Post-Obturation Pain Following Single-Visit Versus Two-Visit Endodontic Treatment Using A Hybrid Root Canal Preparation Technique

Abstract

Background and Objective: The number of appointments required to complete root canal treatment remains a clinically relevant consideration, particularly because postoperative pain can influence patient comfort and treatment acceptance. This study compared the frequency of post-obturation pain 24 hours after single-visit and two-visit endodontic treatment performed using a hybrid root canal preparation technique.

Materials and Methods: This randomized clinical trial was conducted in the Operative Dentistry Department of Nishtar Institute of Dentistry, Multan, Pakistan, from 1^st January 2023 to 30^th June 2023. One hundred forty patients aged 12–40 years with acute pulpitis or asymptomatic non-vital maxillary anterior teeth through first molars were allocated equally to a single-visit group (n=70) or a two-visit group (n=70). Both groups underwent the same hybrid canal preparation protocol. Postoperative pain was assessed 24 hours after treatment using the Heft-Parker visual analogue scale. Categorical variables were compared using the chi-square test, with p≤0.05 considered statistically significant.

Results: At 24 hours, 18/70 (25.7%) patients in the single-visit group reported pain compared with 38/70 (54.3%) in the two-visit group. No pain was reported by 52/70 (74.3%) and 32/70 (45.7%) patients, respectively. The between-group difference was statistically significant (χ² test, p=0.001). Age and sex were not significantly associated with pain within either treatment group.

Conclusion: In this study population and under the treatment protocol used, single-visit endodontic treatment was associated with a lower frequency of pain at 24 hours than two-visit treatment. However, the findings should be interpreted in the context of the study's limited follow-up, single-center design, and the evolving evidence base regarding the influence of treatment visits on postoperative pain.