Effective one-visit therapy for the acute periapical abscess.

By Southard DW, Rooney TP

Date: 06/1984
Journal: JOE

Summary: 

Purpose: to evaluate a concise protocol for treating the abscessed tooth endodontically in a single visit.

N= 19 patients. Inclusion: patients of the emergency dental service who presented with endodontically involved teeth with associated soft tissue fluctuant swelling, teeth with one or 2 canals only.

Materials/Methods:

•All the treatment performed in single visit.

•All the teeth anesthetized with block anesthesia.

•Incision and drainage of the fluctuant swelling obtained before the procedure and maintained to 3 days post tx.

•Cleaning and shaping done using 5.25% NaOCl, GG coronally and K files apically.

•Obturation done with vertically condensed GP fitted using chloroform and coated with Kerr pulp canal sealer.

•7 days of antibiotics were prescribed (Penicillin V, 500 mg every 6 h, or erythromycin, 500 mg every 6 h).

•The patients were instructed to return in 3 days to evaluate the swelling and for drain removal.

•All patients were called at 24-h post operatively to check their pain status. •Patients were followed up at 3, 6 and 12 months to assess the healing process.

Most highlighted Results: 

•None of the patients experienced exacerbations of presenting signs and symptoms after treatment.

•Complete resolution of swelling was achieved within 3 to 7 days.

•All of the patients who were contacted at 24-h postoperatively (12 pts) reported either a significant decrease or complete absence of pain.

•At the 1-yr recall appointment, 11 of the original 19 patients returned. All were asymptomatic & showed radiographic evidence of reduction in lesion size.

Clinical significance: 

The proposed technique (single visit  RCT with incision/drainage and antibiotics) was found to be safe, effective and well tolerated method of treating ER cases on necrotic pulp with acute abscess.