one visit vs multi visits

1. Single v/s Multi Visits Endodontic Treatment Sudanese dental center Khartoum June 2020

2. Endodontic Disease l • Pulpitis is the most common inflammatory • disease in dental clinic. • Mohammadi Z, Abbott PV, Shalavi S, et al. • Postoperative pain following treatment of teeth • with irreversible pulpitis: a review. • N Y State Dent J 2017; 83: 44–53. • 57% of patients de Oliveira BP, Caˆmara AC and Aguiar CM. Prevalence of endodontic diseases: an epidemiological evaluation in a Brazilian subpopulation. Braz J Oral Sci 2016; 15:119–123. Sudanese dental center Khartoum June 2020

3. Endodontic Treatment Surgical TreatmentNon-Surgical Treatment One –Visit TreatmentMulti-Visit Treatment Sudanese dental center Khartoum June 2020

4. Multi-Visit Endo. Treatment A conservative, non surgical treatment of an endodontically involved tooth consisting of complete chemo-mechanical preparation and obturation of the root canal system in a morethan one visit . Sudanese dental center Khartoum June 2020

5. One-Visit Endo. Treatment A conservative, non surgical treatment of an endodontically involved tooth consisting of complete chemo-mechanical preparation and obturation of the root canal system in asingle visit . Sudanese dental center Khartoum June 2020

6. One-Visit Endo. Treatment • No re-appointments • No re-confirmations • No re-anesthesia • No re-isolation with rubber dam Sudanese dental center Khartoum June 2020

7. Indications One-Visit Endo. Treatment All teeth are candidate either Vital Non-Vital Even when there is - periapical inflammation - acute abscess Sudanese dental center Khartoum June 2020

8. Indications One-Visit Endo. Treatment • Fractured anterior teeth where esthetics is a concern • Apprehensive but cooperative patients • Physically compromised patients who have to • make an effort to come to the dental clinic. • Medically Compromised Patients. • Patients treated under general anesthesia or intravenous sedation. • Patients requiring full mouth rehabilitation Sudanese dental center Khartoum June 2020

9. Indications One-Visit Endo. Treatment • Teeth with accidental/mechanical pulp exposure. • Intentional root canal therapy. • Vital pulp exposures due to caries or trauma with symptomatic pulpitis. • Teeth requiring immediate post placement, where esthetics is the concern. • Teeth with sub-gingival breakdown, multiple coronal walls missing, where • isolation and sealing is the problem. • Non vital teeth with sinus tract. • Some of the re-treatment cases Sudanese dental center Khartoum June 2020

10. Contraindications One-Visit Endo. Treatment • Teeth with anatomic anomalies for e.g. calcified and severely curved canals. • Acute alveolar abscess cases with pus discharge. • Patients who are unable to keep mouth open for long duration (TMJ disorders). • Teeth with limited access. • Symptomatic non vital teeth and no sinus tract. • Asymptomatic non vital teeth with periapical pathology and no sinus tract. • For most of the re-treatment cases. Sudanese dental center Khartoum June 2020

11. Practice management advantages One-Visit Endo. Treatment • The number of teeth that patients are willing to save may increase • because they do not have to return as often . • Patient remembers a single healing procedure rather than multiple • episode of pain and discomfort associated with the clinician. • Prosthetic work can begin without delay. • Single appointment treatment limits schedule interruption to replace • lost or broken temporary restorations. Sudanese dental center Khartoum June 2020

12. Practice management advantages One-Visit Endo. Treatment • The risk of cancelled appointments is reduced. • Materials needed for separate visits are saved (disposable bibs, suction tips, • anesthetic and irrigation needles and rubber dams). • Medico legal risk is reduced: • Time is saved. cross contamination is minimized Sudanese dental center Khartoum June 2020

13. Patients advantages One-Visit Endo. Treatment • Patient comfort as the number of visits are reduced . • Economics use of less chair side time, fewer materials decrease • the economics to both patient as well as doctor. • Restorative considerations – immediate placement of coronal • restoration (post and core placements) • ensure effective coronal seal and esthetics. • Patient convenience – no additional appointments, no discomfort • of local anesthesia, reduced intra appointment • pain and reduced mid-treatment flare-up. Sudanese dental center Khartoum June 2020

14. One-Visit Vs Multi-Visit Endo. • There is no evidence to suggest that one treatment regimen (single visit • or multiple-visit root canal treatment) is better than the other, neither • can prevent 100%of short- and long-term complications. • factors play an important role in the decision-making process • of one –visit vs multi -visit endodontics:- • Objective factors • Preoperative Diagnosis • the ability to obtain infection control • root canal anatomy • procedural complications • Subjective factors • patients’ signs and symptoms. Sudanese dental center Khartoum June 2020

15. One-Visit Vs Multi-Visit Endo. Postoperative Pain • Patients with single-visit follow-up experienced postoperative • pain less frequently (1.35%) than those with multiple-visit • root canal treatment(2%). . Ng YL, et al…Prevalence of and factors affecting post obturation pain in patients undergoing root canal treatment Int Endod J 2004;37: 381–91. Sudanese dental center Khartoum June 2020

16. One-Visit Vs Multi-Visit Endo. Postoperative Pain Discomfort was the most common short-term outcome of root canal treatment procedures. Patients with single-visit follow-up experienced postoperative pain less frequently (1.35%) than those with multiple-visit root canal treatment (2%). Glennon et al. Prevalence of and factors affecting postpreparation pain in patients undergoing two-visit root canal treatment. Int Endod J 2004;37:29–37. Sudanese dental center Khartoum June 2020

17. One-Visit Vs Multi-Visit Endo. Postoperative Pain This is a reprint of a Cochrane review, prepared and ‘maintained by The Cochrane Collaboration and published in The Cochrane Library2008, Issue 1 www.thecochranelibrary.com • The success and failure of endodontic treatment are determined by long-term results and not the presence or absence of short-term postoperative pain. Sudanese dental center Khartoum June 2020

18. One-Visit Vs Multi-Visit Endo. Postoperative Pain • The incidence of post obturation pain is similar • with single- and multiple-visit RCT. • In the single-visit approach the working time is longer, • causing a more severe acute inflammatory response. Sudanese dental center Khartoum June 2020

19. One-Visit Vs Multi-Visit Endo. Postoperative Pain The reduction of situations like apical extrusion of infected debris and changes in the root canal microbiota and/or in environmental conditions caused by incomplete chemomechanical preparation can avoid postoperative pain. Sudanese dental center Khartoum June 2020

20. One-Visit Vs Multi-Visit Endo. Postoperative Pain Sudanese dental center Khartoum June 2020

21. One-Visit Vs Multi-Visit Endo. Postoperative Pain • The use of rotary instruments in canal preparation is associated with a lower • incidence of post-endodontic pain than reciprocating instruments. • . Sudanese dental center Khartoum June 2020

22. Postoperative Pain One-Visit Endo. Treatment • Root canal treatments with postoperative pain occurring shortly after treatment can result in long-term success, whereas treatment without such • pain may result in failure. • Mattscheck et al; Retreatment versus initial root canal treatment: • factors affecting post-treatment pain. • Oral Surg Oral Pathol Oral Radiol Endod 2001;92:321–4. Sudanese dental center Khartoum June 2020 Success Rate of Single- versus Two-visit Root Canal Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial. Paredes-Vieyra and Enriquez JOE — Volume 38, Number 9, September 2012

23. One-Visit Vs Multi-Visit Endo. Postoperative Flare-up • Less pain associated with flare-ups for the single-visit group (3.0%) than for the multiple-visit group (8.0%). • Eleazer and Eleazer • Flare-up rate in pulpally necrotic molars in one-visit versus • two-visit endodontic procedures. J Endod 1998;24:614 Sudanese dental center Khartoum June 2020

24. One-Visit Vs Multi-Visit Endo. Postoperative Flare-up • Given the possibly increased risk of flare-ups, multiple-visit treatment might be • preferred for certain teeth (eg, those with periapical lesions). Sudanese dental center Khartoum June 2020

25. One-Visit Vs Multi-Visit Endo. Treatment outcome (healing • No statistically significant difference in success rates (healed lesion) was • observed between the 1- and 2-visit. • Teeth treated in 2 visits with an interappointment dressing of calcium hydroxide would result in improved healing when compared with 1-visit root canal therapy was not supported by our results. Sudanese dental center Khartoum June 2020

26. One-Visit Vs Multi-Visit Endo. Treatment outcome (healing • Intracanal interappointment medication may be unnecessary when the operator, during a single visit, carefully cleans the canals with an adequate irrigant. Sudanese dental center Khartoum June 2020

27. One-Visit Vs Multi-Visit Endo. Treatment outcome (healing) • In meticulously instrumented root canal, a one-visit antimicrobial treatment including 10-min dressing with 5% IPI, might be as effective as a two-visit • procedure using CH. • There was no significant difference in radiographic evidence of • periapical healing between 1-visit and 2-visit root canal treatment. Sudanese dental center Khartoum June 2020

28. One-Visit Vs Multi-Visit Endo. Sudanese dental center Khartoum June 2020