Methods in Medicine

Single Visit Root Canal Treatment

Col SM Londhe * , Brig HG Garge +

MJAFI 2007; 63 : 273-274

Key Words : Root canal; Pulp capping; Rotary instruments

Introduction A total of sixty molars were treated over a period of

four months out of which fifty-six reported for review
E ndodontic therapy in defence dental setup should
be simple, predictable and time saving. Root canal
treatment (RCT) is the preferred management modality
six months postobturation and 90% of these were
asymptomatic (Table 1).
for root canal infections. The execution of RCT is more Discussion
challenging and demanding in molars for their unique
The management of direct pulp exposure by caries
multi canal system. The canals are often ‘c’ or‘s’ shaped
or other injuries has been challenging and various
and narrow. Since loss of permanent molars is a threat
methods like pulp capping, pulpotomy, and pulpectomy
to the occlusal table, single visit root canal treatment
followed by root filling have been used. Proponents of
was tried to assess its viability in defence environment.
pulp capping prefer the procedure as it is less invasive,
Clinical procedure less tissue destructive and easier to carry out thus saving
To minimise the man hours lost on account of multiple time, effort and money. The mechanism of lesion
visits for RCT in defence set up, we tried single sitting development and pulp breakdown may be an important
therapy with the available equipment and material. reason why pulps show a declining rate of survival over
Endodontic rotary instrument with profiles, absorbent time following capping in pulpotomy [1].
paper points. root canal sealant, gutta percha points,
sodium hypochlorite 3% and EDTA based root canal
conditioner were used for the procedure.
Cases were selected from daily out patient
department. Pulpal exposure was ascertained clinically
and confirmed radio graphically. After the preparation
of access cavity, the canals were prepared using above
mentioned rotary instrument and profiles. After the
removal of pulp, the canals were flushed with 3 %
sodium hypochlorite. Root canal conditioner was
dispensed on the instrument and carried to the canal.
The instrumentation was followed by irrigation with
sodium hypochlorite. The procedure was repeated with
instruments being used in increasing order from size 15
to 40. The canals were prepared using 3% sodium
hypochlorite until all evidence of bubbling had ceased.
The canals were instrumented to 0.5 mm short of the
radiographic apex (Fig.1). The canals were dried and
obturated with lateral condensation method using sealant
and gutta percha points and the tooth was restored with
a suitable restoration. Approximately fifty minutes were
required to complete the entire procedure in each case. Fig. 1 : Conformation of working length

+
Dy Commandant & Classified Specialist (Orthodontics), +Commandant & Command Dental Advisor, Command Military Dental Centre
(Northern Command), C/o 56 APO
Received : 16.03.2006; Accepted : 25.01.2007
274 Londhe and Garge

Table 1 session is a controversial issue. There are many inclusion

Comparison of pre and post treatment pain criteria for selection of cases [9]. It is suggested that
Pain Pretreatment Six months post obturation* decisions on the use of single or multiple-visit treatment
Severe 36 0 should be based solely on the diagnosis and not the
Moderate 14 2 time available for treatment. Studies have found no
Mild 10 1 difference in the incidence of postoperative pain
Nil 0 53 between one and multiple visit endodontics [10] where
Four cases did not report for post obturation review as fewer failures were noted in the two visit treatment
group than in the one visit treatment group [11]. Inability
Predictability of successful pulp capping is inferior to dry canals completely, insufficient time for the
to long term success rate of endodontic therapy. More procedure, long appointment induced stress on patient,
over the repair phenomenon developing in the pulp may
the operator skill, root canal anatomy and instrument
result in the narrowing of the pulpal space making availability should also be considered while deciding upon
endodontic treatment difficult [2]. single visit treatment.
Between these two points of view are those who
In a vital pulp, the infection is superficial therefore
consider pulp capping appropriate only for exposures in pulp extirpation and the root filling are best completed in
healthy pulps after accidental trauma or those displaying a single visit treatment. Flare up induced by the leakage
signs of minimal pulpitis. In case of caries penetration,
of the temporary seal is reduced and the teeth are ready
the tissue may be more or less inflamed, depending on sooner for final restoration diminishing a risk of a
the extent of the bacterial invasion [3]. There are no fracture. Completing root canal treatment in one
reliable methods to assess the extent of inflammation
appointment is an effective and time saving procedure
and identify a cut off point between a reversible or in selected cases.
irreversible inflammatory pulpal condition. Spontaneous
or inductible pain episodes of a lingering character, Conflicts of Interest
combined with percussion sensitivity, appear to be the None identified
best clinical predictors, currently available to suggest References
an impaired prognosis for pulp capping [4].
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MJAFI, Vol. 63, No. 3, 2007