Postoperative Pain of Endodontic Re-treatment in Single and Multiple Visits: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Abstract Aim: This systematic review aimed to evaluate the influence of single-visit and multi-visit non-surgical endodontic re-treatments on the incidence, intensity, and duration of postoperative pain and adverse effects. Materials and Methods: A search of the literature was conducted after registration of the study protocols in PROSPERO to find randomized clinical studies assessing postoperative pain in non-surgical endodontic re-treatment conducted during one or more visits in PubMed, Cochrane library, and Scopus databases and EBSCO using a definitive search strategy based on inclusion and exclusion criteria. Using the Cochrane risk of bias method, two independent reviewers determined the studies that were eligible for inclusion, extracted data, and evaluated the quality. Meta-analysis was carried out at wherever appropriate. Results: A total of 827 citations were found by the database search and 16 citations from other sources. Eleven full-text articles were obtained after duplicates were eliminated. Three clinical trials were deemed eligible for inclusion; on qualitative evaluation, two studies showed an unclear risk and one was graded as having a significant high risk of bias. The sample size was significant in only one study, and the other two studies had a smaller sample size. Meta-analysis was performed at 24 h, 48 h, and 7 days. The random-effects model at 24 and 48 h and fixed-effects model after 7 days indicated that there is no significant difference in pain intensity between single-visit and multi-visit re-treatments. Conclusion: The significance of the number of visits on the subsequent pain following the re-treatment procedure was underlined by this current systematic review and meta-analysis. The single visit re-treatment caused less postoperative pain and can be considered based on the clinical scenario.