This randomized controlled trial aims to compare the incidence of endodontic flare-ups in patients undergoing single-visit versus multiple-visit root canal treatment (RCT) at Saidu College of Dentistry, Swat. The study will recruit 344 patients aged above 10 and below 60 years, with permanent first molars indicated for RCT and meeting specific clinical and radiographic criteria. Participants will be randomly allocated into two groups: one receiving single-visit RCT and the other receiving multiple-visit RCT. Pain and flare-up incidence will be evaluated using the Visual Analog Scale (VAS) and swelling grading criteria at 6, 24, and 48 hours post-treatment. The primary outcome is the frequency of endodontic flare-ups requiring additional intervention. The study also examines the role of occlusal reduction in managing postoperative discomfort. Data will be analyzed using SPSS v23 with chi-square and Fisher's exact tests to compare outcomes. The findings aim to inform evidence-based protocols for endodontic treatment in the local population.
Children in the age group >10 years with deep caries approximating pulp on radiograph and indicated for a root canal treatment.
Proper bone support.
No evidence of severe mobility/discharge of frank pus
Radiographically tooth indicated for root canal treatment.
Tooth/teeth with extensive periodontal pathology/ periapical radiolucency.
Teeth with evidence of internal or external root resorption involving more than one third of the root length.
Children with facial cellulitis or significant extraoral swelling.
Patients with any systemic diseases.
Parallel
single visit root canal treatment
Procedure/SurgeryRoot canal procedure performed in a single visit using ProTaper file system, sodium hypochlorite irrigation, and lateral compaction with gutta-percha and sealer. Final restoration with GIC.
Multiple visit root canal treatment
Procedure/SurgeryRoot canal procedure performed over two or more visits using the same instrumentation and irrigation protocol. Canals are medicated between appointments before obturation and restoration.
Incidence of endodontic flare-ups
Flare-up defined as severe postoperative pain (VAS score ≥ 7) and/or swelling requiring unscheduled dental intervention, excluding pre-existing conditions
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