To evaluate the success in an acute emergency setting of :‘single visit pulpectomy and pulpotomy,‘single vs multiple visit endodontic therapy’ and‘trephination’ vs ‘no trephination’.
Methods:
The MEDLINE and EMB Reviews: Cochrane Databases were searched using the OvidSP PubMed search engine, and Embase.com search engines. All articles published in dental journals in English from their inception to 2014. Citation mining also identified,388 studies dealing with emergency endodontic treatment
Results:
23 eligible RCTs and prospective studies were identified but only 7 included: Single visit pulpectomy vs pulpotomy; 1 RCT and 1 prospective study representing 972 patients found no statistically significant differences. One-visit pulpotomy vs multiple visit pulpotomy: 3 RCTs compared one-visit versus multiple visits pulpotomies in 382 patients and found no statistically significant differences in success rates.Trephination: in the 2 RCTs evaluating trephination, as an augmentation technique, no statistically significant difference was observed.
Conclusion:
These conclusions are based on small numbers of studies and patient pools. There is insufficient reliable evidence refuting or supporting the various emergency endodontic procedures. Pulpotomy procedures with Ca(OH) cement were found to be just as successful as pulpectomy. Pulpotomy may be a viable option for clinicians with time restraints. Single appointments were found to be no better or worse than multiple visit appointments (P value = 0.430). In regards to trephination, there is not enough evidence to support or refute this treatment option. In some cases trephination may cause more pain post-operatively.