Juzer Shabbir1, Tazeen Zehra1, Naheed Najmi1, Arshad Hasan2, Madiha Naz1, Lucila Piasecki3, Adham A Azim4. 1. Department of Operative Dentistry and Endodontics, Liaquat College of Medicine and Dentistry, Karachi, Pakistan. 2. Department of Operative Dentistry and Endodontics, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan. 3. Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, New York. 4. Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, New York. Electronic address: azim@buffalo.edu.
Abstract
INTRODUCTION: Several endodontic access cavity designs have been proposed in the past decade to access the root canal space in a minimally invasive manner. The rationale for this approach was derived from the assumption that preserving more tooth structure during access preparation will improve the tooth's resistance to fracture and its long-term survivability. However, is this assumption valid? Also, can this approach compromise other treatment-related aspects? METHODS: We conducted a literature review using 4 online databases and classified the access cavity designs presented in each article according to our proposed classification. RESULTS: Through the literature search, we identified 49 articles that evaluated the effect of the access cavity design on 11 different treatment parameters. The majority of the studies failed to demonstrate clear benefits of the minimally invasive access designs, whereas others raised concerns regarding the ability to adequately disinfect, fill, and restore teeth with a minimally invasive access cavity design. CONCLUSION: Minimally invasive access cavity designs present more risk than benefit on the outcome of endodontic treatment. Clinicians should reconsider the application of a minimally invasive access cavity for routine endodontics and cautiously apply it in selected cases when the proper armamentarium is available. Published by Elsevier Inc.
INTRODUCTION: Several endodontic access cavity designs have been proposed in the past decade to access the root canal space in a minimally invasive manner. The rationale for this approach was derived from the assumption that preserving more tooth structure during access preparation will improve the tooth's resistance to fracture and its long-term survivability. However, is this assumption valid? Also, can this approach compromise other treatment-related aspects? METHODS: We conducted a literature review using 4 online databases and classified the access cavity designs presented in each article according to our proposed classification. RESULTS: Through the literature search, we identified 49 articles that evaluated the effect of the access cavity design on 11 different treatment parameters. The majority of the studies failed to demonstrate clear benefits of the minimally invasive access designs, whereas others raised concerns regarding the ability to adequately disinfect, fill, and restore teeth with a minimally invasive access cavity design. CONCLUSION: Minimally invasive access cavity designs present more risk than benefit on the outcome of endodontic treatment. Clinicians should reconsider the application of a minimally invasive access cavity for routine endodontics and cautiously apply it in selected cases when the proper armamentarium is available. Published by Elsevier Inc.