The Incidence and Intensity of Postendodontic Pain and Flareup in Single and Multiple Visit Root Canal Treatments: A Systematic Review and Meta-Analysis

Abstract

To assess the incidence and intensity of postendodontic pain and flareup in single and multiple visit root canal treatment (RCT) and determine if the difference between the two is significant, a search of PubMed, Medline, Embase, Cochrane, Scopus and Web of science was conducted. The grey literature was searched using Google Scholar and Saudi digital library. Randomised controlled trials evaluating the incidence and intensity of postendodontic pain and flareup published in English from 1 January 2000 to 15 April 2020 were searched. The PRISMA protocol was followed to select the articles. A random effects model was used for the meta-analysis of the data in the included studies. Twenty-one articles were included in the review. Three compared both the incidence and the intensity, while the rest compared either one of the parameters. Most studies used both hand-driven and rotary instruments and irrigated with sodium hypochlorite. Twelve studies used an intracanal medicament. Although individual studies showed discordant treatment outcomes, the meta-analysis did not reveal any significant difference in the incidence or the intensity of the postendodontic flareup between the single and multiple visit RCT groups. Single or a multiple visit root canal treatment is not an independent determinant for the risk of postendodontic pain or a flareup.

Apical periodontitis after intense bruxism

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Outcomes reporting in systematic reviews on vital pulp treatment: A scoping review for the development of a core outcome set

“…Some studies used a numerical rating scale (NRS) and nonspecified questionnaires, whilst the visual analogue scale (VAS), which is more sensitive than other pain scales (Price et al, 1994), was used in few studies. This lack of standardization in reporting pain is a major problem for meta-analysis in systematic reviews reporting on endodontic pain (Vishwanathaiah et al, 2021). There are many other patient-reported outcomes such as cost effectiveness of treatment and satisfaction with treatment which are not reported in most of the studies.…”