderate-quality evidence showed people undergoing RoCT in a single visit were more likely to use painkillers than those receiving treatment over multiple visits (RR 2.35, 95% CI 1.60 to 3.45; 648 participants, 4 studies, I2 = 0%). AUTHORS' CONCLUSIONS There is no evidence to suggest that one treatment regimen (single-visit or multiple-visit root canal treatment) is better than the other. Neither can prevent all short- and long-term complications. On the basis of the available evidence, it seems likely that the benefit of a single-visit treatment, in terms of time and convenience, for both patient and dentist, has the cost of a higher frequency of late postoperative pain (and as a consequence, painkiller use).
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Affiliation(s)
- Maddalena Manfredi
- University of ParmaPolo Clinico di Odontostomatologia, SBiBiT DepartmentVia Gramsci, 14ParmaItaly43100
| | | | - Massimo Gagliani
- DMCO San PaoloClinica OdontoiatricaVia Beldiletto 1MilanItaly20142
| | - Giovanni Lodi
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
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Tan KS, Yu VSH, Quah SY, Bergenholtz G. Rapid method for the detection of root canal bacteria in endodontic therapy. J Endod 2015; 41:447-50. [PMID: 25576208 DOI: 10.1016/j.joen.2014.11.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 09/22/2014] [Accepted: 11/29/2014] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Complete eradication of microorganisms is essential for successful root canal therapy. However, current methods to evaluate persistent bacteria after therapy are not widely practiced. Adenosine triphosphate (ATP) is an indicator of viable cells. The bioluminescence-based ATP assay is easy to perform, and results can be obtained in a clinically relevant time frame of 5 minutes. The aims of this study were to evaluate the sensitivity of the ATP detection method and the specificity of this assay for viable cells and to compare the ATP and culture methods from root canal samples of patients undergoing endodontic treatment. METHODS The sensitivity of the ATP assay was determined using bacterial species commonly isolated from root canals. Bacteria were treated with sodium hypochlorite; after which, culture plating and the ATP assay were performed. Forty-three root canal samples before (S1) and after (S2) instrumentation and 36 samples after the removal of calcium hydroxide dressing (S3) were collected from patients undergoing root canal treatment and subjected to ATP assay and anaerobic culture. RESULTS The sensitivity of the ATP assay was determined to be between 10 and 100 bacterial cells. This method of detection also correlated well with the presence of viable bacteria. The ATP readings obtained allowed clear segregation of anaerobic culture-positive and -negative samples obtained from infected root canals of patients. CONCLUSIONS The ATP detection method can be used as a rapid tool to determine the presence of viable bacteria during root canal therapy. This method may be potentially useful as an adjunct to root canal treatment.
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Affiliation(s)
- Kai Soo Tan
- Faculty of Dentistry, National University of Singapore, Singapore.
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Wong AWY, Zhang C, Chu CH. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment. Clin Cosmet Investig Dent 2014; 6:45-56. [PMID: 24855389 PMCID: PMC4020891 DOI: 10.2147/ccide.s61487] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy) AND (single-visit OR one-visit OR 1-visit). Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of single-visit versus multiple-visit endodontic treatment.
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Affiliation(s)
- Amy WY Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
| | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
| | - Chun-hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
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Bhagwat S, Mehta D. Incidence of post-operative pain following single visit endodontics in vital and non-vital teeth: An in vivo study. Contemp Clin Dent 2013; 4:295-302. [PMID: 24124293 PMCID: PMC3793548 DOI: 10.4103/0976-237x.118352] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This clinical study was conducted to compare the post-operative pain following single visit endodontics in vital and non-vital teeth, with and without periapical radiolucency. A total of 60 adult patients requiring root canal therapy in anterior and premolar teeth were selected for this study. Single sitting root canal treatment was carried out and the subjects were recalled after 2 weeks and instructed to fill out a series of self-report questionnaires for responses about pain in the interim after 1 day, 2 day, 3 day, 1 week and 2 weeks. In vital teeth (Group I) 60% of the treated cases had pain, of which 36% had mild pain (non-significant) and 24% had moderate pain (significant). In non-vital teeth without periapical radiolucency (Group II) 64% of cases had pain, of which 48% had mild pain (non-significant) and 16% had moderate pain (significant). In non-vital teeth with periapical radiolucency (Group III) 32% of the cases had pain of which 24% had mild pain (non-significant) and 8% had moderate pain (significant). None of the teeth in any of the groups had severe pain. There was no statistical difference between incidence of pain in vital and non-vital teeth without periapical radiolucency. Non-vital teeth with periapical radiolucency exhibited relatively less pain as compared with non-vital teeth without periapical radiolucency, but the pain continued in a significant percent of teeth even after 2 weeks. Pain incidence dropped significantly within a period of 1 day to 2 weeks in vital teeth and non-vital teeth without periapical radiolucency. There was a tendency for less incidence of significant pain after a single visit root canal treatment in these groups. Results obtained were comparable with those obtained by several investigators.
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Affiliation(s)
- Sumita Bhagwat
- Department of Conservative Dentistry and Endodontics, Padm. Dr. D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
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Ali SG, Mulay S, Palekar A, Sejpal D, Joshi A, Gufran H. Prevalence of and factors affecting post-obturation pain following single visit root canal treatment in Indian population: A prospective, randomized clinical trial. Contemp Clin Dent 2013; 3:459-63. [PMID: 23633809 PMCID: PMC3636834 DOI: 10.4103/0976-237x.107440] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aim: This prospective randomized clinical study (1) investigated the prevalence of post-obturation pain after single visit root canal treatment and (2) evaluated the influence of factors affecting the pain experience. Materials and Methods: One thousand three hundred and twenty eight (1328) patients were included in this study. Conventional single visit root canal treatment was carried out. The chemicomechanical preparation of root canals was done by a rotary protaper system with a combination of hand instruments. Post-operative pain was recorded by each patient by using visual analogue scale in well-defined categories at three time intervals, 12 h, 24 h, and 48 h. The data were analyzed using Fisher's exact test. Results: The prevalence of post-obturation pain (severe) within 48 h after treatment was 4% (n = 54) but less as compared to the pain experienced after 12 h (9%) and 24 h (8.6%). The factors that significantly influenced post-obturation pain experience were: Age (Fishers exact test = 46.387, P = 0.0), gender (Fishers exact test = 23.730, P = 0.0), arch (Fishers exact test = 11.710, P = 0.001), and presence of pre-operative pain (Fishers exact test = 67.456, P = 0.0). Conclusion: The presence of post-operative pain was low (4%). The important prognostic determinants of post-obturation pain were: Old age, female, mandibular teeth, and presence of pre-operative pain. The vital condition of the tooth does not affect the intensity and frequency of post-obturation pain.
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Affiliation(s)
- Syed Gufran Ali
- Department of Conservative Dentistry and Endodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
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Nery MJ, Cintra LTA, Gomes-Filho JE, Dezan-Junior E, Otoboni-Filho JA, Sivieri-Araujo G, Nery TS, Salzedas LMP. Estudo longitudinal do sucesso clínico-radiográfico de dentes tratados com medicação intracanal de hidróxido de cálcio. REVISTA DE ODONTOLOGIA DA UNESP 2012. [DOI: 10.1590/s1807-25772012000600005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: O tratamento endodôntico é de fundamental importância para abolir a infecção presente em dentes que apresentam necrose pulpar. OBJETIVO: O objetivo do presente estudo foi avaliar clínica e radiograficamente a eficácia dos tratamentos de canais radiculares de dentes com lesão periapical crônica, efetuados pelos graduandos em Odontologia, da Faculdade de Odontologia de Araçatuba - UNESP. MATERIAL E MÉTODO: Foram selecionados 100 pacientes que possuíam dentes com lesão periapical crônica para serem tratados. Após o preparo biomecânico, os canais radiculares receberam uma medicação intracanal de hidróxido de cálcio durante o período de 14 dias. Os canais radiculares foram obturados com cimento endodôntico à base de hidróxido de cálcio. Foi realizada a proservação por um período entre oito e 11 meses. RESULTADO: A análise dos resultados permitiu constatar a porcentagem de 78,46% dos casos com reparo total da lesão periapical e de 21,54% dos casos em que não houve evidências de reparo. CONCLUSÃO: Ocorreu reparo das lesões periapicais nos dentes tratados pelos graduandos da Faculdade de Odontologia de Araçatuba - UNESP.
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Singh S, Garg A. Incidence of post-operative pain after single visit and multiple visit root canal treatment: A randomized controlled trial. J Conserv Dent 2012; 15:323-7. [PMID: 23112477 PMCID: PMC3482743 DOI: 10.4103/0972-0707.101888] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 02/28/2012] [Accepted: 07/23/2012] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Smita Singh
- Department of Conservative Dentistry and Endodontics, Darshan Dental College, Udaipur, Rajasthan, India
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17
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Paredes-Vieyra J, Enriquez FJJ. Success Rate of Single- versus Two-visit Root Canal Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial. J Endod 2012; 38:1164-9. [DOI: 10.1016/j.joen.2012.05.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 05/27/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
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Pain Prevalence and Severity before, during, and after Root Canal Treatment: A Systematic Review. J Endod 2011; 37:429-38. [DOI: 10.1016/j.joen.2010.12.016] [Citation(s) in RCA: 199] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 12/10/2010] [Accepted: 12/20/2010] [Indexed: 11/18/2022]
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19
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Wang C, Xu P, Ren L, Dong G, Ye L. Comparison of post-obturation pain experience following one-visit and two-visit root canal treatment on teeth with vital pulps: a randomized controlled trial. Int Endod J 2010; 43:692-7. [DOI: 10.1111/j.1365-2591.2010.01748.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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de Andrade Risso P, da Cunha AJLA, de Araujo MCP, Luiz RR. Postoperative pain and associated factors in adolescent patients undergoing two-visit root canal therapy. AUST ENDOD J 2009; 35:89-92. [PMID: 19703082 DOI: 10.1111/j.1747-4477.2008.00134.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This prospective study investigated the frequency and intensity of postoperative pain and identified associated factors in adolescents undergoing two-visit root canal therapy. Sixty-four patients aged 11 to 18 years old presenting with molars with pulp necrosis were assigned consecutively to two visits (plus an interappointment dressing using calcium-hydroxide paste). Pain intensity was recorded on a visual analogue scale (VAS) of 0-5. Data were analysed using multivariate logistic regression. The frequency of postoperative pain was 32.8% (21/64), with intensities of VAS 1 and VAS 2 in 81%, VAS 3 in 14.3% and VAS 4 in 4.7% of the 21 cases in which it was experienced. Spontaneous preoperative pain (odds ratio (OR) = 6.60; 95% confidence interval (CI) = 1.61-26.97; P = 0.009) and absence of apical perodontitis (OR = 5.65; 95% CI = 1.34-23.87; P = 0.01) were associated with postoperative pain. The frequency of postoperative pain was high, but the intensity, in general, was low, including flare-ups. The presence of spontaneous preoperative pain and absence of apical periodontitis increase the probability of suffering from postoperative pain.
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Affiliation(s)
- Patrícia de Andrade Risso
- Department of Medical Clinic, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Singla R, Marwah N, Dutta S. Single Visit versus Multiple Visit Root Canal Therapy. Int J Clin Pediatr Dent 2008; 1:17-24. [PMID: 25206084 PMCID: PMC4086535 DOI: 10.5005/jp-journals-10005-1004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2008] [Accepted: 11/08/2008] [Indexed: 11/23/2022] Open
Abstract
Aim: The purpose of this study was to determine clinical success rate of single visit verses multiple visit root canal treatment in cariously exposed vital primary molars. Material& methods: 40 children in age group of 4 to 7 years were divided equally into two treatment groups and recall visits were carried out after one week, one month and three months and six months.
Results: Statistically no significant difference was found. Conclusion: Multiple visit and single visit root canal treatment demonstrated almost equal success but most important aspect for success in pulpectomy cases is the indication of each case and then its subsequent treatment, be it multiple or single visit root canal treatment.
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Affiliation(s)
- Rajesh Singla
- Postgraduate Student, Govt. Dental College, Rohtak, India
| | - Nikhil Marwah
- Asst. Professor, Govt. Dental College, Rohtak, India
| | - Samir Dutta
- Sr. Professor and Head, Govt. Dental College, Rohtak, India
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Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after Endodontic Treatment: A Meta-analysis of Literature. J Endod 2008; 34:1177-81. [DOI: 10.1016/j.joen.2008.07.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 07/06/2008] [Accepted: 07/16/2008] [Indexed: 10/21/2022]
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23
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Risso PA, Cunha AJLA, Araujo MCP, Luiz RR. Postobturation pain and associated factors in adolescent patients undergoing one- and two-visit root canal treatment. J Dent 2008; 36:928-34. [PMID: 18771838 DOI: 10.1016/j.jdent.2008.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2008] [Revised: 07/12/2008] [Accepted: 07/21/2008] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- P A Risso
- School of Medicine, Federal University of Rio de Janeiro, Brazil.
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Figini L, Lodi G, Gorni F, Gagliani M. Single Versus Multiple Visits for Endodontic Treatment of Permanent Teeth: A Cochrane Systematic Review. J Endod 2008; 34:1041-7. [DOI: 10.1016/j.joen.2008.06.009] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 06/24/2008] [Accepted: 06/25/2008] [Indexed: 11/25/2022]
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Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J 2007; 41:91-9. [PMID: 17956561 DOI: 10.1111/j.1365-2591.2007.01316.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this systematic review was to assess the evidence regarding postoperative pain and flare-up of single- or multiple-visit root canal treatment. METHODOLOGY CENTRAL, MEDLINE and EMBASE databases were searched. Reference lists from identified articles were scanned. A forward search was undertaken on the authors of the identified articles. Papers that had cited these articles were also identified through Science Citation Index to identify potentially relevant subsequent primary research. REVIEW METHODS The included clinical studies compared the prevalence/severity of postoperative pain or flare-up in single- and multiple-visit root canal treatment. Data in those studies were extracted independently. RESULTS Sixteen studies fitted the inclusion criteria in the review, with sample size varying from 60 to 1012 cases. The prevalence of postoperative pain ranged from 3% to 58%. The heterogeneity amongst included studies was far too great to conduct meta-analysis and yield meaningful results. CONCLUSION Compelling evidence indicating a significantly different prevalence of postoperative pain/flare-up of either single- or multiple-visit root canal treatment is lacking.
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Affiliation(s)
- C Sathorn
- Endodontic Unit, School of Dental Science, University of Melbourne, Melbourne, VIC, Australia.
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Figini L, Lodi G, Gorni F, Gagliani M. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev 2007:CD005296. [PMID: 17943848 DOI: 10.1002/14651858.cd005296.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms and clinical signs in teeth without radiographic evidence of periodontal involvement. The success of RoCT depends on a series of variables related to the preoperative condition of the tooth, as well as the endodontic procedures. OBJECTIVES To compare the effectiveness of single- and multiple-visit RoCT, measured as tooth extraction due to endodontic problems and radiological success.To assess the difference in short- and long-term complications between single- and multiple-visit RoCT. SEARCH STRATEGY The following databases were searched for relevant trials: Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, and EMBASE. Handsearching was performed for the major oral medicine journals. References of included studies and reviews were checked. Endodontics experts were contacted through e-mail. No language limitations were imposed. Date of last search was 6th March 2007. SELECTION CRITERIA Randomised and quasi-randomised controlled trials of patients needing RoCT were included. Surgical endodontic treatment was excluded. The outcomes considered were the number of teeth extracted for endodontic problems; radiological success after at least 1 year, that is, absence of any periapical radiolucency; postoperative pain; painkiller use; swelling; or sinus track formation. DATA COLLECTION AND ANALYSIS Data were collected using a specific extraction form. The validity of included studies was assessed on the basis of allocation concealment, blindness of the study, and loss of participants. Data were analysed by calculating risk ratios. When valid and relevant data were collected, a meta-analysis of the data was undertaken. MAIN RESULTS Twelve randomised controlled trials were included in the review. Four studies had a low risk of bias, four a moderate risk, and another four had a high risk of bias. The frequency of radiological success and immediate postoperative pain were not significantly different between single- and multiple-visit RoCT. Patients undergoing single-visit RoCT reported a higher frequency of painkiller use and swelling, but the results for swelling were not significantly different between the two groups. We found no study that included tooth loss and sinus track formation among its primary outcomes. AUTHORS' CONCLUSIONS 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.
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Abstract
A growing perception in endodontic circles is that root canal therapy requires one treatment visit only. One-visit endodontics offers many potential advantages. It is less time-consuming, resulting in less cost for the patient, potentially more profit for the dentist, less painful and less traumatic than multi-visit treatment. Conversely, if the pulp is necrotic and/or associated with periradicular disease, the root canal system is infected. In these cases, the root canal system should ideally be cleaned, an intracanal medication placed, and the canal filled at a second visit. In this paper we aim to review several aspects of one-visit versus multi-visit endodontic treatment and future perspectives in this field.
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Affiliation(s)
- Zahed Mohammadi
- Department of Endodontics, Sadoughi University of Medical Sciences, Yazd, Iran.
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Al-Negrish ARS, Habahbeh R. Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital. J Dent 2006; 34:635-40. [DOI: 10.1016/j.jdent.2005.12.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2005] [Revised: 11/27/2005] [Accepted: 12/06/2005] [Indexed: 10/25/2022] Open
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Gesi A, Hakeberg M, Warfvinge J, Bergenholtz G. Incidence of periapical lesions and clinical symptoms after pulpectomy—A clinical and radiographic evaluation of 1- versus 2-session treatment. ACTA ACUST UNITED AC 2006; 101:379-88. [PMID: 16504873 DOI: 10.1016/j.tripleo.2005.05.073] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Revised: 04/04/2005] [Accepted: 05/19/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVE 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. STUDY DESIGN 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Andrea Gesi
- Department of Endodontics and Restorative Dentistry, Faculty of Dentistry, University of Siena, Siena, Italy
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30
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Gagliani M, Colombo M, Maddalone M, Figini L, Gorni F, Lodi G. Single versus multiple visits for endodontic treatment of permanent teeth. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd005296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Oginni AO, Udoye CI. Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a Nigerian teaching hospital. BMC Oral Health 2004; 4:4. [PMID: 15566567 PMCID: PMC539257 DOI: 10.1186/1472-6831-4-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Accepted: 11/26/2004] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Adeleke O Oginni
- Department of Restorative Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Christopher I Udoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Yoldas O, Topuz A, Isçi AS, Oztunc H. Postoperative pain after endodontic retreatment: Single- versus two-visit treatment. ACTA ACUST UNITED AC 2004; 98:483-7. [PMID: 15472665 DOI: 10.1016/j.tripleo.2004.03.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Oguz Yoldas
- Department of Conservative Dentistry and Endodontics, University of Cukurova Faculty of Dentistry, Adana, Turkey.
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Abstract
Various treatment regimens for the relief of pain during endodontic therapy, including relief of occlusion, pre-medication, establishment of drainage, and intracanal and systemic medications are presented. In addition, the rationale for the use of placebos is discussed.
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Affiliation(s)
- Samuel Seltzer
- Maxillofacial Pain Control Center, Temple University, Philadelphia, PA, USA
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35
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Holland R, Otoboni Filho JA, de Souza V, Nery MJ, Bernabé PFE, Dezan E. A comparison of one versus two appointment endodontic therapy in dogs' teeth with apical periodontitis. J Endod 2003; 29:121-4. [PMID: 12597712 DOI: 10.1097/00004770-200302000-00009] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was conducted to observe the healing process in dogs' teeth with apical periodontitis after root canal treatment in one or two appointments. Premolars and anterior dogs' teeth had their root canals opened to the oral environment for 6 months before being treated. After root canal negotiation they were filled by the lateral condensation technique with gutta-percha points and Sealapex in one appointment or after a dressing with calcium hydroxide for 7 and 15 days. Six months after the treatment the animals were killed and the tissues prepared for histomorphological analysis. Scores attributed to the different histomorphological events were submitted to statistical analysis, which resulted in ranking the experimental groups from the best to the worst in the following way: (a) calcium hydroxide 14 days; (b) calcium hydroxide 7 days; and (c) one appointment. It was concluded that the use of a calcium hydroxide dressing helps to achieve better results (p < 0.01) than the treatment in one appointment.
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Affiliation(s)
- Roberto Holland
- Department of Endodontics, Faculdade de Odontologia de Araçatuba, UNESP, São Paulo, Brazil
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36
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DiRenzo A, Gresla T, Johnson BR, Rogers M, Tucker D, BeGole EA. Postoperative pain after 1- and 2-visit root canal therapy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:605-10. [PMID: 12075212 DOI: 10.1067/moe.2002.121900] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES 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. STUDY DESIGN 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. RESULTS There was no statistically significant difference between groups at preoperative intervals or at any of the 4 postoperative intervals (P <.01). CONCLUSIONS 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.
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Affiliation(s)
- S Kenrick
- Department of Operative Dentistry and Endodontics, University of Western Australia, Nedlands, Western Australia 6907
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Albashaireh ZS, Alnegrish AS. Postobturation pain after single- and multiple-visit endodontic therapy. A prospective study. J Dent 1998; 26:227-32. [PMID: 9594474 DOI: 10.1016/s0300-5712(97)00006-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES 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). METHODS 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. RESULTS 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. CONCLUSIONS Pain was significantly higher in the multiple-visit RCT group and significantly associated with the treatment of the nonvital pulp.
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Affiliation(s)
- Z S Albashaireh
- Department of Restorative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Abstract
Patient's perceived problems related to endodontically treated teeth are an important consideration for all dental practitioners. Chronic pain or restorative problems may occur that are not reported back to the attending dentist in a timely manner and thus may not be resolved. The authors conducted a study involving a one-year follow-up of endodontically treated patients. They offer suggestions for interventions that could minimize the reported problems.
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Affiliation(s)
- W K Lobb
- Department of Developmental Science and Community Heath, Marquette University School of Dentistry, Milwaukee, USA
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Fava LR. Single visit root canal treatment: incidence of postoperative pain using three different instrumentation techniques. Int Endod J 1995; 28:103-7. [PMID: 7665199 DOI: 10.1111/j.1365-2591.1995.tb00168.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A clinical study was carried out on nonvital maxillary central incisors to evaluate the incidence of postoperative pain following single-visit root canal treatment using three different instrumentation techniques. Ninety teeth from 78 patients whose ages ranged from 14 to 63 years were selected and divided into three groups. Each group (30 teeth) was prepared by a different coronal-to-apical technique using different instrument movement depending upon the technique employed: modified double-flared, crown-downpressureless and balanced force techniques. No difference was observed in the incidence of postoperative pain among the groups.
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Abstract
A clinical study using vital maxillary central incisors was performed to evaluate the incidence of postoperative pain after root canal treatment in one- or two-appointments using a calcium hydroxide-containing root canal sealer. No differences were observed between the two groups.
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Holland R, Soares IJ, Soares IM. Influence of irrigation and intracanal dressing on the healing process of dogs' teeth with apical periodontitis. ENDODONTICS & DENTAL TRAUMATOLOGY 1992; 8:223-9. [PMID: 1302685 DOI: 10.1111/j.1600-9657.1992.tb00248.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Dogs' teeth with apical periodontitis were treated endodontically, Dakin's solution being used in an experimental group as the irrigation solution, and camphorated paramonochlorophenol as an intracanal dressing. For a second group of teeth, the irrigation solution used was physiologic saline, dry cotton only being placed into the pulpal chamber to take the place of an intracanal dressing. In a second visit, overinstrumentation and a new application of the same kind of dressing were performed, the root canals being then filled with gutta-percha cones and zinc oxide-eugenol cement. Other specimens were treated, in one visit, where physiologic saline or Dakin's solution were the irrigation solutions. The animals were sacrificed 6 months after the obturation of the root canals. Histologic exams showed better results for the experimental group where Dakin's solution and camphorated paramonochlorophenol had been used, with signs of repair characterized by newly formed cementum and bone tissue, as well as a marked reduction in size of the periapical lesions. No differences were seen in the results with physiologic saline or Dakin's solution as irrigants.
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Affiliation(s)
- R Holland
- Department of Endodontics, UNESP, Araçatuba, Sao Paulo, Brasil
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Sommer M, Yaffe A. Endodontic therapy as an adjunct for treatment of juvenile periodontitis: case report. ENDODONTICS & DENTAL TRAUMATOLOGY 1991; 7:230-2. [PMID: 1810718 DOI: 10.1111/j.1600-9657.1991.tb00442.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The four first permanent molars in a 16-year-old girl with juvenile periodontitis were treated by selective grinding, tooth eruption, conventional periodontic treatment and endodontic therapy. The endodontic treatment was carried out as an elective procedure under ideal conditions, thereby pre-emptying the emergency treatment which would have been necessary following occlusal reduction. The two-year follow-up examination showed successful resolution of the original condition.
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Affiliation(s)
- M Sommer
- Department of Endodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem
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Abstract
The purpose of the study was to compare the flare-up rate for single-visit endodontics among teeth without radiographic or clinical signs of apical periodontitis, those with radiographic or clinical signs of apical periodontitis not previously root-treated, and those with apical periodontitis where retreatment was performed. All teeth were instrumented to a predetermined minimum size with a 0.5 per cent solution of sodium hypochlorite being used as the irrigant. The root canal was obturated without regard to the presence or absence of symptoms or diagnosis of the apical condition. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed, the patient was instructed to telephone immediately and was considered to have had a flare-up. Teeth without signs of apical periodontitis did not have any flare-ups. One flare-up occurred in 69 teeth with signs of apical periodontitis not previously root-treated. The majority of the flare-ups (3 of 22 teeth) occurred in teeth with signs of apical periodontitis requiring retreatment.
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Affiliation(s)
- M Trope
- Department of Endodontology, Temple University, School of Dentistry, Philadelphia
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Morse DR, Esposito JV, Furst ML. Comparison of prophylactic and on-demand diflunisal for pain management of patients having one-visit endodontic therapy. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1990; 69:729-36. [PMID: 2356085 DOI: 10.1016/0030-4220(90)90358-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To determine whether the posttreatment prophylactic use of diflunisal (Dolobid 500) would be more effective than the on-demand use of diflunisal in reducing endodontic posttreatment pain, the current open-label, randomized study was undertaken. After one-visit nonsurgical endodontic therapy, 100 patients with asymptomatic teeth having either vital-inflamed pulp, pulpal necrosis, or pulpal necrosis with periapical radiolucent lesion were randomly given either prophylactic diflunisal (two tablets immediately at the conclusion of the visit, then four tablets to be taken in the schedule of one every 8 to 12 hours for pain if needed) or on-demand diflunisal (same dosage schedule; pills to be taken only if needed). The outcome showed that compared to the on-demand usage, the posttreatment prophylactic administration of diflunisal resulted in a statistically significant reduction in the number of episodes of endodontic posttreatment pain that required analgesic intervention. It appears from the results of this study that the posttreatment prophylactic use of diflunisal is significantly more effective than the on-demand usage of diflunisal in reducing endodontic posttreatment pain for one-visit endodontic therapy with all types of originally asymptomatic endodontic conditions. Further studies are necessary to determine whether pretreatment prophylactic deflunisal would be more effective, and also the effectiveness of prophylactic diflunisal in reducing posttreatment pain in presenting symptomatic cases and for cases treated in multiple visits.
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Affiliation(s)
- D R Morse
- Temple University School of Dentistry, Department of Endodontology, Philadelphia, PA 19140
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Abstract
A clinical study using upper central incisors was carried out to evaluate the incidence of postoperative pain after root canal preparation by the double-flared technique. Sixty teeth with necrotic pulps from 48 patients whose ages ranged from 12 to 65 years were prepared and filled in either one or two appointments. No difference was observed in the incidence of postoperative pain between the two groups.
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Negm MM. Management of endodontic pain with nonsteroidal anti-inflammatory agents: a double-blind, placebo-controlled study. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1989; 67:88-95. [PMID: 2911450 DOI: 10.1016/0030-4220(89)90309-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The ability of two nonsteroidal anti-inflammatory agents--piroxicam and diclofenac--to control endodontic pain was compared with that of a placebo control in a double-blind study of 267 patients requiring endodontic therapy. Endodontic treatment was carried out over three visits with an interval of 5 to 7 days between each two consecutive visits. All patients were clearly instructed to take the medication only if they experienced pain, between the visits or postoperatively, for 3 consecutive days. The patients subjectively rated their pain on a scale of 1 to 4 as none, mild, moderate, or severe. The ratings were done preoperatively and at 2, 4 and 8 hours after the initial dose of medication was taken, as well as on the second and third days. Statistical analysis of the data revealed that both piroxicam and diclofenac significantly reduced the mean pain score at the end of all observations and were significantly superior to the placebo until the end of the study. More than 90% of the patients treated with piroxicam and more than 80% of the patients treated with diclofenac showed complete relief of pain. Overall, piroxicam was clearly more effective than diclofenac or the placebo. It provided more consistent relief of pain, beginning 2 hours after the initial dose, and it continued to do so at every interval thereafter. Diclofenac required longer time to reach maximum effectiveness. Piroxicam's superiority was greater at the first and second days after the initial dose of medication was taken. With respect to side effects, piroxicam was better tolerated by the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M M Negm
- Department of Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Egypt
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Torabinejad M, Kettering JD, McGraw JC, Cummings RR, Dwyer TG, Tobias TS. Factors associated with endodontic interappointment emergencies of teeth with necrotic pulps. J Endod 1988; 14:261-6. [PMID: 3251982 DOI: 10.1016/s0099-2399(88)80181-x] [Citation(s) in RCA: 118] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Genet JM, Hart AA, Wesselink PR, Thoden van Velzen SK. Preoperative and operative factors associated with pain after the first endodontic visit. Int Endod J 1987; 20:53-64. [PMID: 3471726 DOI: 10.1111/j.1365-2591.1987.tb00590.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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