Single Versus Multi‑visit Endodontic Treatment of Teeth with Apical Periodontitis: An In vivo Study with 1‑year Evaluation

Author(s):

Gurdeep SG*, Bhuyan AC, Kalita C, Das L, Kataki R and Bhuyan D

Background: Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy.

Aim: This prospective study was conducted with the objective to compare the periapical healing of teeth with AP treated in (a) single visit versus (b) two visits, either with or without Vitapex as an intracanal medicament.

Subjects and Methods: Patients were selected randomly from the Department of Conservative Dentistry and Endodontics. FortyâÂÂÃ?Â?ÂÂÃ?Â?three patients (81 teeth) met the inclusion criteria, i.e., AP (both symptomatic and asymptomatic) visible radiographically size ≥2 mm × 2 mm, not suffering from any immuneâÂÂÃ?Â?ÂÂÃ?Â?compromising disease, age between 16 and 65 years and tooth not accessed previously. Patients were randomly divided into three groups, i.e., singleâÂÂÃ?Â?ÂÂÃ?Â?visit group (Group 1), multiâÂÂÃ?Â?ÂÂÃ?Â?visit group without any intracanal medicament (Group 2), and multiâÂÂÃ?Â?ÂÂÃ?Â?visit group with Vitapex as interim intracanal medicament (Group 3). Comparison was done radiographically using periapical index (PAI). The primary outcome measure was the change in periapical radiolucency after 1 year assessed by PAI scores. The Mann–Whitney UâÂÂÃ?Â?ÂÂÃ?Â?test was used to evaluate differences between groups at baseline (immediate postoperative) and at the 12âÂÂÃ?Â?ÂÂÃ?Â?month followâÂÂÃ?Â?ÂÂÃ?Â?up evaluation. Change in PAI score for each group from baseline to 12âÂÂÃ?Â?ÂÂÃ?Â?month followâÂÂÃ?Â?ÂÂÃ?Â?up evaluation was tested with the Wilcoxon signed rank test. The secondary outcome measures, proportion of teeth in each group that could be considered improved (decreased PAI score) or healed (PAI <2), were assessed with the ChiâÂÂÃ?Â?ÂÂÃ?Â?square test.

Results: No statistically significant difference in periapical healing was found between three groups.

Conclusion: After 1âÂÂÃ?Â?ÂÂÃ?Â?year evaluation, no difference in periapical healing was found between singleâÂÂÃ?Â?ÂÂÃ?Â?visit treatment and multiâÂÂÃ?Â?ÂÂÃ?Â?visit treatment groups with the given sample size.