Comparison of Postoperative Pain Following One-Visit and Two-Visit Vital Pulpectomy in Primary Teeth: A Single-Blind Randomized Clinical Trial.
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The aim of this study was to compare post-operative pain following one-visit pulpectomy and placing stainless steel crown (SSC), with two-visit treatment (performing pulpectomy at the first visit followed by placing SSC at the next visit one week later) in vital pulp of primary molars with carious involvement.In this randomized clinical trial, 100 children aged 6-12 years with a carious primary molar tooth in need of pulpectomy were randomly divided into two groups of 50 each. In one-visit group, pulpectomy and placement of SSC were carried out at the same appointment. In two-visit group, pulpectomy of root canals was carried out at the first visit and placement of SSC was performed at the second visit one week after the first appointment. Post-operative pain was recorded using visual analogue scale (VAS) during one week after each treatment visit.No significant difference was found in the mean age and gender distribution between the two groups (P˃0.05 for both comparisons). Findings revealed that in the two-visit (pulpectomy) group during first three days and 4-7 days after the first treatment appointment, pain felt by the children was significantly lower than that felt by the one-visit group at the same time period (P˂0.0001 for both comparisons). Moreover, children in two-visit (pulpectomy) group consumed significantly lower amount of analgesics than those in the one-visit group (P<0.0001).No significant difference was found between pain felt by children during the first three days following one-visit pulpectomy and placement of SSC at the same appointment. Therefore, one-visit treatment of vital primary tooth is recommended.Keywords:
Pulpectomy
Quadrant (abdomen)
Objective To evaluate the post-operative outcomes of one-visit endodontic treatment after a short clinical observation. Methods 107 teeth were included in one-visit root canal therapy group.The standardized protocols for root canal preparations and filling were performed.The clinical outcomes were evaluated after one week and half a year respectively. Results The cure rates of one-visit group were 95.3%.There were no significant differences between the one-visit group and those of two-visit group. Conclusion One-visit endodontic treatment has the same clinical efficacy as two-visit. With limited numbers of visits, it is promising for a regular therapy methods.
Endodontic therapy
Clinical efficacy
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Background: Root canal treatment (RCT) is a standard element of dental therapy. Several studies have demonstrated that most of the clinicians complete RCT on patients in multiple visits. However, in the last few decades several researchers in over 70% of the medical centers worldwide have advocated a single-visit RCT. Objective: The objective of this study was to compare the incidence and intensity of post-obturation pain after single- and two-visit RCT on vital and nonvital maxillary and mandibular single-rooted teeth. Materials and Methods: Data were collected from the 140 patients who were classified and treated in two groups, Group A (n=70) with single-visit obturation and Group B (n=70) with two-visit obturation. Results: In this study, it was observed that post-operative pain related with single-visit (Group A) RCT was overall similar as the post-operative pain associated with two-visit (Group B) treatment. In this study, sterile cotton pellet was positioned in the root canals between visits. Discussion: In this comparative study, under the studied conditions no difference in post-operative pain between patients treated in single-visit and patients treated in two-visit was observed. Thus, the present study demonstrates that two-visit endodontics is not helpful in reducing the pain incidence and that RCT completion in single-visit can be safe.
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Context: This study highlights success rate as well as advantages and disadvantages of single- versus multiple-visit pulpectomy in children. Aims: This study was aimed to compare the success rate of single- and multiple-visit pulpectomy in primary teeth with apical periodontitis. Settings and Design: It was a randomized, double-blind study. The study was conducted in children with one or more restorable sixty primary molars with deep carious lesions and requiring pulpectomy in the age group of 4–8 years. Subjects and Methods: Selected teeth were divided into two groups of thirty each and treated either in single visit or multiple visits. Follow-up was done at the period of 1 month, 3 months, and 6 months and evaluated using Gutmann criteria. Statistical Analysis Used: The normality of data was checked by Shapiro–Wilk test. Intragroup comparison was made by using Friedman test and post hoc-Wilcoxon test. Mann–Whitney U-test was used for inter group comparison. Results: Clinical and radiographical success for both group showed statistically significant (P < 0.001) improvement when the baseline score (preoperative) was compared with other time intervals. No statistically significant difference (P > 0.05) was obtained when clinical outcome was compared between two groups. Although radiographical success for multiple-visit group is slightly more than the single-visit group at all time intervals, statistically it was not significant (P > 0.05). Conclusions: Single-visit can be considered a viable alternative to multiple-visit pulpectomy considering its various advantages, especially in children.
Pulpectomy
Post-hoc analysis
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Objectives: The current investigation evaluated parameters leading to the utilization of pulpectomy versus extraction for treatment of nonvital primary second molars. Study design: This retrospective chart review identified patients up to 8-years of age with primary second molars treated by pulpectomy or extraction. Patients in the extraction group were age and gender-matched to the pulpectomy group. Demographic, clinical, radiographic and behavioral data were extracted for comparison. Chi-square, Fisher and T-test were performed for statistical analysis. Results: There were 23 patients in each group, with a mean age of 5 years (ranging 3–8 years, ±1.5 for pulpectomy and ±1.3 for extraction). Significantly more pulpectomies were performed in the mandible (p=0.002), specifically on the left side (p=0.0035). Internal and external root resorption were significantly higher in the extraction group (p=0.033 and p=0.007 respectively). Restorability was significantly lower in the extraction group (p<0.0001). Pre-procedural pain was reported by 76.5 percent of all patients, but pharmacologically treated in 15.2 percent. Nitrous oxide was administered to 73.9 percent of patients for behavior guidance. Conclusion: Pathologic root resorption and non-restorability were significantly higher in the extraction group. Behavior and pathologic bone resorption did not influence treatment choice. A higher proportion of children reported pre-treatment pain and needed adjunctive behavior guidance than children who did not have pre-treatment pain or did not need adjunctive behavior guidance.
Pulpectomy
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Introduction: The difficulties in endodontics are due to the unique anatomy
of primary teeth. To achieve a successful treatment, the dentist must have a
thorough knowledge on the anatomy and morphology of primary teeth and
the variations that may exist within them. A major goal in pediatric dentistry
is the preservation of the integrity of primary teeth and their supporting
tissues until the physiological process of exfoliation takes place. Pulpectomy
serves such a purpose using various materials and techniques to fill the
canals of primary teeth.
Materials & Methods: The study consisted of
children between the age of 5-10 years. Data was obtained from 86,000
patients who checked into the clinics from June 2019 to March 2020. From
that, data of children who underwent pulpectomy was obtained and was 725
in number. All the case sheets were carefully reviewed. Data was tabulated
and exported to SPSS software where the output was obtained later.
Results: Sample size consisted of 725 patients and among them 43.3% were girls and
56.7% were boys, belonging to the age group of 5-10 years. Children of the
age group of 5 years (43.31%) received the most treatment and children
belonging to the age group of 10 years (56.69%) received the least treatment.
Chi square test was done where p value=0.038 (p<0.05) statistically
significant.
Conclusion: This study concludes that pulpectomy was
performed more at the age of 5 years and less at the age of 10 years. The
frequency of pulpectomy treatment done was more in boys compared to
girls.
Pulpectomy
Primary Tooth
Age groups
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AIM:To evaluate the postoperative pain level and treatment effect after 1 year by using nickel-titanium rotary systems(ProTaper and Hero642)in one-visit root canal therapy for infected root canals. METHODS: One hundred and twelve infected teeth were included in one-visit root canal therapy group and 95 infected teeth were in two-visit group. A comparison of the clinical results was done between the two groups. The observations included post operative pain, x-ray examination and treatment effect after 1 year. RESULTS: Teeth without pain or postoperative pain lasted for 24h accounted for 80.4% in one-visit group, and 81.1% in the two-visit group(P0.05). After 1 week there was also no significant difference between the two groups in moderate and severe pain. After 1 year, the success rate of one-visit group was 90.6%, and the other was 92.5% (P0.05). CONCLUSIONS:One-visit endodontic treatment for infected root canals has the same clinical efficacy as two-visit in regard to postoperative pain and 1-year success rate.
Endodontic therapy
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Objective To evaluate the effect of two different visit frequencies on the clinical curative results of the Invisalign system for non-extraction orthodontic cases. Methods 200 cases of malocclusion patients who had been clinically diagnosed and intended for non extraction Invisalign orthodontic treatment within 15 months were selected,and then divided into two groups according torandomized grouping principles. One group was asked to come back to the clinic once a month,while the other group was asked to come back once every 3 months. When the patient completed the planned 15 months' orthodontic therapy,the data of patients' satisfaction with the treatment result,patients' response to the visit frequency and improvement of crowded dentition were collected and analyzed to reveal the relationship between different visit frequencies and Invisalign orthodontic effect. Results In 1 month group,the VAS score of patients' satisfaction for Invisalign orthodontic effect was 8. 18 ± 2. 34; and in 3 months group,the VAS score was 7. 82 ± 1. 86,and two independent samples t-test result showed that the difference was not statistically significant(P 0. 05). The difference in VAS score of satisfaction on Invisalign orthodontic effect between the two groups was not statistically significant(P 0. 05). In 3 months group,more patients thought that re-visit trimonthly was reasonable and acceptable than the patients in 1 month group who thought that re-visit monthly was reasonable and acceptable(P 0. 05). In 1 month group,the improvement value of patients' dental crowding degree was3. 18 ± 2. 34; and in 3 months group,the improvement value was 3. 82 ± 1. 86 which showed that the difference was not statistically significant(P 0. 05). Conclusions Whether the visit frequency is once a month or every 3 months,it has no influence on the patients' satisfaction of Invisalign orthodontic results and improvement value of patients' dental crowding degree. At the same time,patients prefer to re-visits every 3 months.
Permanent dentition
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Aim: To compare the incidence of flare up between single visit and multiple visit endodontic therapy in mandibular molars to find the best possible treatment for the patient in minimal time and cost.
Method: A retrospective study was done in Department of conservative dentistry and endodontics. A total of 300 endodontically treated mandibular molars were selected. They were divided into two groups- Group 1 where single visit endodontic treatment was done and Group 2 where multiple visit endodontic treatment was done using the same techniques. Incidence of flare up was evaluated on the basis of age, gender and preoperative diagnosis between both the groups.
Result: Flare up rate was found to be higher in females and in the age group of 40-60 years. The incidence of flare up was independent of preoperative pulp and periapical status in single visit and multiple visit endodontic therapy.
Conclusion: Single visit endodontic treatment can be safely carried out in all cases of symptomatic, asymptomatic irreversible pulpitis and chronic apical periodontitis if meticulous biomechanical preparation and irrigation is done. Flare up was found to be more in 40 – 60year age group and in females.
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The dental pulp is a delicate connective tissue. It includes ample blood vessels, lymphatics, nervous fibers, and undifferentiated cells. Patients with irreversible pulpitis often need strong analgesics and may have difficulty locating the precise tooth that causes pain. The aim of this present study is to evaluate the association of gender and tooth involved in single visit/multiple visit root canal treatment based on the diagnostic test response. 3170 patients underwent Single visit RCT, and 4140 patients underwent Multivisit RCT were assessed and examined for the diagnostic test done, teeth involved and gender, data entered in Microsoft excel sheet and transferred to SPSS software for statistical results. Descriptive statistics and Chi-square tests were used to determine the correlation between the variables where P-value<0.05 is considered statistically significant with a confidence interval of 95%. Within the limitations of the present study, it showed that a higher number of male patients were reported in Single visit and Multi visit RCT. Maxillary Anterior and Maxillary Molars teeth had been reported to be the highest number of teeth involved in single visit RCT, and in Multi visit RCT, Mandibular Molars were reported to be the highest in Multi visit RCT. Most of the patients who underwent Single visit and Multi visit RCT were given the diagnostic test response as Cold Test-Abnormal response. There is significant evidence to show an association between the different teeth numbers involved and the gender for patients in both the single and Multi-visit Root Canal Treatment procedure,and an association between the different teeth numbers involved and the diagnostic test responses for patients underwent single and Multi-visit Root Canal Treatment procedure as both correlations showed P-value<0.05.
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