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A Controlled final Irrigation Protocol Reduces the Acute Pain Rate of Single versus Two-visit RCT of Teeth with Necrotic Pulp and Apical Periodontitis: A Multicenter Clinical Trial

Objective: To determine whether controlled final irrigation protocol after cleaning and shaping procedures would result in a reduced acute pain rate of single versus two-visit RCT of teeth with necrotic pulp and apical periodontitis: A multicenter clinical trial.

Methodology: Ninety patients were treated. Working length was established with electronic device and confirmed radiographically. For mechanical enlargement, the Twisted file adaptive, and Protaper Next instruments were used in brushing rotary movement and reciprocating mode correspondingly. For the control group, Balanced Force technique was employed. A controlled Final irrigation protocol was used in all groups. The same clinical protocol was used in three different cities of Mexico.

Results: The distribution of clinical samples was 45 teeth to one-visit and 45 teeth to two-visit treatment. Two cases (2.5%) experienced acute pain in teeth that receive an RCT. Of the earlier Asymptomatic/symptomatic teeth, the treatment was successful in eradicating pain in 83.33%. Statistical analysis of the healing results did not show any significant difference between the groups (p=0.05).

Conclusions: This study provided clinical evidence that an accurately instrumented one-visit root canal treatment can be as effective as a two-visit treatment. The use of substances with antibacterial activity is a valuable tool to control endodontic infection.

Clinical relevance: A controlled final irrigation protocol after clean and shape the canals reduced the incidence of postoperative pain and the need for medication in patients presenting with a diagnosis of necrotic pulp and symptomatic apical periodontitis.


Jorge Paredes Vieyra, Haydee Gómez Llanos Juárez, Francisco Javier Jimenez Enriquez, Fabian Ocampo Acosta, Mario Ignacio Manriquez Quintana, Alan Hidalgo Vargas

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