A Comparison of One versus Two Appointment Endodontic Therapy in Dogs’ Teeth with Apical PeriodontitisHolland R, PhD, Filho JAO, PhD, de Souza V, PhD, et al.

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.

To know that we know what we know, and that we do not know what we do not know, that is true knowledge.

Henry DavidThoreau

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Abstract: The antimicrobial efficacy of endodontic procedures performed in one-visit (including a 10-min intra-appointment dressing with 5% iodine-potassium-iodide) was compared with a two-visit procedure (including an inter-appointment dressing with calcium-hydroxide paste). Teeth with apical periodontitis (n=96) were randomly assigned to either group. Root canal sampling and culturing were performed before and immediately after instrumentation, and after medication. Initial sampling demonstrated the presence of microorganisms in 98% of the teeth. Post instrumentation sampling showed reduction of cultivable microbiota. Antibacterial dressing further reduced the number of teeth with surviving microbes. In the post medication samples, residual microorganisms were recovered in 29% of the one-visit teeth and in 36% of the two-visit treated teeth. No statistically significant differences between the groups were discerned. It was concluded that from a microbiological point of view, treatment of teeth with apical periodontitis performed in two appointments was not more effective than the investigated one-visit procedure. (J Endod 2004;30(8);572-576)

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From: https://www.facebook.com/groups/rootsendo - Dr. Marco Laguna

Microbiological Evaluation of One- and Two-Visit Endodontic Treatment of Teeth with Apical Periodontitis: A Randomized, Clinical TrialKvist T, DDS, PhD, Molander A, DDS, PhD, et al

Clinical and Radiographic Evaluation of One- and Two-visit Endodontic Treatment of Asymptomatic Necrotic Teeth with Apical Periodontitis: A Randomized Clinical TrialMolander A, DDS, PhD, Warfvinge J, DDS, PhD, et al

Abstract: The present investigation recorded the 2-year clinical and radiographic outcome of one- and two visit endodontic treatment and studied the significance of the bacteriologic sampling results on the outcome. A randomization procedure allocated 53 teeth to one-visit treatment and 48 teeth to two-visit treatment. At the end of the study period, 32 teeth (65%) in the one-visit group and 30 teeth (75%) in the two-visit group were classified as healed. The statistical analysis of the healing results did not show any significant difference between the groups (p0.75). Forty-nine (80%) of the 61 teeth that were obturated after a negative micobiologic sample were classified as healed. Teeth sealed after positive samples healed in 44%. The present study gave evidence that similar healing results might be obtained through one- and two-visit antimicrobial treatment.(J Endod 2007;33:1145–1148)

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Abstract: The purpose of this study was to compare the favorable outcome of root canal treatment determined by periapical radiographs (PRs) and cone beam computed tomography (CBCT) scans. Ninety-six roots of dogs’ teeth were used to form four groups (n= 24). In group 1, root canal treatments were performed in healthy teeth. Root canals in groups 2 through 4 were infected until apical periodontitis (AP) was radiographically confirmed. Roots with AP were treated by one-visit therapy in group 2, by two-visit therapy in group 3, and left untreated in group 4. The radiolucent area in the PRs and the volume of CBCT-scanned periapical lesions were measured before and 6 months after the treatment. In groups 1, 2, and 3, a favorable outcome (lesions absent or reduced) was shown in 57 (79%) roots using PRs but only in 25 (35%) roots using CBCT scans (p = 0.0001). Unfavorable outcomes occurred more frequently after one-visit therapy than two-visit therapy when determined by CBCT scans (p = 0.023). (J Endod 2009; 35:723–726)

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An example of the segmentation procedure on a CBCT scan. The lesion is visible (arrow) on (A) a two-dimensional sagittal slice and is (B) highlighted in red. A three-dimensional volume-rendered image of the jaw is shown in C, and the lesion is highlighted in a three-dimensional view in D. The green box shows the region of interest selection.

Outcome of Root Canal Treatment in Dogs Determined by Periapical Radiography and Cone-Beam Computed Tomography ScansDe Paula-Silva FWG, DDS, MSc, Hassan B, BDS, MSc, da Silva LAB, DDS, MSc, PhD, et al

Identification of Cultivable Microorganisms from Root Canals with Apical Periodontitis Following Two-Visit Endodontic Treatment with Antibiotics/Steroid or Calcium Hydroxide DressingsChu FCS, BDS, MSc, PhD, Leung WK, BDS, MDS, PhD, et al

Abstract The study was aimed at comparing the efficacy of disinfection of root canals with periapical radiolucencies when treated with either antibiotics/steroid medicaments (Ledermix or Septomixine) or a calcium hydroxide paste (Calasept). Microbiological samples were taken before and after two-visit endodontic treatment from 88 canals with apical periodontitis. All of the canals but one (87 of 88) had cultivable growth before treatment. After dressing with Ledermix, Septomixine, or Calasept, the percentages of canals remained with positive growth were 48% (13 of 27), 31% (8 of 26), and 31% (11 of 35), respectively. The 2 tests showed there were no significant differences in the number of canals with positive growth or mean colony forming units counts after instrumentation, irrigation and dressing. In the Ledermix group, 38 strains of bacteria were recovered. The Septomixine group had 25 strains, and the Calasept group had 25 strains. Gram-positive facultative anaerobic cocci (including staphylococci and streptococci) were more prevalent than the Gram-negative obligate anaerobic rods after treatment in all three groups. Similarities in the reduced number of canals with residual growth, and the prevalence of Gram-positive facultative anaerobic cocci suggest that the use of different interappointment dressings produced similar microbiological outcomes. However, factors other than the antimicrobial effectiveness of intracanal medicaments may also be responsible for the results observed. (J Endod 2006;32: 17–23)

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Abstract: The Cochrane Collaboration promotes evidence-based healthcare decision making globally through systematic reviews of the effects of healthcare intervention. The purpose of this systematic review was to investigate whether the effectiveness and frequency of short-term and long-term complications are different when endodontic procedure is completed in one or multiple visits. Randomized and quasi-randomized controlled trials enrolling patients undergoing endodontic treatment were identified by searching biomedical databases and handsearching relevant journals. The following outcomes were considered: tooth extraction as a result of endodontic problems and radiologic failure after 1 year, postoperative discomfort, swelling, analgesic use, or sinus track. Twelve studies were included in the review. No detectable difference was found in the effectiveness of root canal treatment in terms of radiologic success between single and multiple visits. Neither single-visit root canal treatment nor multiple-visit root canal treatment can prevent 100% of short-term and long-term complications. Patients undergoing a single visit might experience a slightly higher frequency of swelling and refer significantly more analgesic use. (J Endod 2008; 34:1041–1047)

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pySingle Versus Multiple Visits for Endodontic Treatment of Permanent Teeth: A Cochrane Systematic ReviewFigini L, DDS, Lodi G, DDS, PhD, et al

Outcome of One-visit and Two-visit Endodontic Treatment of Necrotic Teeth with Apical Periodontitis: A Randomized Controlled Trial with One-year EvaluationPenesis VA, DDS, Fitzgerald PI, DDS, et al

Abstract: The choice of one-visit versus two-visit root canal therapy for necrotic teeth with apical periodontitis is a source of current debate. The primary objective of this randomized controlled clinical trial was to compare radiographic evidence of periapical healing after root canal therapy completed in one visit or two visits with an interim calcium hydroxide/chlorhexidine paste dressing. Ninety-seven patients met the inclusion criteria and consented to participate in this study. Patients were randomly assigned to either the one-visit or two-visit group, and root canal therapy was performed with a standardized protocol. Patients in the two-visit group received an intracanal dressing of calcium hydroxide/chlorhexidine paste. Sixty-three patients, 33 in the onevisit group and 30 in the two-visit group, were evaluated at 12 months. The primary outcome measure was change in apical bone density by using the periapical index (PAI). Secondary outcome measures were proportion of teeth healed or improved in each group. Both groups exhibited equally favorable periapical healing at 12 months, with no statistically significant differences between groups. (J Endod 2008;34:251–257)