Radiographic and Clinical Findings of Single-Visit Root Canal Treatments with Apical Enlargement in Necrotic Teeth: A Retrospective Cohort Study.

This study evaluated the long-term clinical outcomes of single-visit root canal treatments with apical enlargement on patients with necrotic pulp tissue retrospectively. A total of 137 teeth with necrotic pulp tissue which underwent single-visit root canal treatments were included. The root canals were shaped up until the apical constriction, which was determined by an apex locator. The outcomes were evaluated by two independent and calibrated endodontists clinically and radiographically. Teeth were dichotomized into healed (PAI ≤ 2, no signs or symptoms) and nonhealed (PAI > 2, with/without signs or symptoms) groups. Each patients' preoperative PAI and lesion size were recorded to evaluate the preoperative periapical status as well as several other prognostic factors. Statistical analyses were performed (p = 0.05) on ninety teeth. The mean observation time was 60 months. Out of ninety teeth, 87 (96.7%) were healed and 3 (3.3%) were nonhealed. No correlations were found between the prognostic factors and the outcomes (p > 0.05). Cohen's kappa and Gwet's agreement coefficient scores between the preoperative PAI scores and preoperative lesion sizes showed good agreements, with values of 0.834 and 0.898, respectively. Apical enlargement is a viable treatment option for single-visit root canal treatments.

Postoperative Pain Intensity after Single- versus Two-visit Nonsurgical Endodontic Retreatment: A Randomized Clinical Trial.

INTRODUCTION: The aim of this study was to evaluate postoperative pain after single-visit and 2-visit non-surgical endodontic retreatments with 2 different intracanal medicaments. METHODS: A total of 150 patients with asymptomatic root canal-treated teeth in need of nonsurgical endodontic retreatment were randomly divided into 3 groups (n = 50). Patients were selected randomly from among those without preoperative pain. Patients in group 1 (single visit) were treated in a single visit. Patients in group 2 and group 3 were treated in different visits with calcium hydroxide and chlorhexidine (CHX) as intracanal medicaments. The presence of postoperative pain was assessed 1, 2, 3, and 7 days and 1 month after treatment. All 2-visit treatments were completed 1 week after the initial visit. Data were analyzed using the Mann-Whitney U, Kruskal-Wallis, and Pearson chi-square tests (α = 0.01, 0.05). RESULTS: Postoperative pain was significantly higher in the CHX group in comparison with the single-visit group (P ≤ .05) on the first day of assessment. On the second day, postoperative pain was significantly less in the single-visit group (P < .05) than in the other 2 groups. There were no significant differences among the groups on the third and seventh days of assessment. At the 1-month assessment, postoperative pain was significantly higher in both the calcium hydroxide group (P < .05) and the CHX group (P < .05) in comparison with the single-visit group. CONCLUSIONS: Single-visit nonsurgical endodontic retreatment presented fewer incidences of postoperative pain in comparison with 2-visit nonsurgical endodontic retreatment based on assessments ranging from 1 day to 1 month.