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Abstract The purpose of this study is to evaluate single- visit versus multiple visit root canal treatment of non-vital teeth in terms of clinical, micro-biological and radiographic outcomes, incidence of postoperative pain, using single- file and multiple files instrumentation techniques. Forty patients were selected in this study, all of them had asymptomatic apical peridontitis associated with a necrotic lower molar. A cone beam computed tomography was taken for each patient before initiating treatment. They were then randomly and equally divided into two groups. The first group received single visit root canal treatment while the second group was treated during multiple visits. In both groups chemo- mechanical root canal preparation and obturation were performed by the same operator. Mechanical preparation was either done using ProTaper Universal system or WaveOne system. Bacterial Sampling was performed before initiating the treatment and after cleaning and shaping in a liquid transport media, which was incubated for 1 week in a 37 ⁰C. Samples were then measured for their optical density using a spectrophotometer. Patients were instructed to fill a numerical scale rate from 0 to 10 to determine the intensity of the post-operative pain. Patient recall after one year and a CBCT was taken again along with digital radiograph to evaluate periapical healing. The presence or absence as well as the increase or decrease in size of existing periapical radiolucency was assessed and a 6-point scoring system was done to determine the healing. The results of the postoperative pain showed no statistical significant difference between single visit and multiple visit groups, as well as ProTaper and WaveOne subgroups regardless any given time. Concerning bacterial reduction, a statistically significant difference was found between (S0) and (S1) in both ProTaper and WaveOne subgroups. While no statistical difference was found between the bacterial reduction of single versus multiple visit groups. Also, the instrumentation technique did no affect the bacterial reduction statistically. The clinical outcomes results showed no different statistically between single or multiple visit treatment groups, as well as no difference between both instrumentation techniques. CBCT showed higher scores than digital radiography. Under the limitation of this study, we concluded that: • Both single and multiple visit are effective treatment strategies in terms of bacterial reduction, postoperative pain and positive clinical outcomes. • Also, single file reciprocating file is as effective as the multiple file rotating system in terms of bacterial reduction, postoperative pain and clinical results. Recommendations: • CBCT is recommended to be used in cases with apical peridontitis as it was more sensitive than digital radiograph. |