Single VS Multiple Visit Endodontics

Abstract: The number of treatment visits required to perform root canal therapy (RCT) has been hotly debated since the establishment of endodontics as a specialty. Single-visit RCT involves cleaning, shaping, and obturation during a single treatment session. Alternatively, multiple-visit treatment includes placement of a short-term medicament, such as calcium hydroxide, for the time between the cleaning and shaping appointment and the obturation appointment. Many practitioners utilize outcomes data to justify their treatment decisions; however, the research comparing single- and multiple-visit RCT has consistently demonstrated equivalent outcomes for both treatment approaches. Although convenience clearly favors single-appointment therapy, patients generally prefer the approach that their provider recommends. As with any area of controversy regarding treatment selection, clinicians must understand the utility of each approach as well as its relative risks and benefits. The selection of either single- or multiple-visit RCT necessitates that practitioners consider factors beyond prognosis, including the presence of preoperative pain, infection status, pulpal and periapical diagnoses, case complexity, and any restorative concerns, to provide a framework for clinical decision-making. These factors should be considered together and not individually because significant interrelationships can exist among them. We will discuss some of the factors beyond outcomes that practitioners should consider in order to develop evidence-based justifications for both single- and multiple-visit RCT. Following the evidence as it relates to these factors allows practitioners to integrate clinical expertise with the most current findings to effectively address patients’ individual needs.

Objectives: 1- Indications of single visit endodontics
2- Advantages and disadvantages of single visit RCT
3- Indications of multiple visit endodontics
4- Advantages and disadvantages of multiple visit RCT
5- Different intracanal medications
6- Different clinical cases for single and multiple visit RCT
7- Recent evidence for single vs multiple visit RCT