Controversies in endodontic access cavity design: A literature review Manahil Maqbool Tahir Yusuf Noorani Jawaad Ahmed Asif Saleem D Makandar Nafij Bin Jamayet Dental Update 2024 47:9, 707-709.
Authors
ManahilMaqbool
BDS, MSc, Postgraduate Student, Paediatric Dentistry Unit
Senior Lecturer, Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
BDS, Grad DipClinSc, MScDent, Senior Lecturer, Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
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.
CPD/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.
Article
Although the role of caries removal and root canal disinfection cannot be overemphasized, there is considerable controversy regarding the size of the preparation of the access cavity and the parameters of the preparation of the root canal. The need for dentine conservation cannot, however, be understated.1 Direct access to the root canal system is one of the purposes of an endodontic access cavity. The traditional endodontic access cavity (TEC) design focuses on the inclusion of all pulp horns and the removal of the roof of the pulp chamber so that the coronal portion of the root canal system is sufficiently debrided (Figure 1 a, b).2 This approach has been contested by the radical design of the access cavity that has been proposed in recent years. It stressed the preservation of pericervical dentine (PCD) and suggested that it was not necessary to unroof the pulp chamber completely.1 The interest in minimally invasive endodontics is enabled by new technologies and techniques that maximize residual dentine.3
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
