For the longest time, there has been a debate on whether RCT should be done in one visit or multiple visits. Some care providers will always complete in one visit, whilst others will always complete a case in multiple visits. There are studies that will support both of these philosophies. Personally, I feel that (if time permits) some cases can be completed in a single visit, whilst others in multiple visits. In cases that are asymptomatic, abscess with facial swelling involved, large chronic apical lesions, I will try to treat them as multi-visit cases. Below is an example.
Here #28 and 29 both were symptomatic to percussion, biting and both had 2 mobility. Both have chronic localized adult periodontitis. Apical inflammatory root resorption was noted for #29. A draining sinus tract was noted at the distal apical area of #29. Prognosis was guarded, and the alternative of extractions were discussed. However, the patient wanted to retain the teeth, and wanted to try to save both of them. RCT was started for both #28 and 29. Both canals were cleaned, shaped and irrigated. Long term Ca (OH) 2 was placed in both teeth. The medication was changed several times, until finally, the sinus tract disappeared and mobility lessened. RCT were both completed and access sealed.
1 Year post-op revaluation. Here we can see that the apical RLs have markedly decreased. Probing and mobility were both normal. No symptoms reported.