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Gesi A, Hakeberg M et al. Oral Surg 2006; 101: 379–388

One visit treatment of vital pulp conditions may be appropriate because infection is more limited than with a non-vital condition. This randomised trial compared 1- and 2-visit treatment of vital pulp conditions. From 295 patients assessed, 256 were accepted and randomised to the groups, and 12 were wholly lost to follow-up; 90% attended at 2- or 3-yr recalls or both; 72% attended the 3-yr recall. The 2-visit treatment used a calcium hydroxide dressing between visits.

Pain was reported in 80% of patients preoperatively, and in 13% postoperatively. Most postoperative pain was in teeth which had been overfilled (P < 0.001), and pain did not differ significantly between groups. Preoperative radiography identified small periapical radiolucencies in 16% of patients, evenly divided between groups. Periapical lesions were present in 7% (17) of patients at 3 yrs and were evenly distributed between groups. In 13 patients, the lesions had been observed at 1 yr. The authors conclude that with aseptic conditions and proper instrumentation and filling, the 2-visit approach had no advantage.