Comparing the Traditional Versus Conservative Endodontic Access Cavities Design of the Maxillary First Molar: Using Cone-Beam Computed Tomography

Sui, Huachao; Zhao, Bo; Nie, Haidan; Hao, Xin; Qian, Feng; Sun, Cuicui; Li, Changyi; Zhou, Liwen; Wu, Ligeng

doi:10.12659/msm.932410

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…Cone beam computed tomography (CBCT) is a relatively new imaging techique that shows 3D images of structures. CBCT scanning can be useful in endodontics for detecting AP, assesing root canal morphology, detecting procedural errors, and evaluating postoperative healing outcomes [ 5 , 6 ]. Estrela et al [ 7 ] evaluated a new periapical index (PAI) based on CBCT for the identification of AP.…”

Section: Introductionmentioning

confidence: 99%

Radiological Assessment of Prevalance and Quality of Periapical Status of Endodontic Treatments

Aysal

Kocasaraç²,

Orhan

et al. 2022

Med Sci Monit

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Background The aim of this study was to determine the current prevalence and quality of endodontic treatments and investigate the relationship of various factors with posttreatment endodontic disease (PTED) in a Turkish subpopulation. Material/Methods The cone beam computed tomography (CBCT) images of 1069 patients (male, 50.9%; female, 49.1%; mean age, 45.32±13.50 years) were retrospectively analyzed. A total of 20 646 teeth were examined; 1604 had undergone root canal. Periapical status was assessed using a modified CBCT periapical index. The relationship between periapical status and quality of root canal fillings (RCFs) was analyzed statistically using the chi-square test. Multivariate logistic regression was performed to evaluate the effect of individual parameters by adjusting them for other variables. Results A total of 7.8% of all teeth had RCF. The prevalence of poor filling (having at least 1 procedural error) was 54.1%; the prevalence of PTED was 56.8%. The prevalence of PTED was 44.3% in teeth with short RCF, 10.8% with overextended RCF, 35.7% with nonhomogeneous RCF, and 15.5% in teeth with untreated root canals. The rate of RCF teeth with procedural errors associated with PTED was 76.2%. There was no significant difference between sexes in apical periodontitis ( P >0.05), which developed more frequently in teeth with procedural errors. Conclusions The overall prevalence of poor fillings (having at least 1 procedural error) among RCF teeth was high (54.1%) in this subpopulation. There is a substantial need to improve the technical quality of endodontic treatment.

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Section: Introductionmentioning

confidence: 99%

Radiological Assessment of Prevalance and Quality of Periapical Status of Endodontic Treatments

Aysal

Kocasaraç²,

Orhan

et al. 2022

Med Sci Monit

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“…Access cavity preparation is usually set up by projecting the outline, including the pulp horn and root canal orifice, onto the occlusal plane to establish the cavity. This is appropriate for permanent teeth, because little change occurs to the horizontal positions of the pulp horns or root canal orifices 22) . In clinical practice, however, severe secondary dentin formation on the side walls of the pulp chamber means that the root canal orifices are often covered with secondary dentin, identification of canal orifice potentially difficult 23) .…”

Section: Discussionmentioning

confidence: 99%

Age-Related Differences in Side Walls of Maxillary First Molar Pulp Cavities in Japanese Using Micro-Computed Tomography

Nomura

Matsunaga

Yamada

et al. 2023

J. Hard Tissue Biology.

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Recent years have seen attempts to perform access cavity preparation in a minimally invasive manner from the standpoint of preserving the tooth substance. However, age-related changes in pulp cavity morphology are unavoidable and may sometimes hinder the operator. Few studies appear to have addressed these changes in detail. The aim of this study was to identify age-related differences in the side walls of the pulp chamber for access cavity preparation using ultra-high-resolution micro-computed tomography (micro-CT). Specimens were human extracted maxillary first molars showing no caries, attrition, or abrasion, classified by age at extraction into adult (age 21-40 years, n=20), middle-aged (age 41-60 years, n=20), and senior (age ≥61 years, n=22) teeth. Specimens were scanned by micro-CT, with the resulting data used to create 3-dimensional (3D) reconstructions for examination of pulp cavity morphology. We also measured dentin thickness using reference lines and measurement lines, and compared the differences between age groups. The observations and measurements of dentin thickness made using these 3D reconstructions showed that in senior teeth, narrowing of the pulp cavity between the mesial and distal side walls was evident from the midline to the pulp chamber floor compared with adult teeth. Narrowing of the pulp cavity was also evident from immediately below the midline of the distobuccal wall to the pulp chamber floor. The dentin thickness of each side wall was measured, and the results showed that senior teeth were significantly thicker than adult teeth in the mesial, distal and distopalatal side walls. These results suggest that when preparing access cavity in senior patients, it is necessary to remove the distobuccal side wall in addition to the mesial and distal side walls for identification of canal orifice in maxillary first molar.

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“…A recent study using cone‐beam computed tomography evaluated traditional and conservative access; it concluded that traditional access requires the removal of 9.61 mm 2 of tissue for males and 8.91 mm 2 for females, and conservative access made the removal of 3.4 mm 2 for males and 3.1 mm 2 for females. Therefore, conservative access results in significantly less structure removal 35 . The controversy between traditional and conservative access relies on whether the clinician completely removes the pulp with conservative access; but this is also related to the skill of the clinician, tooth anatomy, and materials and methods utilized to open the access, clean, shape and obturate the root canal 36–38 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, conservative access results in significantly less structure removal. 35 The controversy between traditional and conservative access relies on whether the clinician completely removes the pulp with conservative access; but this is also related to the skill of the clinician, tooth anatomy, and materials and methods utilized to open the access, clean, shape and obturate the root canal. [36][37][38] The literature offers several successful cases reporting conservative endodontic accesses for anterior and posterior natural teeth and crowns.…”

Section: Discussionmentioning

confidence: 99%

Traditional versus conservative endodontic access impact on fracture resistance of chairside CAD‐CAM lithium disilicate anterior crowns: An in vitro study

Jurado

Amarillas-Gastelum

Tonin

et al. 2022

Journal of Prosthodontics

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PurposeTo evaluate the effect of traditional and conservative endodontic access hole preparation on fracture resistance of chairside computer‐aided design and computer‐aided manufacturing (CAD‐CAM) lithium disilicate maxillary right central incisor crowns.Materials and methodsFifty‐seven milled lithium disilicate maxillary right central incisor crowns were designed and fabricated with a chairside CAD‐CAM system (Planmeca Romexis, Planmeca). The abutment preparation had a 1.0 mm incisal reduction and 1.0 mm chamfer finish. The restorations were bonded with resin cement to printed resin dies (n = 19 per group) and were treated and divided into three groups, (1) no endodontic access, (2) traditional triangular endodontic access, and (3) conservative ovoidal endodontic access. The endodontic access of the crowns was sealed with flowable resin composite. Restorations were subjected to 10,000 cycles of thermal cycling between 5° and 55°C. Then, restorations were loaded and exposed to compressive loading force, and the crack initiation (CI) and complete fracture (CF) were recorded. SEM micrographs of broken specimens on the printed dies were captured. ANOVA test and Bonferroni's correction were used for statistical comparison.ResultsThe fracture resistance among the three groups varied. Crowns with no endodontic access displayed significantly (p < 0.001) higher resistance [CI: 1025 (121) N; CF 1134 (127) N], followed by crowns with conservative ovoidal endodontic access [CI: 924 (60) N; CF: 1000 (72) N. Crowns with traditional triangular endodontic access showed the significantly (p < 0.001) lowest fracture resistance [CI: 635 (82) N; CF: 709 (75) N].ConclusionThe fracture resistance of chairside CAD‐CAM lithium disilicate maxillary anterior crowns is influenced by the type of endodontic access provided. Conservative ovoidal endodontic access provides crowns with higher fracture resistance than traditional triangular endodontic access. Crowns with no endodontic access provided the highest resistance than other types of endodontic access.

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Comparing the Traditional Versus Conservative Endodontic Access Cavities Design of the Maxillary First Molar: Using Cone-Beam Computed Tomography

Cited by 3 publications

References 24 publications

Radiological Assessment of Prevalance and Quality of Periapical Status of Endodontic Treatments

Radiological Assessment of Prevalance and Quality of Periapical Status of Endodontic Treatments

Age-Related Differences in Side Walls of Maxillary First Molar Pulp Cavities in Japanese Using Micro-Computed Tomography

Traditional versus conservative endodontic access impact on fracture resistance of chairside CAD‐CAM lithium disilicate anterior crowns: An in vitro study

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