A survey of current trends in root canal treatment: access cavity design and cleaning and shaping practices

Abstract

The purpose of this study was to evaluate current trends in access cavity design and cleaning and shaping among endodontists. A survey was e‐mailed to active members of the American Association of Endodontists. Data showed that most respondents used traditional (57%) or conservative (43%) access cavities; less than 1% reported using ultraconservative access cavities. A glide path was created by 93% of respondents; NaOCl was used as lubricant by 51% of respondents, while 28% used RC Prep, 9% used liquid EDTA, 7% used Glyde, and 2% did not use any lubricant. Most respondents used NaOCl at 5.25% or higher concentration. Smear layer was removed by 92% of endodontists. Apical gauging was mostly accomplished with hand files. Clinical preferences varied among surveyed endodontists and among different age groups. Currently, very few endodontists use ultraconservative access preparations. There was large variation among the respondents suggesting a possible need for quality guidelines.

Global survey of endodontic practice and adoption of newer technologies

“…Close to the time of the survey, 180 endodontists were registered in Australia (AIHW, 2022), giving a representative response rate in this group of 37.2%. From the AAE mailing list, 463 responses were received giving an actual response rate of 8.3%, very similar to another recently published survey (Martinho & Griffin, 2021) but lower than 23%-24% achieved by others (Logsdon et al, 2020;Tsotsis et al, 2021). The proportion of female respondents in this study at 22% was lower than 34.4% reported in one recent international survey of endodontists (Galicia et al, 2021) but similar to 20%-21% reported in recent surveys of members of the American Association of Endodontists (Lin et al, 2015;Tsotsis et al, 2021).…”

“…A few surveys exploring endodontists' overall clinical preferences have previously been published (Ferreira et al, 2017; Kohli et al, 2014; Rajbhandari et al, 2018). Other studies have investigated endodontists' preferences in specific areas such as single‐visit versus multiple‐visit treatment (Inamoto et al, 2002; Sathorn et al, 2009), surgical trends (Creasy et al, 2009), regenerative endodontic procedures (Epelman et al, 2009; Lee et al, 2018), dental operating microscope (Kersten et al, 2008; Mines et al, 1999), CBCT (Krug et al, 2019; Setzer et al, 2017), disinfection protocols (Clarkson et al, 2003; de Gregorio et al, 2015; Dutner et al, 2012), use of nickel–titanium instruments (Bird et al, 2009; Logsdon et al, 2020; Parashos & Messer, 2004), and access cavity and instrumentation (Tsotsis et al, 2021).…”

Effect of access cavities on the biomechanics of mandibular molars: a finite element analysis

“…Since different designs of the MIE cavity have been proposed, many practitioners have already begun to apply them in clinical practice [ 2 , 19 , 20 ]. Previous studies have reported conflicting results regarding the influence of cavities on the fracture resistance of ETT.…”

“…In the clinic, most practitioners prepare CECs with a combination of dentists’ experience and the results of cone bone computed tomography scans. [ 20 ] It is inevitable that more PCD and dentin in the pulp chamber roof will be removed in CECs, which will weaken the fracture resistance of ETT with CECs.…”

Accuracy of the KontrolFlex AccuFile when used with the Root ZX electronic apex locator in vitro

“…The electronic measurement of working length with hand files involves attaching the EAL file holder above the stopper on the metal shank of the instrument. A recent survey of practicing endodontists in the United States showed that a majority of clinicians use hand files to establish working length as a glide path (19). Subsequent shaping of the canal influences the outcome of irrigation, filling and success of the root canal therapy (20).…”