Comparison of the Effectiveness of Single-Visit and Multi-Visit Root Canal Treatment on Healing Intraoral Sinus Tract

Objective: This research sought to investigate and compare the levels of postoperative discomfort and the rate of intraoral sinus tract healing in teeth affected by chronic apical periodontitis, treated either through single-visit (SV) root canal therapy (RCT) or multi-visit (MV) therapy employing calcium hydroxide as an intracanal medicament. Materials and Methods: A total of 60 participants, aged between 18 and 65 years, with single-rooted teeth exhibiting single canals, radiographic evidence of apical periodontitis, and associated intraoral sinus tracts, were included in the study. The participants were randomly divided into two treatment groups: Group 1 underwent SV therapy, while Group 2 received MV therapy. In the MV group, calcium hydroxide was introduced as an intracanal dressing following the preparation phase, and the root canal obturation was performed in a subsequent session after 1 week. In the SV group, obturation was completed in the same session. For the MV group, calcium hydroxide was removed during the second visit, the irrigation procedure was repeated, and obturation was finalized. Pain levels were measured postoperatively using a visual analog scale (VAS). Participants documented their pain at 6 and 12 h following treatment, as well as daily for the next 2 days. In the MV group, pain was additionally evaluated at the beginning of the second session, and patients were asked to report any pain experienced during the interval between visits. Follow-up appointments were conducted to assess the progress of sinus tract healing, which was defined as the complete closure or resolution of the tract over a 14-day period. Data were analyzed using the two-sample proportion test and Pearson's chi-square test, with statistical significance set at α = 0.05. Results: The findings indicated no statistically significant differences between the two groups regarding the frequency of postoperative pain (p > 0.05). Median scores showed that VAS scores were highest after 6 h (Mdn = 3, IQR = 5.25), followed by 12 h (Mdn = 3, IQR = 6), after 24 h (Mdn = 0, IQR = 3.25), and after 48 h (Mdn = 0, IQR = 3). In both groups, pain levels at the 6^th h were found to be higher than at the 48^th h (p < 0.05). Mean recovery time was 6.8 days for the SV group and 6.56 days for the MV group. The duration required for sinus tract healing showed no significant variation between the SV and MV treatment modalities (p > 0.05). Conclusion: Both SV and MV root canal treatments (RCTs) yielded comparable outcomes in terms of postoperative pain levels and the time necessary for sinus tract resolution, with no statistically significant differences observed between the two approaches. The observed similarity in healing parameters and pain levels suggests that both treatment methods demonstrate comparable clinical effectiveness.