Exploring access cavity through non‐carious cervical lesions: Impacts on instrumentation, obturation, and fracture resistance in mandibular incisors

Exploring access cavity through non‐carious cervical lesions: Impacts on instrumentation, obturation, and fracture resistance in mandibular incisors

Aim To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors. Methodology Twenty recently extracted and intact mandibular incisors were initially scanned using a micr...

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Bibliographic Details
Published in:International endodontic journal Vol. 57; no. 11; pp. 1689 - 1698
Main Authors: Silva, Emmanuel J. N. L., Vianna, Patrícia S., Lima, Carolina O., Barbosa, Ana Flávia A., Vieira, Victor T. L., Versiani, Marco A.
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-11-2024
Subjects:
Composite materials
conservative access cavity
Dental pulp
Dental Pulp Cavity
Dental restorative materials
Endodontics
fracture resistance
Humans
In Vitro Techniques
Incisor
Incisors
Mandible
micro‐CT
minimally invasive endodontics
non‐carious cervical lesion
root canal
Root Canal Obturation - methods
Root Canal Preparation - instrumentation
Root Canal Preparation - methods
Root canals
Statistical analysis
Surface area
Teeth
Tooth Cervix - pathology
Tooth Fractures
X-Ray Microtomography
fracture resistance
micro‐CT
non‐carious cervical lesion
root canal
minimally invasive endodontics
conservative access cavity
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Summary:Aim To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors. Methodology Twenty recently extracted and intact mandibular incisors were initially scanned using a micro‐CT device. The specimens were anatomically matched to create two groups (n = 10). A wedge‐shaped non‐carious cervical lesion (NCCL) was created on the buccal aspect of all teeth using a double‐faced segmented diamond disc. In group 1, a TradAC was prepared, whilst in group 2, access was created through the simulated NCCL using a round diamond bur 1012. After root canal preparation with Rotate instruments sizes 15/0.04, 20/0.04, and 25/0.04, the teeth were scanned again and evaluated for root canal volume and surface area, static voxels, volume of removed dental tissue, and dentine thickness. After that, the root canals were filled using the single‐cone technique, teeth were restored with composite resin, and subsequently rescanned to calculate the volume of filling materials and voids. Then, the restored teeth were subjected to fracture resistance tests using a universal testing machine. Statistical comparisons between groups were performed with the Mann–Whitney test or the Student's t‐test, with a statistical significance level of 5%. Results Statistical comparisons indicated no significant differences between groups in terms of root canal volume, surface area, static voxels, removed root dentine, root canal filling volume, percentage of voids, or fracture resistance load (p > .05). Conversely, teeth prepared with TradAC showed a significantly higher percentage of dental tissue removed from the crown (p = .001) and a greater volume of filling material remnants in the pulp chamber (p < .001) compared to the CervAC group. A significantly lower percentage reduction in dentine thickness was observed only on the mesial aspect of root at Level 1 in TradAC group (p = .008). Conclusions CervAC can be considered a viable alternative approach in the presence of NCCL in mandibular incisors.
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ISSN:0143-2885
1365-2591
1365-2591
DOI:10.1111/iej.14123