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Purpose: To evaluate whether it is more effective to complete endodontic treatment in a single visit or in two visits with 1-week intracanal calcium hydroxide medication in symptomatic teeth and teeth with periapical lesions., Materials and Methods: One hundred and ninety-nine patients, with one symptomatic tooth or a tooth with a periapical lesion, were randomised, according to a parallel group design, to receive a complete endodontic treatment in a single visit (99 patients) or in two visits with 1-week intracanal calcium hydroxide medication (100 patients), at two centres. Patients were followed for up to 1 year post-treatment and the outcome measures were tooth loss, radiographic healing, any complication, post-treatment pain and amount of painkillers used., Results: Seven patients dropped out from the single-visit and ten patients from the two-visit group (all patients from one centre only). One patient lost his tooth from the single-visit and two patients from the two-visit group (difference in proportion = -0.01; 95% CI: -0.05 to 0.03; P = 0.619). Five single-visit patients and nine two-visit patients experienced one complication each (difference in proportion = -0.05; 95% CI: -0.12 to 0.03; P = 0.278). There were no statistically significant differences in tooth loss and complications. One year after treatment, complete radiographic healing was observed in 22 patients of the single-visit group and in 19 patients of the two-visit group; improvement in 43 patients of the single-visit group and in 54 patients of the two-visit group; and no changes/worsening in 24 patients of the single-visit group and in 15 patients of the two-visit group. There were no statistically significant differences in radiographic healing between the two groups (P = 0.509). Pre-treatment pain was reported by 68 single-visit patients and by 68 two-visit patients; 1-week post-treatment pain was reported by 27 single-visit patients and by 46 two-visit patients, and 2-week post-treatment pain was reported by 2 single-visit patients and 11 two-visit patients. For the first week, an average of 0.53 ± 1.23 tablets was taken by single-visit patients and 1.44 ± 3.32 tablets by two-visit patients. For the second week, no single-visit patients needed tablets and in the two-visit group the average was 0.37 ± 1.72 tablets. Patients of the two-visits group had statistically significant more post-treatment pain at 1 (P = 0.002) and 2 weeks (P = 0.011), and took more ibuprofen tablets at 1 (difference = -0.92; 95% CI: -1.62 to -0.21; P = 0.011) and 2 weeks after treatment (difference = -0.37; 95% CI: -0.72 to -0.03; P = 0.033), than in patients treated in a single visit., Conclusions: One year after treatment, both groups achieved similar clinical results; however, patients endodontically treated in a single visit suffered less postoperative pain and took less analgesics than patients treated in two visits, therefore a single-visit treatment should be recommended. Conflict-of-interest statement: This trial was self-funded and the authors have no conflict of interests to declare, however, rotary instruments were kindly provided by Sweden & Martina, Due Carrare PD, Italy.

Purpose: To evaluate the 10-year prognosis of consecutively endodontically treated or retreated teeth and to investigate some of the prognostic factors which could predict the long-term outcome of endodontic therapy., Materials and Methods: This retrospective cohort study included any patient who had endodontically treated or retreated teeth from 1986 to 1998 by a single operator in a private practice. Outcome measures were clinical and radiographic success assessed by the operator, radiographic success assessed by an independent outcome assessor and complications evaluated 10 years after treatment. Descriptive statistics, life table, Kaplan-Meier and Cox regression analyses for success were fitted., Results: A total of 411 patients with 1175 endodontically treated teeth were identified. Ten years after treatment 102 patients (24.8%) with 223 (19.0%) teeth were lost at the follow-up. The number of teeth that were originally treated and retreated were 704 and 471, respectively. Thirty-two teeth (2.7%) had one complication, which was successfully treated. A total of 988 (84.1%) teeth were considered a complete success, 46 (3.9%) a partial success, 52 (4.4%) a partial failure and 68 (5.8%) had to be extracted according to the treating clinician. For 21 teeth (1.8%) there was no follow-up information. The radiographic healing of 1086 teeth was evaluated by an independent assessor: 980 (90.2%) showed complete healing, 52 (4.8%) improvement, and 54 (5.0%) no change or worsening. The life-table analysis showed 93% of teeth surviving at 10 years after endodontic treatment. There were no differences for survival rates between teeth treated for the first time and those that were retreated (Kaplan-Meier). Teeth retreated because of symptoms or for a periapical/lateral radiolucency were more likely to fail., Conclusions: Approximately 7% of endodontically treated teeth were extracted 10 years after treatment. Symptoms and radiolucency of teeth needing retreatment may be important predictors for failure.