PROFICIENCY EVALUATION OF SINGLE-SESSION ENDODONTIC THERAPY FOR PULPAL NECROSIS AND ASYMPTOMATIC PERIAPICAL PERIODONTITIS

Abstract

Introduction: Effective infection control and minimizing post-obturation pain are critical aspects for the success of root canal treatment (RCT), irrespective of whether it's performed in single or multiple sessions. Single-visit RCT is increasingly recognized as a viable substitute for the traditional multiple-visit approach, reflecting its potential to enhance treatment outcomes.

Objectives: To. The objective of this study is to assess the short-term post-operative pain outcomes following single-visit endodontic treatment in patients with pulpal necrosis and asymptomatic periapical periodontitis.

Study design: Descriptive Cross-Sectional Study

Settings: Department of Operative Dentistry, Faryal Dental College, Lahore

Study duration: From March 2021 to August 2021.

Materials & Methods: Total 150 patients presenting with teeth affected by pulpal necrosis and asymptomatic periapical periodontitis were included based on clinical and radiographic examination findings. Single-visit endodontic treatment was performed on eligible teeth by experienced endodontists following standardized protocols. This included access cavity preparation, thorough cleaning and shaping of root canals using rotary instrumentation, irrigation with antimicrobial solutions, and obturation with biocompatible materials. Clinical and radiographic evaluations were conducted at baseline and follow-up appointments (at 1st day or 24 hours & 7^th day post-treatment). Pain intensity was measured using the Visual Analog Scale (VAS), and patients' responses were documented accordingly. Outcome measures included pain assessment and successful treatment. Data were collected using standardized forms and radiographs.

Results: The mean age of the participants was 42.5±11.3. Gender distribution showed that 46.7% were male and 53.3% were female. Regarding dental arch, 68% of cases were maxillary and 32% were mandibular. A total of 130 patients (86.7%) experienced successful treatment. Overall, 87.33% of patients experienced no pain at 24 hours, increasing to 94% by the 7th day. Conversely, the proportion reporting pain decreased from 12.66% to 6%. For patients with pulpal necrosis, 81.33% experienced no pain at 24 hours, increasing to 86% by the 7th day, with pain decreasing from 18.66% to 14%. In cases of pulpal necrosis with periapical periodontitis, 73.33% had no pain at 24 hours, rising to 88.6% by the 7th day, with pain decreasing from 26.66% to 11.3%. In the maxillary region, 75.33% had no pain at 24 hours, increasing to 82% by the 7th day, while in the mandibular region, 84.0% had no pain at 24 hours, rising to 90.6% by the 7th day.

Conclusion: In conclusion, our study demonstrates that mean post-obturation pain remains low in single-visit endodontics conducted on teeth with pulpal necrosis and asymptomatic periapical periodontitis, steadily decreasing from 24 hours to the 7th day post-treatment.