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Moreira MS, Anuar ASN et al. J Endod 2017;43: 864–870

An umbrella review considers only the highest level of evidence, specifically systematic reviews and meta-analyses. Such a review offers decision-makers an insight into the subject area (Int J Evid Based Healthc 2015; 13: 132–140). These investigators compared outcomes following single and multiple visits for endodontic treatments. Twenty systematic reviews were identified of which only eight were of sufficient rigor to be included (two papers were considered together as a single systematic review). The Assessment of Multiple Systematic Reviews tool (AMSTAR) was used to assess the risk of bias; three systematic reviews were of low risk, three of moderate risk and one of high risk. The investigators reported there were no differences in outcomes between single visit root canal therapy or that carried out with multiple visits, irrespective of the pulpal or periradicular status. Patient-centred outcomes should also be considered in such reviews. These authors did not cite a recent paper that found '...scheduling treatments as well as patients' and dentists' preferences' should influence the decision between single or multiple visits root canal therapy (J Endod 2016; 42: 1446–1452). This latter paper found there was no difference in cost-effectiveness between single and multiple visits root canal therapy.