A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment
A systematic review comparing single-visit versus multiple-visit nonsurgical root canal treatment — examining success rates, postoperative pain, and clinical implications for everyday practice.
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Background Root canal treatment is one of the most common procedures in dentistry. A longstanding clinical question has been whether nonsurgical endodontic treatment should be completed in a single visit or across multiple visits. Both approaches have proponents, and the evidence has evolved considerably over the years. What the Systematic Review Found A systematic review published in Clinical, Cosmetic and Investigational Dentistry (PMC4020891) evaluated the available randomized controlled trials comparing single-visit versus multiple-visit nonsurgical root canal treatment.
Key findings included: - Success rates were comparable between single-visit and multiple-visit approaches for vital and necrotic teeth in most studies. - Postoperative pain was not significantly different between the two approaches in the majority of trials, though some studies showed slightly higher flare-up rates with single-visit treatment in necrotic cases. - Patient convenience is a clear advantage of single-visit treatment — fewer appointments, reduced time away from work, and lower overall cost.
- Multiple-visit treatment may be preferred in complex cases, teeth with persistent symptoms, or situations where achieving full working length or hemostasis is difficult. Clinical Implications The choice between single-visit and multiple-visit endodontic treatment should be individualized based on: - Pulp vitality status (vital vs. necrotic) - Presence of apical periodontitis - Case complexity and canal anatomy - Patient preference and systemic health There is no universal "best" approach — the evidence supports clinical flexibility guided by case-specific factors.
📄 Read the full systematic review (PDF)