Department of Endodontics, Faculty of Dentistry, Ege University, İzmir, Turkey.
Int Endod J. 2022 Aug;55(8):833-843. doi: 10.1111/iej.13758. Epub 2022 May 17.
The aim of the study was to evaluate the clinical and radiographic outcome of single-visit root canal retreatment and compare the results with conventional two-visit root canal retreatment as control group.
One hundred root canal-treated, single-rooted asymptomatic teeth with periapical lesion were retreated by one operator. Fifty of the teeth were randomly assigned to the single-visit group and the others were treated in two visits. In both groups, root canal filling material was removed, and re-instrumentation of the root canal was performed using step-back technique with hand files using 2.5% NaOCl and 5% EDTA as irrigants. In the single-visit group, 5 ml 2% chlorhexidine (CHX) were applied as the final irrigation and in the two-visit group, calcium hydroxide paste was placed into the root canal as an interappointment dressing. All root canal obturations were performed with lateral compaction. All patients were followed up for 24 months. The success was determined depending on both healed and healing cases. The chi-square or Fisher's exact test was used to analyse the differences between the groups for success rates and the factors affecting the outcome.
The recall rate was 89 (89%). At 24 months, 39 teeth (88.6%) were considered as healed, three teeth (6.8%) as healing, and two teeth (4.5%) were identified as failed in the single-visit group, while in the two-visit group 39 teeth (86.7%) had healed, two teeth (4.4%) were scored as healing, and four teeth (8.9%) as failed. There was no statistically significant difference in the success rates between the two groups (p > .05). Size of the lesion and the preoperative length of root canal filling had a statistically significant impact on the outcome (p < .05).
No statistically significant difference was observed in terms of healing in 24-month follow-up of retreatments completed in single visit or two visits in asymptomatic teeth with periapical lesions. The size of the periapical lesion and initial apical level of root canal filling have affected the outcome of root canal retreatment.
本研究旨在评估单次就诊根管再治疗的临床和放射学效果，并与作为对照组的常规两次就诊根管再治疗进行比较。
由一位操作者对 100 颗有根尖病变的根管治疗后、单根、无症状的牙齿进行再治疗。其中 50 颗牙齿被随机分配到单次就诊组，其余牙齿则分两次就诊。两组均采用逐步后退技术，使用手动器械和 2.5%次氯酸钠（NaOCl）和 5%乙二胺四乙酸（EDTA）作为冲洗剂，去除根管内的充填材料，并进行再预备。在单次就诊组中，最后冲洗使用 5ml 2%洗必泰（CHX）；在两次就诊组中，根管内放置氢氧化钙糊剂作为暂封剂。所有根管充填均采用侧向压实技术。所有患者均随访 24 个月。根据愈合和愈合病例来确定成功率。采用卡方检验或 Fisher 确切概率法分析两组间的成功率和影响结果的因素。
随访率为 89%（89 颗牙齿）。在 24 个月时，单次就诊组有 39 颗牙齿（88.6%）被认为是愈合的，3 颗牙齿（6.8%）是愈合中的，2 颗牙齿（4.5%）是失败的；而在两次就诊组中，有 39 颗牙齿（86.7%）是愈合的，2 颗牙齿（4.4%）是愈合中的，4 颗牙齿（8.9%）是失败的。两组间的成功率无统计学差异（p>.05）。病变大小和术前根管充填长度对结果有统计学显著影响（p<.05）。
在无症状伴有根尖病变的牙齿中，单次就诊或两次就诊的根管再治疗在 24 个月的随访中，在愈合方面无统计学差异。根尖病变的大小和根管初始根尖充填的水平影响根管再治疗的效果。
