Clinical Outcomes of Single-Visit Versus Multiple-Visit Endodontic Treatment in Mature Permanent Teeth

Root canal treatment is a widely performed procedure aimed at eliminating infection from the root canal system, preserving natural teeth, and promoting healing of periapical tissues. The optimal number of treatment visits required to achieve favorable clinical outcomes has long been debated in endodontics. Traditionally, multiple-visit treatment has been recommended to allow the placement of intracanal medicaments between appointments, whereas advances in instrumentation, irrigation, and obturation techniques have increased the feasibility of completing treatment in a single visit. As a result, comparisons between these treatment strategies have become an important area of clinical research. Clinical outcomes associated with single-visit and multiple-visit endodontic treatment have been evaluated through randomized clinical trials, systematic reviews, and meta-analyses. Measures commonly assessed include treatment success, periapical healing, postoperative pain, flare-ups, and patient-centered outcomes. Available evidence indicates that both approaches achieve high rates of clinical and radiographic success in mature permanent teeth when adequate disinfection and obturation are accomplished. Periapical healing outcomes are generally comparable between the two protocols, with no consistent evidence demonstrating clear superiority of either treatment schedule. Postoperative pain may occur following both approaches, although reported differences are often temporary and tend to diminish during follow-up. Similarly, flare-up rates remain relatively low and do not appear to be strongly influenced by the number of treatment visits. Clinical decision-making is influenced by several factors, including pulpal diagnosis, presence of apical pathology, complexity of root canal anatomy, degree of infection, operator experience, and patient preferences. Single-visit treatment offers advantages related to convenience, reduced chair time, and fewer appointments, while multiple-visit treatment may be preferred in selected cases requiring additional intracanal disinfection or management of persistent symptoms. Contemporary evidence supports a patient-centered and case-specific approach rather than routine reliance on a single treatment protocol. Careful assessment of clinical conditions and treatment objectives remains essential for achieving predictable outcomes and maintaining long-term tooth function in mature permanent teeth undergoing endodontic therapy.