Abstracts & Treatment Resources
Topic: One vs Two Appointment Molar Treatment
One- versus Two-visit Endodontic Treatment
of Teeth with Apical Periodontitis: A Histobacteriologic Study.
Vera j, Siqueira J, Ricucci D, Loghin S., Fernandez N, Flores B,
Cruz A. JOE 2012 Vol 38, No. 8:1040-1052.
Methods: Necrotic teeth with chronic apical periodontitis were
treated in one or two visits. The teeth of both groups were
extracted at one week and evaluated with light microscopy.
One appointment protocol: 6 mesial roots of mandibular molars were
instrumented, irrigated for a minimum of 45 minutes with 5% NaOCl,
with maintenance of patency and smear layer removal, and final
irrigation with 2% chlorhexidine, and then obturated with
gutta-percha and Pulp Canal Sealer.
Two appointment protocol (7 mandibular molar mesial roots): Same as
one appointment treatment, but medicated with CaOH for one week. At
second appointment canals were irrigated with 5% NaOCl and a final
rinse with 2% chlorhexidine.
Results:
None of the 1-visit group were rendered bacterial free. Four of the
six roots had bacteria in the main canals in the middle and apical
thirds. All six had bacteria in the apical third. Bacteria were in
the dentinal tubules and isthmuses in five of the six specimens.
Bacterial penetration reached varying depths sometimes reaching more
than two thirds of the dentin thickness.
Two Visit Group: Two of the seven roots were rendered bacterial
free. No bacteria were seen in the dentinal tubules of the main
canals in all seven roots.
Conclusions:
“The present findings
indicate that the root canal systems of teeth treated in 2 visits
with 1-week calcium hydroxide inter-appointment medication had an
improved microbiological status when compared with teeth treated in
a single visit.”
“The present findings confirm that it requires time for the
therapeutic antibacterial procedures to affect bacteria located in
anatomic complexities and then maximize bacterial reduction to
levels that cannot be achieved in 1 visit.”