Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth

Corsentino, Giacomo; Pedullà, Eugenio; Castelli, Laura M.; Liguori, Marzia; Spicciarelli, Valentina; Martignoni, Marco; Ferrari, Marco; Grandini, Simone

doi:10.1016/j.joen.2018.05.012

Cited by 107 publications

(134 citation statements)

References 29 publications

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“…Dentin loss is an important factor that adversely affects the survival of endodontically treated teeth. 20,21 Endodontic treatment steps include preparation of access cavity and instrumentation of the root canal system, which may result in excessive loss of the tooth structure and subsequently lead to weakening of the tooth and its consequently decreased fracture strength against loads. 23,24 Recently, TREC design was suggested as an alternative to the TEC design since the former better preserves the tooth structure and does not compromise its strength.…”

Section: Discussionmentioning

confidence: 99%

“…REC.1395.243). Sample size was calculated to be 10 in each group according to previous studies, 6,21 assuming alpha=0.05, beta=0.2 and study power of 80%.…”

Section: Methodsmentioning

confidence: 99%

“…Teeth with almost similar shape and size were allocated to each group for the purpose of standardization and in order to minimize the effect of variable sizes and shapes of the teeth on the results. 21…”

Section: Methodsmentioning

confidence: 99%

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<p>Effects of Endodontic Access Cavity Design and Thermocycling on Fracture Strength of Endodontically Treated Teeth</p>

Saberi¹,

Pirhaji²,

Zabetiyan³

2020

CCIDE

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Introduction: This study aimed to assess the fracture strength of endodontically treated mandibular molars with traditional endodontic access cavity (TEC) and truss endodontic access cavity (TREC) designs that were restored with composite resin and underwent thermocycling. Methods: Sixty mandibular first and second molars were randomly divided into 6 groups (n=10) of intact controls without thermocycling (group 1), intact controls with thermocycling (group 2), TEC without thermocycling (group 3), TEC with thermocycling (TEC-TC, group 4), TREC without thermocycling (group 5) and TREC with thermocycling (TREC-TC, group 6). The root canals were then instrumented to #25,7% using nickel-titanium files and were filled with gutta-percha and AH26 sealer with lateral compaction technique. Access cavity was restored with Gradia composite. All teeth were then thermocycled for 480 cycles between 5°C and 55°C for 30 seconds and their fracture strength was measured in a universal testing machine with a round-end piston with 6 mm diameter at a speed of 1 mm/min. Data were analyzed using two-way and one-way ANOVA. Results: Without thermocycling, the fracture strength of endodontically treated teeth with TREC designs had no significant difference with the control group (P>0.05). However, both TEC and TREC designs significantly decreased the fracture strength of endodontically treated teeth after thermocycling (P<0.05), such that minimum fracture strength was noted in TEC-TC group. Conclusion: Under the conditions of this ex vivo study, TREC enhances the fracture strength of endodontically treated teeth under thermal stresses.

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Section: Discussionmentioning

confidence: 99%

“…REC.1395.243). Sample size was calculated to be 10 in each group according to previous studies, 6,21 assuming alpha=0.05, beta=0.2 and study power of 80%.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

<p>Effects of Endodontic Access Cavity Design and Thermocycling on Fracture Strength of Endodontically Treated Teeth</p>

Saberi¹,

Pirhaji²,

Zabetiyan³

2020

CCIDE

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“…Therefore, the second null hypothesis was also rejected. Hence, despite the canal debridement optimization associated with the Clearsonic tip, the larger volume of dentine removed may weaken the tooth and thus decrease its mechanical stability and fracture resistance (Corsentino et al 2018). Based on the fact that conservation of tooth structure is an 53,[410][411][412][413][414][415][416][417][418][419][420]2020 important factor that affects the survival of root filled teeth, one may argue that the increased removal of dentine by the use of the Clearsonic tip might be a disadvantage.…”

Section: Discussionmentioning

confidence: 99%

Arrowhead design ultrasonic tip as a supplementary tool for canal debridement

et al. 2019

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Aim To investigate the shaping and cleaning performance of the Clearsonic ultrasonic tip as a supplementary tool during the preparation of long oval‐shaped root canals through micro‐computed tomographic (micro‐CT) imaging technology. The Reciproc M‐Wire R40 instrument was used as a reference instrumentation technique for comparison. Methodology Twenty mandibular incisors with single, straight and long oval‐shaped canals were selected and pair‐matched by micro‐CT scanning. The root canals were prepared with Reciproc R25 and R40 instruments, scanned again in a micro‐CT device and randomly allocated into one of the two experimental groups (n = 10), according to the supplementary debridement protocol used: Clearsonic or Reciproc R40 used in a brushing motion against buccal and lingual walls. Noninstrumented canal areas, accumulation of hard‐tissue debris (AHTD) and volume of removed dentine were assessed using micro‐CT imaging following the supplementary debridement protocols. Data were analysed statistically in two phases using a t‐test with a significance level of 5%. Results In phase‐1, there was a significant similarity between the samples regarding the evaluated micro‐CT baseline parameters (P > 0.05), validating the anatomical similarity between the tooth pairs. In phase‐2, there was a significant difference between the groups for canal volume, surface area, noninstrumented root canal walls and the amount of removed dentine for both absolute and percentage values (P < 0.05), but not for AHTD (P = 0.759). Conclusions The Clearsonic tip outperformed the Reciproc R40 instrument as a supplementary debridement protocol as it was associated with significantly greater reduction of noninstrumented root canals walls and consequently a larger amount of removed dentine. Both groups performed similarly regarding the AHTD.

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“…Previous studies have reported conflicting results regarding the influence of access cavities on the fracture resistance of root filled teeth. Whilst some studies have reported a greater resistance to fracture in root filled teeth with conservative access cavities (Krishan et al 2014, Plotino et al 2017, the overwhelming majority of studies have failed to produce evidence of any advantages in terms of fracture resistance in root filled teeth subjected to different types of minimally invasive endodontic access cavities (Moore et al 2016, Chlup et al 2017, Ivanoff et al 2017, Rover et al 2017, Corsentino et al 2018, Marchesan et al 2018, Neelakantan et al 2018, Ozyurek et al 2018, Sabeti et al 2018, Silva et al 2020. Moreover, a systematic review on the topic found no evidence to support minimally invasive access cavities over TEC with minimally invasive access cavities not being associated with any improvement in fracture resistance (Silva et al 2018).…”

Section: Introductionmentioning

confidence: 99%

A laboratory study of the impact of ultraconservative access cavities and minimal root canal tapers on the ability to shape canals in extracted mandibular molars and their fracture resistance

Augusto¹,

Barbosa²,

Guimaraes³

et al. 2020

Int Endodontic J

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Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth

Cited by 107 publications

References 29 publications

<p>Effects of Endodontic Access Cavity Design and Thermocycling on Fracture Strength of Endodontically Treated Teeth</p>

<p>Effects of Endodontic Access Cavity Design and Thermocycling on Fracture Strength of Endodontically Treated Teeth</p>

Arrowhead design ultrasonic tip as a supplementary tool for canal debridement

A laboratory study of the impact of ultraconservative access cavities and minimal root canal tapers on the ability to shape canals in extracted mandibular molars and their fracture resistance

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