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Title |
Two-Visit Endodontic Treatment Versus One-Visit Endodontic Treatment For necrotic teeth With Periapical Periodontitis |
Clinical Question |
For a patient presenting with periapical periodontitis, does an endodontic treatment completed in one visit take longer to heal than a two-visit endodontic treatment with placement of calcium hydroxide in the instrumented canal between visits? |
Clinical Bottom Line |
One-visit endodontic treatment is as effective in healing periapical lesions compared to two-visit endodontic treatment with placement of calcium hydroxide between visits. This is true in cases where effective disinfection can be achieved in one appointment. (See Comments on the CAT below) |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 18291270 | Penesis/2008 | 63 patients with evidence of periapical periodontitis; 33 in a one-visit group; 30 in a two-visit group | randomized controlled trial | Key results | Both groups exhibited equally favorable periapical healing at 12 months, with no statistically significant differences between the groups. The primary outcome measure was the change in periapical bone density. | #2) 15910469 | Sathorn/2005 | 3 RCT were found | systematic review and meta-analysis | Key results | Based on the current best available evidence, single-visit root canal treatment appeared to be slightly more effective than multiple visit, i.e. 6.3% higher healing rate. However, the difference in healing rate between these two treatment regimens was not statistically significant (P = 0.3809). | |
Evidence Search |
Pubmed; (("Periapical Periodontitis"[Mesh] AND "Root Canal Therapy"[Mesh]) AND "Treatment Outcome"[Mesh]) AND "Office Visits"[Mesh] |
Comments on
The Evidence |
The meta-analysis found 3 RCT that were all of small sample sizes, and the healing rates of a one-visit versus multi-visit endodontic appointment were not statistically significant. |
Applicability |
If healing rates of periapical periodontitis is similar for one-visit versus two-visits then in a practice setting it would be clinically acceptable to complete root canal therapy in one visit. The benefit to the patient is only one visit without risk of prolonged healing of the periapical lesion. And for the dentist this means successful treatment in less appointments. |
Specialty/Discipline |
(Endodontics) (General Dentistry) |
Keywords |
periapical periodontitis; calcium hydroxide; multi-visit endodontics; one-visit endodontics; root canal therapy; office visits; treatment outcome
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ID# |
488 |
Date of submission: |
01/07/2010 |
E-mail |
naomiseverdds@gmail.com |
Author |
Nicholas Sager |
Co-author(s) |
Naomi Sever |
Co-author(s) e-mail |
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Faculty mentor/Co-author |
Kenneth Hargreaves, DDS, PhD |
Faculty mentor/Co-author e-mail |
HARGREAVES@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Jonathan Fu (San Antonio, TX) on 07/09/2012 After using identical search terms as this CAT, the current literature still supports the findings of this CAT. The Randomized Clinical Trial from 2008 by Penesis et. al., is still the best study to support the CAT. | by Sang Do (San Antonio, TX) on 04/16/2012 The PubMed search I conducted on this topic April 2012 and found a more recent in vivo study that have the same findings as the published CAT: PubMed ID 21838499. | |
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