Page 109 - Demo

No medicament versus calcium hydroxide1076the case, the question might raise whether that also would have influenced the number of interappointment emergencies. Those extra visits, though, were always free of charge for the patient, and they were aware of that. The incidence of interappointment emergencies found in the present study seems high. However, this might be explained by the length of the follow-up interval. Until eleven days following intervention, the incidence found in the present study was within the previously reported range of 1.5% to 5.5% (Table 3). Most studies assessed the incidence only a few days following intervention. In a recent study that was comparable to the present study, an incidence of 2.3% in three days interval was found [2], which is close to the incidence in the same time interval in the present study (2.9%). The longer follow-up interval used in the present study made it possible to see that interappointment emergencies might occur not only in the first few days following intervention but also considerably later. An interappointment emergency occurs only in cases of pain or swelling that is severe enough to influence a patient’s normal life, resulting in an unscheduled visit to the dental clinic [5]. Most studies used the term ‘flare-up’ to define similar emergency situations of pain or swelling [1,2,5]. According to the American Association of Endodontists, the definition of a flare-up is ‘an acute exacerbation of an asymptomatic pulpal and/or periradicular pathosis after the initiation or continuation of root canal treatment’ [30], the onset of which usually falls within a few days following intervention [5]. In the present study, both asymptomatic and symptomatic teeth were included, and the follow-up interval was extended to two months. This is the reason that in the present study the term interappointment emergency is used instead of flareup. Interappointment emergencies as defined in the present study are clinically relevant since the time between appointments for the root canal treatment may take weeks or even months, not only in the undergraduate clinic, but also in other dental clinics. The apparent absence of increased risk of interappointment emergencies when no intracanal medicament is used in multiple-visit root canal treatment is valuable information that presumably contradicts opinions of practitioners and educators. Annemarie Baaij.indd 107 28-06-2023 12:26