New study finds little difference between 1 or 2 visit RCT

A new study has found little difference between 1 or 2 visit Royal canal Therapy (RCT). The authors concluded that the evidence showed that a meticulously instrumented 1-visit RCT can be as successful as a 2-visit treatment. There was no significant difference in radiographic evidence of periapical healing between 1-visit and 2-visit RCT.

The aim of this study was to evaluate the outcome of single- versus 2-visit root canal treatment of teeth with apical periodontitis after a 2-year follow-up period.

Patients with radiographic evidence of apical periodontitis (minimum size ≥2.0 x 2.0 mm) and a diagnosis of pulpal necrosis were included. Other inclusion criteria were a non-vital pulp and apical periodontitis with or without ?a sinus tract; negative response to hot and cold pulp sensitivity tests; presence of enough coronal tooth structure for rubber dam ?isolation; no previous endodontic treatment of tooth and no analgesics or antibiotics prior to the clinical procedures. Patients were randomised (block randomization) prior to the clinical procedure patients undergoing 2-visit treatment has second appointment at least 1 week after 1st appointment.  Teeth were evaluated clinically and radiographically at 2 years. Radiographs were coded to blind evaluators.

The researchers found that

  • 287 patients (300 teeth) were randomised
  • 155 teeth were allocated to single visit and 145 to 2-visit treatment.
  • 18 teeth were lost to follow up, 9 from each group.
  • At 2 years there were no significant differences between the groups
    • 96.57% (141 of 146 teeth) in the 1-visit group were classified as healed
    • 88.97% (121 of 136 teeth) in the 2-visit group were classified as healed

Reference: Paredes-Vieyra J, Enriquez FJ. Success Rate of Single- versus Two-visit Root Canal Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial. J Endod. 2012 Sep;38(9):1164-9. Epub 2012 Jul 26. PubMed PMID: 22892729

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Alyn Morgan
And in further news, Pope seen wearing a big hat and Bear toilet found in woods..
Nothing new here really, power of study insufficient to draw any meaningful conclusions, follow up period too short etc., etc
Also impossible to doubly blind study, so again a risk of bias (not the investigators fault, inevitable).
Can't see we will ever get a really meaningful answer to this one.

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