Guided Endodontics: Volume of Dental Tissue Removed by Guided Access Cavity Preparation—An Ex Vivo Study

Loureiro, Marco Antônio Zaiden; Elias, Marcela Ramos Abrahão; Capeletti, Lucas Raineri; Silva, Júlio Almeida; Siqueira, Patrícia Correia; Chaves, Gustavo Silva; Decúrcio, Daniel de Almeida

doi:10.1016/j.joen.2020.09.008

Cited by 25 publications

(18 citation statements)

References 29 publications

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“…However, there was no significant difference in the amount of tooth tissue removed between the CEC and GEC groups. This result is in agreement with previous studies, which indicated that minimally invasive methods for endodontic access cavity preparation were associated with less dentine removal (Connert et al, 2019;Loureiro et al, 2020;Rover et al, 2017). The result of this study revealed that there was no significant difference amongst the TEC, CEC and GEC groups in the amount of tooth tissue removed in the middle third of the canal and below.…”

Section: Discussionsupporting

confidence: 92%

“…The CEC and GEC create minimally invasive access cavities to preserve more tooth tissue, including the roof of pulp chambers and pericervical dentine (Bürklein & Schäfer, 2015;Loureiro et al, 2020;Moreno Rabié et al, 2020). It has been suggested that CEC can reduce the amount of dentine removal compared with TEC, especially in the coronal region of molars (Plotino et al, 2017;Rover et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…It has been suggested that CEC can reduce the amount of dentine removal compared with TEC, especially in the coronal region of molars (Plotino et al, 2017;Rover et al, 2017). Loureiro et al (2020) also reported that GEC can preserved a greater volume of tooth tissue in maxillary molars than TEC. However, no data are available regarding a comparison of the removal of tooth tissue and pericervical dentine amongst TEC, CEC and GEC.…”

Section: Introductionmentioning

confidence: 99%

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The effects of endodontic access cavity design on dentine removal and effectiveness of canal instrumentation in maxillary molars

Wang

et al. 2021

Int Endodontic J

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Aim:To evaluate in a laboratory setting, the impact of three designs of endodontic access cavities on dentine removal and effectiveness of canal instrumentation in extracted maxillary first molars using micro-computed tomography (micro-CT).Methodology: A total of 30 extracted intact maxillary first molars were selected and scanned by micro-CT with a voxel size of 24 µm and randomly distributed into three groups: the traditional endodontic cavity (TEC) group, the conservative endodontic cavity (CEC) group and the guided endodontic cavity (GEC) group. The pulp chambers of teeth in the groups were accessed accordingly. After root canal preparation, the teeth were rescanned. The volume of dentine removed after canal preparation, the noninstrumented canal areas, canal transportation and centring ratio were analysed. Data were analysed statistically using one-way analysis of variance. Tukey's post hoc test was used for multiple comparisons. The significance level was set at p < .05. Results:The total volume of dentine removed was significantly greater in the TEC group after root canal preparation (p < .05). No significant differences in the volume of dentine removed occurred between the CEC and GEC groups (p > .05). The volume of dentine removed in the crown, pericervical dentine and coronal third of the canal was significantly lower in CEC and GEC groups when compared to that in the TEC group (p < .05), no difference was observed in the middle third of the canal and apical third of the canal amongst the three groups (p > .05). There was no significant difference in noninstrumented canal area, canal transportation and centring ratio amongst the TEC, CEC and GEC groups (p > .05). Conclusions:In extracted maxillary molars tested in a laboratory setting, CEC and GEC preserved more tooth tissue in the crown, pericervical dentine and coronal third of the canal compared with TEC after root canal preparation. The design of the endodontic access cavity did not impact on the effectiveness of canal instrumentation in terms of noninstrumented canal area, canal transportation and centring ratio.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of endodontic access cavity design on dentine removal and effectiveness of canal instrumentation in maxillary molars

Wang

et al. 2021

Int Endodontic J

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“…From the 29 research studies, only 1 study compared SGE with DGE [ 20 ], both showing excellent results. Twelve of these studies compared GE (DGE or SGE) with manual endodontic treatment [ 14 , 15 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], obtaining better results. Eight of the studies were performed with 3D replicas instead of natural teeth [ 21 , 22 , 24 , 28 , 31 , 32 , 33 , 34 ] and only one with acrylic dentition [ 27 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Guided Endodontics: A Literature Review

Kulinkovych-Levchuk

Pecci-Lloret

Rodríguez‐Lozano

et al. 2022

IJERPH

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The main objective of this paper is to perform an updated literature review of guided endodontics based on the available up-to-date scientific literature to identify and describe the technique, its benefits, and its limitations. Four electronic databases (PubMed, Scopus, Science Direct, and Web of Science) were used to perform a literature search from 1 January 2017 to 13 May 2022. After discarding duplicates, out of 1047 results, a total of 29 articles were eligible for review. Guided endodontics is a novel technique that is currently evolving. It is applied in multiple treatments, especially in accessing and locating root canals in teeth with pulp canal obliteration, microsurgical endodontics, and removing glass fiber posts in endodontic retreatments. In addition, it is independent of an operator’s experience, requires less treatment time for the patient, and is more accurate and safer than conventional endodontics.

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“…According to several authors, the SG approach offers a highly predictable alternative to access the root canals in comparison to freehand drilling in challenging cases (Ali & Arslan, 2021;Buchgreitz et al, 2016Buchgreitz et al, , 2019aBuchgreitz et al, , 2019bByun et al, 2015;Casadei et al, 2020;Connert et al, 2017Connert et al, , 2018Connert et al, , 2019Kostunov et al, 2021;Krastl et al, 2016;Krug et al, 2020;Lara-Mendes et al, 2018aLlaquet Pujol et al, 2021;Loureiro et al, 2020;Maia et al, 2019;Shi et al, 2018; Tchorz et al, 2019;Todd et al, 2021;Torres et al, 2019Torres et al, , 2021bZehnder et al, 2016). However, the application of SG for endodontic access may be burdened with multiple sources of errors during the workflow because of an inadequate intraoral scan or impression, CBCT artefacts, human error during the design leading to poor alignment during meshing of digital and CBCT renderings, and inconsistency in resin thickness during 3D printing, which ultimately may cause instability of the guide (Jain et al, 2020b) (Table 2).…”

Section: Static-guided Techniquementioning

confidence: 99%

Present status and future directions – Minimal endodontic access cavities

et al. 2022

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In the last decades, the move of medicine towards minimally invasive treatments is notorious and scientifically grounded. As dentistry naturally follows in its footsteps, minimal access preparation have also becume a trend topic in the endodontic field.This procedure aims to maximize preservation of dentine tissue backed up by the idea that this is an effective way to reduce the incidence of post-treatment tooth fracture. However, with the assessment of the body of evidence on this topic, it is possible to observe some key points (a) the demand for nomenclature standardization, (b) the requirement of specific tools such as ultra-flexible instruments, visual magnification, superior illumination, and three-dimensional imaging technology, (c) minimally invasive treatment does not seem to affect orifice location and mechanical preparation when using adequate armamentarium, but it (d) may impair adequate canal cleaning, disinfection and filling procedures, and also (e) it displays contradictory results regarding the ability to increase the tooth strengthen compared to the traditional access cavity. In spite of that, it is undeniable that methodological flaws of some benchtop studies using extracted teeth may be responsible for the conflicting data, thus triggering the need for more sophisticated devices/facilities and specifically designed research in an attempt to make clear the role of the access size/design on long-term teeth survival. Moreover, it is inevitable that a clinical approach such as minimal endodontic access cavities that demands complex tools and skilled and experienced operators bring to the fore doubts on its educational impact mainly when confronted with the conflicting scientific output, ultimately provoking a cost-benefit analysis of its implementation as a routine technique. In addition, this review discusses the ongoing scientific and clinical status of minimally invasive access cavities aiming to input an in-depth and unbiased view over the rationale behind them, uncovering not only the related conceptual and scientific flaws but also outlining future directions for research and clinical practices. The conclusions attempt to skip from passionate disputes highlighting the current body of evidence as weak and incomplete to guide decision making, demanding the development of a close-to-in situ laboratory model or a large and well-controlled clinical trial to solve this matter.

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Guided Endodontics: Volume of Dental Tissue Removed by Guided Access Cavity Preparation—An Ex Vivo Study

Cited by 25 publications

References 29 publications

The effects of endodontic access cavity design on dentine removal and effectiveness of canal instrumentation in maxillary molars

The effects of endodontic access cavity design on dentine removal and effectiveness of canal instrumentation in maxillary molars

Guided Endodontics: A Literature Review

Present status and future directions – Minimal endodontic access cavities

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