After reviewing the literature, 47 pertinent studies were found, involving 5,805 participants. Conducted in countries around the world (the largest number based in India), the studies also analyzed whether the root canal treatment was performed on vital permanent teeth or non-vital permanent teeth, or both. “Success of root canal treatment is largely dependent on effective chemical disinfection and thorough instrumentation of the canal system,” explains Dr. Mary Dabuleanu, clinical demonstrator in endodontics at the University of Toronto and an endodontist in North York, Ontario. “Improvements in endodontic irrigants and methods of delivery and agitation of these antimicrobials aim to draw these fluids further into the apical portion of the root canal,” says Dr. Dabuleanu. “Chitosan nanoparticles, for instance, show efficacious removal of dentinal wall biofilm and have been found to extend their powerful antimicrobial effects into the un-instrumented portions of canals and their varying anatomical complexities.” The Cochrane Review showed that the number of visits had little or no effect on the likelihood of tooth extraction, but the results remain uncertain given the lack of evidence from the studies. However, single- and multiple-visit treatments did not appear to have different impacts when assessing radiological healing one year after treatment (data found in 13 studies). “Single-visit endodontic treatment offers a clear benefit to both the operator and patient,” says Dr. Dabuleanu. “Fewer appointments translates into lower operating costs and less stress for the patient. And single-appointment treatments eliminate concerns of a leaky temporary filling or re-infection of the root canal system.” However, routine completion of root canal treatment in one session would result in a greater proportion of patients suffering more discomfort one week later, and this can present an unpleasant situation for both the clinician and the patient,” she adds. Success of root canal treatment is largely dependent on effective chemical disinfection and thorough instrumentation of the canal system. 34 | 2023 | Issue 3 SupportingYour Practice
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