1 visit vs 2 visit root canal

The 1 visit vs 2 visit root canal treatment debate depends a lot on who you ask but the research is pretty clear. The 1 visit root canal treatment performs better or just as good in all categories.

Our protocol of 1 visit vs 2 visit root canal.

As of 9/8/13 we are switching our protocol from all necrotic teeth get 2 treatments to only those with oozing (blood or exudate) will get CaOH treatment.  The only worry we have is any bias in the literature to make things faster and the short (often 1-2 years) amount of follow-up time.

2 visit with CaOH decreased microbial load but never truly clean

2 visit with CaOH decreased endotoxins but never truly clean (used pretty weak chemical protocols)

Number of visits did not impact outcome Pearl network Bernstein 2012 May

“At two years there were no significant differences between the groups, with 96.57% (141 of 146 teeth) in the single-visit group being classified as healed compared with 88.97% (121 of 136 teeth) in the two-visit group.” 1  JOE same study

Systemic review – No significant difference in the healing rate.  Prevalence of post-obturation pain was significantly lower in single-visit than in multiple-visit group.

Meta-analysis BUT prob using same RCT as above

Cochrane Collaboration – No detectable difference in terms of success. Neither can prevent 100% of short-term and long-term complications. Patients undergoing a single visit might experience a slightly higher frequency of swelling and require significantly more analgesic use.

Pain studies on 1 visit vs 2 visit treatments

There is less pain when doing root canals in one step. Hepsenoglu 2018 JOE

Retreatment endodontic cases of 1 visit vs 2 visit.

Healing at 18 months of both 1 and 2 visit treatment protocols is the same. Toia 2022 JOE