Single versus multiple visits endodontic therapy on healing rate of periapical lesions: A systematic review and meta-analysis

The choice of one or more sessions for the endodontic treatment of teeth with pulp necrosis and apical periodontitis is controversial. The purpose of this systematic review was to compare the radiographic healing of necrotic teeth with pre-existing periapical lesions after at least 1 year of follow-up period between two therapy groups: 1. single visit endodontic treatment, 2. multiple visits endodontic treatment with calcium hydroxide as intracanal medicament. It was made a literature search of only Randomized Controlled Trials (RCTs) on PubMed database. 5 RCTs met the inclusion and exclusion criteria and were included in this review, with a total sample size of 513 cases. Complete radiographic healing was observed in 226 (83.4%) of 271 cases treated in one visit and 198 (81.8%) of 242 cases treated in more than one visit. A meta-analysis was performed, showing no significant difference in the healing rate between the two therapy groups (fixed effect model, RR: 1.025; 95% Cl: 0.950 - 1.107). Based on the results of this study, endodontic treatment of teeth with pulp necrosis and radiographic evidence of apical periodontitis in one or more appointments showed similar radiographic healing rate.