Single-visit versus multi-visit endodontic retreatment: A systematic review of outcomes in patients with secondary endodontic infection

Introduction: Secondary endodontic infections present intricate challenges in dental practice, necessitating effective retreatment strategies. The current systematic review aimed to critically evaluate the outcomes of single-visit versus multi-visit endodontic retreatment in patients with secondary endodontic infections. Materials and Methods: The current systematic review was registered in the Open Science Framework database and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Searches were conducted in PubMed/Medline, Scopus, and Web of Science databases for articles published until April 2023. The inclusion criteria for the current systematic review were clinical trials reporting the comparison of nonsurgical single-visit versus multiple-visit endodontic retreatments with predictive outcome. The Cochrane scale was used to assess the risk of bias. Results: Six studies were included in the systematic review. Four studies reported the incidence of postoperative pain, and two studies reported the periapical lesion healing after single- and multiple-visit endodontic retreatments with an 18- and 24-month follow-up. Three studies showed a low risk of bias, one study showed unclear risk of bias, and two studies showed a high risk of bias. Conclusion: Comparative analyses indicated that single-visit endodontic retreatment yielded comparable postoperative pain levels and healing outcomes as retreatment conducted over multiple visits. Notably, the utilization of intracanal medicaments such as calcium hydroxide and triple antibiotic paste demonstrates promise in mitigating postoperative pain subsequent to retreatment procedures.