Conservative endodontics II: A truss access/ orificeoriented access case series of premolars

Abstract

Strategic dentin preservation is the prime objective of this case report (i.e. leaving a truss of dentin between the 2 cavities thus prepared). Permanent teeth with an indication for endodontic treatment can be treated via the truss access cavity design rather than traditional access cavity protocol using copious irrigation. The teeth were then given post-endodontic restorations. Endodontically treated teeth did not show any post-operative symptoms or any presence of post-operative periapical radiolucency or flare-up. The main objective of Orifice oriented access/truss access approach mainly stresses on the preservation of the healthy tooth structure with the minimally invasive approach. This minimal invasive approach in truss access designs avoids the need for conventionally placed crowns. Thus, the aim of this case report was to strategically plan truss access cavity designs on premolars.

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

“…Conservative dentistry aims to provide the least invasive treatment possible 33 . In endodontics, access design involving minimum tooth tissue removal has been developed to provide root canal therapy with less removal of tissue structure 34 . 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.…”

Modern versus Traditional Endodontic Access Cavity Designs

“…“Truss” AC is a Cons endodontic AC (Conservative Endodontic Access Cavity (CEC)) technique. [ 1 ] Its aim is to keep the dentinal bridge in place between two or more small cavities made to access the canal orifice(s) in each multirooted tooth root. [ 2 ] Separate cavities are formed in the mandibular molars to approach the mesial and distal canal systems, whereas, in maxillary molars, the mesio- and disto-buccal canals are accessed via one cavity, while the palatal canal is addressed through another.…”

“…[ 2 ] Separate cavities are formed in the mandibular molars to approach the mesial and distal canal systems, whereas, in maxillary molars, the mesio- and disto-buccal canals are accessed via one cavity, while the palatal canal is addressed through another. [ 1 ]…”

“…Several access cavity (AC) designs involving minimum tooth tissue removal have been developed in the recent decade for gaining admission to pulp chambers during root canal therapy. [ 1 ] Endodontic modern AC designs have lately been developed to reduce tooth structural loss. [ 1 ] The debates should not be over whether to completely or partially unroof the pulp chamber roof, or whether to drill a ninja AC or use truss access; ultimately, the outlines of the AC are influenced by anatomical issues, skills, and the tools and methods used to open, clean, shape, and obturate various root canal systems.…”

“…[ 1 ] Endodontic modern AC designs have lately been developed to reduce tooth structural loss. [ 1 ] The debates should not be over whether to completely or partially unroof the pulp chamber roof, or whether to drill a ninja AC or use truss access; ultimately, the outlines of the AC are influenced by anatomical issues, skills, and the tools and methods used to open, clean, shape, and obturate various root canal systems. [ 2 ] The maintenance of the pericervical dentin is the most important aspect in retaining the normal function, esthetics, and durability of the treated tooth.…”