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Article: Volume 47 Number 9 Page 747 - October 2020

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  Dent Update 2020; 47: 747-754

Endodontics:  Controversies in Endodontic Access Cavity Design: a Literature Review

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Abstract: The purpose of this article is to compare and contrast the different types of endodontic access cavity designs based on the current available evidence. Four types of access cavity designs, namely, traditional endodontic access cavity design (TEC), contracted/conservative endodontic access cavity design (CEC), ultra-conservative or ninja endodontic access cavity design (NEC) and truss endodontic access cavity design (TREC) have been suggested, and the latter three are currently in the limelight. Studies in vitro have been performed comparing the TECs, CECs, TRECs and NECs; except for the TECs, the other three types have not undergone clinical trials on patients. The choice of endodontic access cavity design affects fracture strength of the tooth, but remnants of pulpal tissue, due to ineffective instrumentation, can cause root canal treatment failure.

Clinical relevance: Root canal treatment with new access cavity designs has been proposed. However, there is lack of evidence to support such practices. It is important to consider the potential deleterious effects of such access cavity designs rather than emphasizing the preservation of tooth structure alone.

Author notes: Manahil Maqbool, BDS, MSc, Postgraduate Student, Paediatric Dentistry Unit, Tahir Yusuf Noorani, DDS, MResDent, FRACDS, Senior Lecturer, Conservative Dentistry Unit (email: dentaltahir@yahoo.com), Jawaad Ahmed Asif, BDS, MOMS, FRACDS, Senior Lecturer, Oral and Maxillofacial Surgery Unit, Saleem D Makandar, BDS, MDS, Senior Lecturer, Conservative Dentistry Unit and Nafij Bin Jamayet, BDS, Grad DipClinSc, MScDent, Senior Lecturer, Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.

Objective: To compare and contrast the different types of endodontic access cavity designs based on the current available evidence.