Single-visit or multiple-visit root canal treatment: systematic review, meta- analysis and trial sequential analysis

By Schwendicke F, Göstemeyer G

Date: 01/2017
Journal: BMJ

Q: In patients needing root canal treatment (P), is single-visit treatment (I) significantly more effective than multiple-visit treatment (C) with regard to risk of long-term failure (O)?

to compare both treatments with regard to risk of short- term postoperative pain as well as the risk of flare-up. 

Materials/Methods: 

•Electronic search in multiple libraries, N = 29 SRs (4341 patients)

•1ry Outcome = long-term complications (pain, infection, Sinus Tract, PAL occurrence or increase in size)

•2ry Outcome = short-term complications (pain, flareup, PAL)

•Use of Intracanal medicaments, preop pulp status, preop pain, presence of RGPAL were assessed

•Risk of bias assessed, type of primary studies, overall analysis

•Electronic search in multiple libraries, N = 29 SRs (4341 patients)

•1ry Outcome = long-term complications (pain, infection, Sinus Tract, PAL occurrence or increase in size)

•2ry Outcome = short-term complications (pain, flareup, PAL)

•Use of Intracanal medicaments, preop pulp status, preop pain, presence of RGPAL were assessed

•Risk of bias assessed, type of primary studies, overall analysis

Most highlighted Results:  

•Risk of long-term complications:

* Not significantly different in single VS multi  *

Preoperative condition not significantly affective

•Risk of short-term complications:

•Not significantly different in single VS multi

•Preop condition or use of CaOH had no significant impact

•Risk of flare up was significantly higher after single visits

Conclusion:

•It is important to evaluate cases carefully and avoid single visit RCT in cases where risk of complication is increased