Does minimally invasive canal preparation provide higher fracture resistance of endodontically treated teeth? A systematic review ofin vitrostudies

Abstract

This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the “PubMed, Web of Science, and Scopus” databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.

Ex vivo investigation on the effect of minimally invasive endodontic treatment on vertical root fracture resistance and crack formation

“…However, it remains controversial whether the selected file size and taper influence fracture resistance 9 , 22 , 25 , 26 and crack formation 22 , 27 . The latest attempts to systematically review results from in vitro studies to answer the question of whether MIE shaping increases the fracture resistance of root canal treated teeth or not were inconclusive 28 . Additionally, the clinical evidence on MIE treatment is limited 2 , 10 , 11 .…”