Effectiveness of single- versus multiple-visit endodontic treatment of teeth with apical periodontitis: a systematic review and meta-analysis.

By Sathorn C, Parashos P, Messer HH.

Date: 03/2006
Journal: IEJ


PICO: Does single-visit root canal treatment without calcium hydroxide dressing, compared to multiple-visit treatment with calcium hydroxide dressing for 1 week or more, result in a lower healing (success) rate (as measured by clinical and radiographic interpretation)?

N= 3 RCT


•Included studies were randomized controlled clinical trials comparing healing rate of single- and multiple-visit root canal treatment in humans. The outcome measured was healing of radiographically detectable lesions.

Inclusion criteria:

  • Subjects had a noncontributory medical history
  • Subjects presented with mature teeth with infected necrotic root canals and radiographic evidence of periapical bone loss.
  • All selected root canals had not received any endodontic treatment previously
  • Subjects underwent nonsurgical root canal treatment during the study
  • The outcome measure was the number of teeth that showed radiographic evidence of healing

Most highlighted Results: 

1.No studies demonstrated a statistically significant difference in healing rate (therapeutic efficacy) between single- and multiple-visit treatment.

2.Combining all 3 studies yielded 77% vs 71% healing for single vs multiple visit endodontics, respectively.

Clinical significance:

The Current best available evidence failed to demonstrate a difference between the two treatment regimens.