Introduction: Endodontic access cavity preparation plays a vital role as preservation of enamel structure is of utmost importance for a tooth's strength to be maintained. As teeth become fragile after a root canal therapy, this study was designed to compare in vitro the fracture resistance of root-filled and restored teeth with traditional endodontic access cavity, conservative endodontic access cavity (CEC), ninja endodontic access cavity (NEC), and truss endodontic access cavity (TEC).Materials and methods: Control (intact teeth) and traditional endodontic access cavity as well as CEC, NEC, and TEC groups were each given a new human mandibular molar that was freshly removed. Cone beam computed tomography (CBCT) scans of the cone beam showed the values of CEC, NEC, and TEC. After that the teeth were endodontically treated and repaired. To test the specimens, universal testing equipment was used. In order to avoid tooth breakage, the maximum load was determined. Statistical analysis was used in the form of Kolmogorov-Smirnov and Levene tests, which were used to examine data for typical dispersion and consistency in change.Results: Intact teeth showed the highest resistance to fracture compared with other groups. TEC showed significantly higher resistance to fracture compared to the CEC design.Conclusions: It is possible, within the restrictions of this research, to infer that the TEC design enhanced tooth fracture strength in comparison with the CEC design.

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The conservative option depends mainly on the ability of the bonded restoration to strengthen the enamel in the same way that dentine gives strength and supports the enamel. In order for a dental material to reinforce the vital tooth, it must bond to dentine. As such, an essential attribute of a good dentine adhesive system is the ability of the adhesive to wet and infiltrate the dentine. In restorative dentistry, numerous studies have demonstrated coronal reinforcement of the vital tooth through bonded restorations. Six bonded amalgams and resin composites have all been shown to reinforce the remaining vital tooth structure by bonding to dentine and enamel.

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