Comparison of single-visit versus multiple-visit root canal therapy for chronic anterior apical periodontitis

Objective: To compare the efficacy of single-visit root canal therapy (RCT) and traditional multi-visit RCT for chronic apical periodontitis in anterior teeth. Methods: A retrospective analysis was conducted on 106 patients with sinus-type anterior chronic apical periodontitis who underwent root canal treatment during March 2020 and April 2023 at Beijing Hospital of Integrated traditional Chinese and Western Medicine. The patients were divided into an observation group (55 cases, single-visit RCT) and a control group (51 cases, traditional multi-visit RCT) according to different treatment methods. Results: There were no significant differences in the sinus tract healing at post-treatment 2 weeks, the pain incidence at post-treatment one month, or clinical composite efficacy at posttreatment 6 months between the two groups (all P>0.05). However, after 3 and 6 months of treatment, the apical projection zone was significantly reduced in both groups compared to pre-treatment areas (P<0.05), though the difference between groups was not significant (P>0.05). The levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in gingival fluid were significantly lower (P<0.05) while interleukin-10 (IL-10) levels were significantly higher (all P<0.05) in both groups after 6 months of treatment compared to the pre-treatment levels. Again, no significant differences were found between the two groups (all P>0.05). The operation time and treatment cost of observation group were remarkably lower than those in control group (P<0.05). Conclusion: For patients with chronic sinus-type anterior apical periodontitis, a single-visit RCT can achieve similar results as traditional multiple-visit RCT, but with significantly shorter operation time and less medical cost. This approach is recommended for clinical practice.