Endodontic treatment – single and multiple visits have similar outcomes


Endodontic treatment is a common dental procedure and can be performed using either a multiple or single visit approach. Previous reviews have suggested that neither approach is better or able to prevent all short or long-term consequences.

The aim of this study was to conduct an overview of published systematic reviews (SRs) comparing endodontic treatment in single and multiple visits.


Searches were conducted in the Medline and Cochrane Central Register of Controlled Trials databases. Systematic reviews related to single and multiple visits techniques were considered. Two independent reviewers abstracted data. AMSTAR (Assessment of Multiple Systematic Reviews) was used to assess risk of bias, studies having 8-11 positive responses were considered to be at low risk of bias; 4-7 a moderate risk;  ≤ 3  a high risk. Three reviewers scored the studies. A narrative summary of the findings was presented.


  • 8 systematic reviews were included with 7 contributing data to the analysis.
  • 3 reviews were considered to be at low risk of bias, 4 at moderate risk, 1 at high risk.
  • The reviews involved a total of 62 primary studies.


The authors concluded: –

In the overall analysis, the single- and multiple-visit approaches showed similar healing or success rates regardless of the precondition of the pulp and periapex. The apical periodontitis subgroup showed a slight trend toward a decreased incidence of postoperative complications and a higher effectiveness for the single-visit approach. Based on the risk of bias, the current level of evidence for this clinical approach is high.


The searches for this review of reviews were completed before the publication of the updated Cochrane review by Manfredi et al (Dental Elf – 5th Dec 2016) which included 25 studies and concluded:-

There is no evidence to suggest that one treatment regimen (single-visit or multiple-visit root canal treatment) is better than the other. Neither can prevent all short- and long-term complications. On the basis of the available evidence, it seems likely that the benefit of a single-visit treatment, in terms of time and convenience, for both patient and dentist, has the cost of a higher frequency of late postoperative pain (and as a consequence, painkiller use).

The reviews included in this overview included between 3 – 63 studies and examined a range of outcomes associated with endodontic treatment essentially finding no significant differences between single and multiple visit treatment approaches.


Primary paper

Moreira MS, Anuar ASN, Tedesco TK, Dos Santos M, Morimoto S. Endodontic Treatment in Single and Multiple Visits: An Overview of Systematic Reviews. J Endod. 2017 Jun;43(6):864-870. doi:10.1016/j.joen.2017.01.021. Epub 2017 Apr 27.Review. PubMed PMID:28457639.

Other references

 Dental Elf – 5th Dec 2016

Root canal treatment: single or multiple visits?

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