A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Incidence of Postoperative Pain after Single Visit and Two Visit Root Canal Therapy: A Randomized Controlled Trial. Root canal therapy reduces multiple dimensions of pain: a national dental practice-based research network study. Root canal treatment in a population-based adult sample: status of teeth after endodontic treatment. Postoperative Pain after Root Canal Treatment: A Prospective Cohort Study A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. The effect of pulpotomy using a Calcium-Enriched Mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial Quality of life and satisfaction of patients after nonsurgical primary root canal treatment provided by undergraduate students, graduate students and endodontic specialists. Predictors of root canal treatment in teeth with full coverage restorations. Relationship between number of proximal contacts and survival of root canal treated teeth. Predicting Severe Pain after Root Canal Therapy in the National Dental PBRN Comparison of post-obturation pain experience following one-visit and two-visit root canal treatment on teeth with vital pulps: a randomized controlled trial. Clinical management of nonhealing periradicular pathosis. Surgery versus endodontic retreatment. Long-term outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Postoperative pain after endodontic retreatment: single- versus two-visit treatment. Two-year outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Postoperative pain after 1- and 2-visit root canal therapy.
AIM To investigate the probability of and factors influencing tooth survival  following primary ( 1 ° RCT x ) or secondary ( 2 ° RCT x ) root canal treatment .  METHODOLOGY This prospect i ve study involved annual follow-up of 2 ( 100 % ) to 4 years ( 50 % ) of 1 ° RCT x ( 759 teeth , 572 patients ) and 2 ° RCT x ( 858 teeth , 642 patients ) carried out by Endodontic postgraduate students . Pre- , intra- and post-operative data were collected prospect ively from consented patients . Information about extraction of the root filled tooth was sought from the patient , the referring dentist or derived from the patient 's records and included the timing and reasons for extraction . Tooth survival was estimated and prognostic factors were investigated using Cox regression . Clustering effects within patients were adjusted in all models using robust st and ard error . RESULTS The 4-year cumulative tooth survival following 1 ° RCT x [ 95.4 % ( 93.6 % , 96.8 % ) ] or 2 ° RCT x [ 95.3 % ( 93.6 % , 96.5 % ) ] was similar . Thirteen prognostic factors were identified . Significant patient factors included history of diabetes and systemic steroid therapy . Significant pre-operative factors included narrow but deep periodontal probing depth ; pain ; discharging sinus ; and iatrogenic perforation ( for 2 ° RCT x cases only ) . Significant intra-operative factors included iatrogenic perforation ; patency at apical terminus ; and extrusion of root fillings . Significant post-operative restorative factors included  presence of cast restoration versus temporary restoration ; presence of cast post and core ; proximal contacts with both mesial and distal adjacent teeth ; and terminal location of the tooth . The presence of pre-operative pain had a profound effect on tooth loss within the first 22 months after treatment [ hazard ratio ( HR ) = 3.1 ; P = 0.001 ] with a lesser effect beyond 22 months ( HR = 2.4 ; P = 0.01 ) . Patency at the apical terminus reduced tooth loss ( HR = 0.3 ; P < 0.01 ) within the first 22 months after treatment but had no significant effect on tooth survival beyond 22 months . Extrusion of gutta-percha root filling did not have any effect on tooth survival ( HR = 1.1 ; P = 0.2 ) within the first 22 months but significantly increased the hazard of tooth loss beyond 22 months ( HR = 3.0 ; P = 0.003 ) . CONCLUSIONS The 4-year tooth survival following primary or secondary root canal treatment was 95 % , with thirteen prognostic factors common to both INTRODUCTION Root Canal Treatment ( RCT ) has become a mainstream procedure in dentistry . A successful RCT is presented by absence of clinical signs and symptoms in teeth without any radiographic evidence of periodontal involvement . Completing this procedure in one visit or multiple visits has long been a topic of discussion . AIM To evaluate the incidence of postoperative pain after root canal therapy performed in single visit and two visits . MATERIAL AND METHODS An unblinded/ open label r and omized controlled trial was carried out in the endodontic department of the Dental Institute , where 78 patients were recruited from the regular pool of patients . A total of 66 maxillary central incisors requiring root canal therapy fulfilled the inclusion and exclusion criteria . Using simple r and omization by biased coin r and omization method , the selected patients were assigned into two groups : group A ( n=33 ) and group B ( n=33 ) . Single visit root canal treatment was performed for group A and two visit root canal treatment for group B. Independent sample t-test was used for statistical analysis . RESULTS Thirty three patients were allotted to group A where endodontic treatment was completed in single visit while 33 patients were allotted to group B where endodontic treatment was completed in two visits . One patient dropped-out from Group A. Hence in Group A , 32 patients were analysed while in Group B , 33 patients were analysed . After 6 hours , 12 hours and 24 hours of obturation , pain was significantly higher in Group B as compared to Group A. However , there was no significant difference in the pain experienced by the patients 48 hours after treatment in both the groups . CONCLUSION Incidence of pain after endodontic treatment being performed in one-visit or two-visits is not significantly different INTRODUCTION Initial ortho grade root canal therapy ( RCT ) is used to treat dentoalveolar pathosis . The effect RCT has on pain intensity has been frequently reported , but the effect on other dimensions of pain has not . Also , the lack of large prospect i ve studies involving diverse groups of patients and practitioners who are not involved in data collection suggest that there are multiple opportunities for bias to be introduced when these data are systematic ally aggregated . METHODS This prospect i ve observational study assessed pain intensity , duration , and its interference with daily activities among  RCT patients . Sixty-two practitioners ( 46 general dentists and 16 endodontists ) in the National Dental Practice -Based Research Network enrolled patients requiring RCT .  Patient-reported data were collected before , immediately after , and 1 week after treatment using the Grade d Chronic Pain Scale . RESULTS The enrollment of 708 patients was completed over 6 months with 655 patients ( 93 % ) providing 1-week follow-up data . Before treatment , patients reported a mean ( ± st and ard deviation ) worst pain intensity of 5.3 ± 3.8 ( 0 - 10 scale ) , 50 % had " severe " pain ( ≥ 7 ) , and mean days in pain and days pain interfered with activities were 3.6 ± 2.7 and 0.5 ± 1.2 , respectively . After treatment , patients reported a mean worst pain intensity of 3.0 ± 3.2 , 19 % had " severe " pain , and mean days in pain and days with pain interference were 2.1 ± 2.4 and 0.4 ± 1.1 , respectively . All changes were statistically significant ( P < .0001 ) . CONCLUSIONS RCT is an effective treatment for patients experiencing pain , significantly reducing pain intensity , duration , and related interference . Further research is needed to reduce the proportion of patients experiencing " severe " postoperative pain The purpose of this study was to quantify treatment outcomes of  endodontically treated teeth , in a representative , population -based adult sample . The " Florida Dental Care Study " was a prospect i ve , longitudinal , cohort study of 873 subjects who had at least one tooth at baseline and who were 45 yr or older . An in-person interview and clinical examination were conducted at baseline , 24 months , and 48 months after baseline , with 6-monthly telephone interviews between those times . Dental record information was abstract ed afterward . Seventy-five teeth had conventional root-canal therapy ( RCT ) performed and met the inclusion criteria of 1-yr of follow-up or extraction . The mean duration of follow-up after RCT was 24.8 months . The mean ( SD ) attachment loss ( AL ) on teeth receiving RCT was only 3.3 ( 1.4 ) mm . Permanent restorations were placed in 79 % of teeth a mean of 4.4 months after the RCT . However , 12 % of teeth did not have any restorative treatment after RCT . After RCT had been completed , 81 % of teeth were retained and 19 % were ultimately extracted . Taken as a whole , this community-based study of a representative sample of adults suggests a higher failure rate than reported from studies in highly controlled environments or insured population s. It also suggests that the length of time to initial restoration of RCT -treated teeth is less than optimal . RCT was almost never performed on teeth with advanced periodontal attachment loss Aim . To evaluate the incidence and severity of  postendodontic treatment pain ( PEP ) subsequent to root canal treatment ( RCT )  in vital and necrotic pulps and after retreatment . Methodology . A prospect i ve study . Participants were all patients ( n = 274 ) who underwent RCT in teeth with vital pulp , necrotic pulp , or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment , by one clinician , during an eight-month period . Exclusion criteria were swelling , purulence , and antibiotic use during initial treatment . A structured question naire accessed age , gender , tooth location , and pulpal diagnosis . Within 24 h of treatment , patients were asked to grade their pain at 6 and 18 hours posttreatment , using a 1–5 point scale . Results . RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP ( 63.8 % ; 2.46 ± 1.4 , resp . ) than RCT of teeth with necrotic pulp ( 38.5 % ; 1.78 ± 1.2 , resp . ) or of retreated teeth ( 48.8 % ; 1.89 ± 1.1 , resp . ) . No statistical relation was found between type of pain ( spontaneous or stimulated ) and pulp condition . Conclusion . RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth AIM To investigate the probability of and factors influencing periapical status of teeth following primary ( 1 ° RCT x ) or secondary ( 2 ° RCT x ) root canal treatment .  METHODOLOGY This prospect i ve study involved annual clinical and radiographic follow-up of  1 ° RCT x ( 1170 roots , 702 teeth and 534 patients ) or 2 ° RCT x ( 1314 roots , 750 teeth and 559 patients ) carried out by Endodontic postgraduate students for 2 - 4 ( 50 % ) years . Pre- , intra- and postoperative data were collected prospect ively on customized forms . The proportion of roots with complete periapical healing was estimated , and prognostic factors were investigated using multiple logistic regression models . Clustering effects within patients were adjusted in all models using robust st and ard error . RESULTS proportion of roots with complete periapical healing after 1 ° RCT x ( 83 % ; 95 % CI : 81 % , 85 % ) or 2 ° RCT x ( 80 % ; 95 % CI : 78 % , 82 % ) were similar . Eleven prognostic factors were identified . The conditions that were found to improve periapical healing significantly were : the preoperative absence of a periapical lesion ( P = 0.003 ) ; in presence of a periapical lesion , the smaller its size ( P ≤ 0.001 ) , the better the treatment prognosis ; the absence of a preoperative sinus tract ( P = 0.001 ) ; achievement of patency at the canal terminus ( P = 0.001 ) ; extension of canal cleaning as close as possible to its apical terminus ( P = 0.001 ) ; the use of ethylene-diamine-tetra-acetic acid ( EDTA ) solution as a penultimate wash followed by final rinse with NaOCl solution in 2 ° RCT x cases ( P = 0.002 ) ; abstaining from using 2 % chlorexidine as an adjunct irrigant to NaOCl solution ( P = 0.01 ) ; absence of tooth/root perforation ( P = 0.06 ) ; absence of interappointment flare-up ( pain or swelling ) ( P = 0.002 ) ; absence of root-filling extrusion ( P ≤ 0.001 ) ; and presence of a satisfactory coronal restoration ( P ≤ 0.001 ) . CONCLUSIONS Success based on periapical health associated with roots following 1 ° RCT x ( 83 % ) or 2 ° RCT x ( 80 % ) was similar , with 10 factors having a common effect on both , whilst the 11th factor ' EDTA as an additional irrigant ' had different effects on the two treatments The purpose of this noninferiority trial was to compare postoperative pain relief after one-visit root canal therapy ( O RCT ) with a pulpotomy performed with a new endodontic calcium-enriched mixture cement ( PCEM ) in human permanent molars with irreversible pulpitis . A total of 407 selected patients were r and omly allocated into the O RCT group ( n = 202 ) or the PCEM group ( n = 205 ) . Numerical Rating Scale question naires were used to record pain intensity ( PI ) by the patients during the first 7 days after treatment . While there was no statistically significant difference in the mean PI at baseline between the two study groups ( P = 0.45 ) , changes in mean PI were significantly different between them ( P < 0.001 ) . In the O RCT group , pain relief was achieved after 36 h [ 95 % confidence interval ( CI ) , 27.00–45.00 ] , compared to 18 h in the PCEM group ( 95 % CI , 15.00–21.00 ) , a significant difference ( P < 0.01 ) . Comparison of the mean PI sum recorded over 7 days showed that patients in the O RCT group experienced significantly more pain than those in the PCEM group ( P < 0.001 ) ; a similar difference was observed for pain in response to percussion tests ( P < 0.001 ) . Treatment with PCEM thus had the better pain-reducing effects than O RCT in irreversible pulpitis cases AIM ( i ) To assess the impact of  primary root canal treatment  on the perceived quality of life amongst a cohort of Jordanian patients , ( ii ) to assess this cohort 's satisfaction of their primary root canal treatment , and ( iii ) to evaluate the association of the level of training and experience of clinicians with these two parameters . METHODOLOGY A systematic r and om sample of 302 subjects was selected from patients who attended undergraduate , graduate and specialty clinics of Jordan University of Science and Technology . Participants were interviewed before and two weeks after completion of root canal treatment . The study instrument included the Oral Health Impact Profile question naire ( Dugas et al. 2002 ) and seven semantic differential scales . Data analyses included descriptive statistics and nonparametric analyses . RESULTS More than 90 % of subjects reported improvements in the sense of taste , pain , eating , altering food temperature , self-consciousness , waking up during sleep , interruption of meals , difficulty to relax and difficulty to sleep after root canal treatment . There was no significant difference in terms of improvement amongst patients treated by specialists , graduate students or undergraduate students . The overall semantic differential score of intraoperative pain , pleasantness , chewing ability and general satisfaction was about 8 . Satisfaction of root canal treatment by specialists was higher in terms of time involved , intraoperative pain , pleasantness and general satisfaction than those treatments by undergraduate students . Patients treated by specialist were least satisfied with the treatment cost compared to those patients treated by graduate or undergraduate students . CONCLUSIONS The impact of root canal treatment on the quality of life was apparent . Satisfaction with root canal treatment approximates 8 on the semantic differential scale with preference for specialists over dental students This case-control study sought to identify variables predictive of subsequent root canal therapy ( RCT )  in teeth receiving full coverage restorations . The University of North Carolina School of Dentistry 's computerized treatment data base was used to identify all patients receiving a single-unit crown on a nonendodontically treated permanent tooth from January 1 , 1998 through December 31 , 2002 . These patients then were classified either as cases ( those whose crowned teeth received RCT before July 1 , 2004 ) or controls ( those whose crowned teeth did not ) . Computerized data , chart entries , and dental radiographs were examined to determine pre- , intra- , and postoperative factors of interest . In the final multivariable logistic regression model that included 66 cases and 71 controls , younger age ( p = 0.005 ) and greater extent of coronal and root destruction ( p = 0.020 ) remained statistically significant predictors of case status , though many potentially important predictors were unavailable through chart review . Patients could benefit if prospect i ve studies were conducted to identify factors predictive of subsequent endodontic involvement in newly crowned teeth AIM The present study tested the hypothesis that having two proximal contacts ( PCs ) at access is associated with improved survival of root canal treated ( RCT ) teeth  , controlling for important presenting conditions , endodontic variables and restorative factors . METHODOLOGY A treatment data base at the University of Iowa College of Dentistry was used to identify permanent teeth undergoing obturation between 1 July 1985 and 31 December 1987 . The list was restricted to teeth of patients with at least one dental visit in each two-year interval from 1985 to 1996 , and a simple r and om sample of 280 patients ( n = 400 teeth ) was selected . Dental charts , radiographs , and computerized data bases were examined to ascertain variables of interest and to verify study inclusion criteria . Kaplan-Meier survival estimates were generated for the 221 teeth satisfying study inclusion criteria . Multivariate Cox models were developed , with st and ard errors adjusted to account for clustering of teeth within patients . RESULTS The final Cox model showed that teeth with < or = 1 PC at access were lost at a rate three times that of teeth with 2 PCs ( hazard ratio = 3.1 ; 95 % confidence interval = 1.9 - 5.1 ) , controlling for tooth type , presence of radiographic caries at access , and presence of a crown before or after obturation . CONCLUSIONS Because RCT teeth with two PCs at access experienced substantially better survival than teeth with fewer than two PCs , the influence of PCs on prognosis should be recognized during treatment planning . Future research should employ prospect i ve study design s , capture additional variables , and provide data to support endodontic treatment decisions Some patients experience severe pain following root canal therapy ( RCT )  despite advancements in care . We sought to identify factors , which can be measured preoperatively , that predict this negative outcome so that future research may focus on preemptive steps to reduce postoperative pain intensity . Sixty-two practitioners ( 46 general dentists and 16 endodontists ) who are members of the National Dental Practice -Based Research Network enrolled patients receiving RCT for this prospect i ve observational study . Baseline data collected from patients and dentists were obtained before treatment . Severe postoperative pain was defined based on a rating of ≥7 on a scale from 0 ( no pain ) to 10 ( pain as bad as can be ) for the worst pain intensity experienced during the preceding week , and this was collected 1 wk after treatment . Multiple logistic regression analyses were used to develop and vali date the model . A total of 708 patients were enrolled during a 6-m period . Pain intensity data were collected 1 wk postoperatively from 652 patients ( 92.1 % ) , with 19.5 % ( n = 127 ) reporting severe pain . In multivariable modeling , baseline factors predicting severe postoperative pain included current pain intensity ( odds ratio [ OR ] , 1.15 ; 95 % confidence interval [ CI ] , 1.07 to 1.25 ; P = 0.0003 ) , number of days in the past week that the subject was kept from their usual activities due to pain ( OR , 1.32 ; 95 % CI , 1.13 to 1.55 ; P = 0.0005 ) , pain made worse by stress ( OR , 2.55 ; 95 % CI , 1.22 to 5.35 ; P = 0.0130 ) , and a diagnosis of symptomatic apical periodontitis ( OR , 1.63 ; 95 % CI , 1.01 to 2.64 ; P = 0.0452 ) . Among the factors that did not contribute to predicting severe postoperative pain were the dentist ’s specialty training , the patient ’s age and sex , the type of tooth , the presence of swelling , or other pulpal and apical endodontic diagnoses . Factors measured preoperatively were found to predict severe postoperative pain following RCT . Practitioners could use this information to better inform patients about RCT outcomes and possibly use different treatment strategies to manage their patients ( Clinical trials.gov NCT01201681 ) AIM To compare the incidence and intensity of post-obturation pain after one- or two-visit  root canal treatment ( RCT ) on anterior teeth with vital pulps and a single root and canal in a r and omized controlled trial . METHODOLOGY One hundred patients requiring RCT on permanent anterior teeth with vital pulps preoperatively were included . The patients were assigned r and omly into two groups of 50 patients each . After local anaesthesia , isolation , access and pulp extirpation , the canals of all teeth were prepared using engine-driven rotary ProTaper nickel-titanium instruments in a crown-down technique and irrigated with 2.5 % NaOCl . The teeth in group 1 ( n = 50 ) were filled with AH Plus sealer and gutta-percha using a lateral compaction technique at the first visit , whilst those in group 2 ( n = 50 ) were medicated with a calcium hydroxide paste , a sterile dry cotton pellet and Caviton and scheduled for a second visit 7 days later . A modified verbal descriptor scale was used to measure preoperative pain and post-obturation pain at 6 , 24 , 48 h and 1 week after operation . Chi-square tests and independent- sample T-tests were used to compare the incidence and intensity of post-obturation pain of two groups at each interval . RESULTS Eleven patients were excluded from the study as they failed to follow the scheduled revisit or their selected teeth had more than one root canal . Data were obtained from the remaining 89 patients . Forty-three patients were undergoing one-visit treatment ( group 1 ) and 46 undergoing two-visit treatment ( group 2 ) . Most patients in both groups reported no pain or only slight pain within each post-obturation interval , only one in group 1 and one in group 2 had flare-ups and slight swelling . There was no statistically significant difference in the incidence and intensity of post-obturation pain experienced by two groups . CONCLUSIONS The incidence and intensity of post-obturation pain experience following one- or two-visit RCT on teeth with vital pulps and a single canal were not significantly different OBJECTIVES This prospect i ve r and omized study compared the outcome of retreatment and surgical intervention in root canal treated teeth with nonhealing periradicular pathosis . STUDY DESIGN One such tooth from each of 38 patients was r and omly allotted to retreatment or root-end resection and root-end filling . Treatment outcome after 1 year was evaluated and compared clinical ly and radiographically . RESULTS The success rate for surgery was higher than for conventional retreatment , but the difference was not statistically significant . CONCLUSIONS For management of nonhealing periradicular pathosis associated with root canal treated teeth , surgical intervention should be considered as an alternative to retreatment . In cases with a similar prognosis for both modes of treatment , the choice should be governed by consideration of intrinsic and extrinsic factors PURPOSE The purpose of this study was to compare long-term outcomes of ferric sulfate pulpotomy ( FS ) and primary tooth root canal therapy ( RCT ) in vital pulps of deciduous molars exposed to caries lesions . METHODS A total of 291 molars were treated in 130 children . One hundred and eighty-two molars received FS  and 109 received RCT by r and om selection . RESULTS At 3-year re- assessment , 29 molars ( 15 FS , 14 RCT ) were available for clinical and radiographic examination . Two independent pediatric dentists evaluated periapical radiographs of the treated molars . Molars were classified 1 of 4 outcomes : ( 1 ) N = normal treated molar ; ( 2 ) H = nonpathologic radiographic change present ; ( 3 ) P(o ) = pathologic change present , follow-up in 6 months ; ( 4 ) P(x ) = pathologic change present extract immediately . Survival analysis was applied . A good level of agreement between raters was found for molars with outcome P(x ) ( K = 0.79 ) . No difference in radiographic outcomes was demonstrated 3 years after treatment ( chi2 = 1.4 ) . Survival analysis demonstrated a 3-year survival probability of 0.62 for FS-treated molars and 0.92 for RCT molars . Survival of RCT molars was significantly greater than for FS molars ( Wilcoxon : P = .01 ; log-rank : P = .02 ) . CONCLUSIONS RCT -treated molars demonstrated significantly greater survival than FS-treated molars 3 years after treatment OBJECTIVE The purpose of this clinical study was to determine the effect of 1- or 2-visit root canal treatment on the postoperative pain in the retreatment cases . STUDY DESIGN Two hundred eighteen cases that required retreatment were included in the study . Obturated and unfilled canal space and the status of periapical tissues were evaluated according to the PAI index . The patients were subcategorized in regard to the presence or the absence of preoperative pain . Approximately half of each category was treated in 1 appointment . After removing the previous root canal obturation material s and biomechanic preparation of root canals , the teeth in the 1-visit group were obturated at the first appointment by using AH 26 sealer and laterally compacted gutta-percha , and those in the 2-visit group were medicated with calcium hydroxide-chlorhexidine combination and then closed with a temporary filling material . One week after the initial appointment , patients were asked about the occurrence of postoperative pain . The level of discomfort was rated as no pain , mild pain , moderate pain , or severe pain ( flare-up ) . Data were statistically analyzed using the chi-squared and Fischer exact tests . RESULTS Eight patients from the 1-visit group and 2 patients from the 2-visit group had flare-ups . There was a statistical difference between the groups ( P < .05 ) . Two-visit root canal treatment was more effective in completely eliminating pain than 1-visit treatment of previously symptomatic teeth ( P < .05 ) . CONCLUSIONS Two-visit endodontic treatment with intracanal medication was found to be effective in reducing postoperative pain of previously symptomatic teeth and decreased the number of flare-ups in all retreatment cases PURPOSE The objective of this outcome study was to compare ferric sulfate pulpotomy ( FS ) and primary tooth root canal therapy ( RCT ) on cariously exposed vital pulps of primary molars . METHODS A total of 291 molars were treated in 130 children--182 molars received FS and 109 received RCT by r and om selection . RESULTS At 2-year re assessment , 116 molars ( 73 FS , 43 RCT ) were available for clinical and radiographic examination . There was no clinical evidence of pathosis in 96 % of FS and 98 % of RCT molars . Two independent pediatric dentists evaluated periapical radiographs of the treated molars . Molars were classified into 1 of 4 outcomes : ( 1 ) N -- normal treated molar , ( 2 ) H -- nonpathologic radiographic change present , ( 3 ) P(O)--pathologic change present , follow-up in 6 months , and ( 4 ) P(X)--pathologic change present , extract immediately . Survival analysis was applied . A good level of agreement between raters was found for molars with outcome P(X ) ( kappa=0.745 ) . Intrarater reliability was good for molars with outcome P(X ) ( kappa=0.710 ) . Significantly greater numbers of FS than RCT molars were rated P(X ) at the 2-year recall ( chi2=5.8 ; P=.02 ) . No significant difference in survival between the 2 types of vital pulp treatments was detected in log rank tests ( P=.22 ) . CONCLUSIONS Outcomes for FS were poorer than RCT outcomes at 2 years ; however , at 2 years , the survival rates were not statistically different OBJECTIVES The factors that influence postoperative pain after root canal treatment are not completely understood . The purpose of this prospect i ve clinical study was to evaluate postoperative pain after root canal therapy performed in 1 appointment versus 2 appointments . STUDY DESIGN Seventy-two patients requiring root canal therapy on permanent molars were included in this study . Patients were r and omly assigned to either the 1-appointment or the 2-appointment group . Both vital and nonvital teeth were included . The st and ardized protocol for all teeth involved local anesthesia , isolation and access , engine-driven rotary nickel-titanium canal instrumentation to a minimum size # 5 ( .028 mm).04 taper Profile with step-back flaring , and irrigation with 2.5 % NaOCl . Teeth in group 1 ( n = 39 ) were obturated at the first appointment by using laterally condensed gutta-percha and Roth 811 sealer . Teeth in group 2 ( n = 33 ) were closed with a sterile dry cotton pellet and Cavit restoration and were obturated at a second appointment 7 to 14 days later . A modified Visual Analogue Scale was used to measure preoperative pain and pain at 6 , 12 , 24 , and 48 hours after the first appointment . Statistical analysis was performed to compare groups at each interval by using an independent- sample s t test with Bonferroni adjustment . RESULTS There was no statistically significant difference between groups at preoperative intervals or at any of the 4 postoperative intervals ( P < .01 ) . CONCLUSIONS There was no difference in postoperative pain between patients treated in 1 appointment and patients treated in 2 appointments . The majority of patients in both groups reported no pain or only minimal pain within 24 to 48 hours of treatment
RESULTS Application of the Oral Health Impact Profile ( OHIP ) demonstrated that disease of pulpal origin affects quality of life with moderate severity , primarily through physical pain and psychological discomfort , and that RCT results in broad improvement of quality of life .
Satisfaction with RCT is extremely high , but cost is the primary reason for dissatisfaction .
Anxiety and fear affect RCT patients , profoundly influencing their behaviors , including treatment avoidance , and their pain experience .
Fear of pain is " fair " to " very much " prior to RCT .
Pain is widely feared , disliked , and remembered ; however , disease of pulpal origin generally produces moderate , but not severe pain .
RCT causes a dramatic decrease in pain prevalence and severity over the week following treatment .
Survival rates of teeth after RCT are very high ; complication rates are low .
Cost is a barrier to RCT , but initial costs , lifetime costs , cost effectiveness , cost utility , and cost benefit all compare extremely well to the alternatives involving replacement using implants or fixed prostheses .
INTRODUCTION Root canal treatment ( RCT ) success criteria inform us of the path to bony healing and of prognostic factors , but tell little about how the patient perceives , feels , or values RCT .
Patients choose , undergo , and pay for RCT , they live with the result , and inform their community .
The purpose of this narrative review was to appraise patient-centered outcomes of initial non-surgical RCT and nonsurgical retreatment , in adults .