Controversies in endodontic access cavity design: A literature review

Abstract

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.

Association of Vital Pulp Therapy Outcomes with Tooth Type, Arch Location, Treatment Type, and Number of Surfaces Destroyed in Deciduous Teeth: A Retrospective Study

“…In another study that evaluated IPT over a four-year follow-up period, no significant difference was found when comparing the number of surfaces involved (occlusal vs occluso-proximal) [11]. An expected difference could arise based on the access cavity design, but further research would be required for validation [31]. In the present study, all DM were restored with a SSC, which could be possible for no relation to surfaces involved with treatment outcomes.…”

Traditional and Conservative Molar Endodontic Access Cavity Designs: A Classification and Overview

“…Little evidence exists for the beneficial use of these minimally invasive access cavity preparations compared to traditional access cavity preparations. 42 In a review article by Maqbool et al 43 the authors also concluded that little evidence is available to suggest CAC or UAC designs aids in the retention of endodontically treated teeth by increasing their fracture resistance. Shabbir et al 42 concluded that there was an increased risk compared to the benefit in terms of endodontic outcomes, when comparing minimally invasive to traditional access cavity designs.…”

Success of a tooth auto-transplant despite delayed endodontic treatment due to COVID-19 pandemic lock-down: a case report

“…Tooth 38 was isolated with rubber dam and accessed. Since, the tooth was completely sound before endodontic treatment, a conservative cavity was prepared to access the root canals for endodontic treatment [13,14]. Root canals were then cleaned and shaped using XP shaper (FKG, Switzerland) rotary endodontic files.…”