Influence of endodontic cavity access on curved root canal preparation with ProDesign Logic rotary instruments

Freitas, Gabiana Rodrigues; Ribeiro, Tiago Magalhães; Grecca, Fabiana Soares; Melo, Tiago André Fontoura de

doi:10.1007/s00784-020-03390-6

Cited by 18 publications

(14 citation statements)

References 38 publications

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“…This would result in excessive pressure of the instrument against the outer aspect of the curvature (Alovisi et al 2018), increasing the risk of transportation, which may explain these results. On the other hand, Freitas et al (2020) reported no difference in the transportation of mesiobuccal canals in maxillary molars with ConsAC and TradAC.…”

Section: Chemomechanical Canal Preparationmentioning

confidence: 90%

“…2018), increasing the risk of transportation, which may explain these results. On the other hand, Freitas et al (2020) reported no difference in the transportation of mesiobuccal canals in maxillary molars with ConsAC and TradAC. However, although using micro‐CT, the major limitation of this study was the linear measurement of transportation at only two root levels, it is important to highlight that the stress level along the length of an instrument in curved canals may exceed its endurance limit, increasing the probability of fracture (Lopes et al .…”

Section: Reviewmentioning

confidence: 97%

“…2018, Zhang et al . 2019, Freitas et al 2020). Overall, canal preparation using ConsAC resulted in a major deviation of the original anatomy at the apical level of the palatal canal of maxillary molars (Rover et al .…”

Section: Reviewmentioning

confidence: 99%

“…The influence of minimally invasive access cavities on canal curvature and transportation were investigated in five studies (Eaton et al 2015, Rover et al 2017, Alovisi et al 2018, Zhang et al 2019, Freitas et al 2020. Overall, canal preparation using ConsAC resulted in a major deviation of the original anatomy at the apical level of the palatal canal of maxillary molars (Rover et al 2017) and in the mesial canals of mandibular molars (Alovisi et al 2018).…”

Section: Chemomechanical Canal Preparationmentioning

confidence: 99%

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Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature

et al. 2020

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In the last decade, several access cavity designs involveing minimal removal of tooth tissue have been described for gaining entry to pulp chambers during root canal treatment. The premise behind this concept assumes that maximum preservation of as much of the pulp chamber roof as possible during access preparation would maintain the fracture resistance of teeth following root canal treatment. However, the smaller the access cavity, the more difficult it may be to visualize and debride the pulp chamber as well as locate, shape, clean and fill the canals. At the same time, a small access cavity may increase the risk of iatrogenic complications as a result of poor visibility, which may have an impact on treatment outcome. This study aimed to critically analyse the literature on minimal access cavity preparations, propose new nomenclature based on self‐explanatory abbreviations and highlight the areas in which more research is required. The search was conducted without restrictions using specifics terms and descriptors in four databases. A complementary screening of the references within the selected studies, as well as a manual search in the highest impact journals in endodontics, namely International Endodontic Journal and Journal of Endodontics, was also performed. The initial search retrieved 1831 publications. The titles and abstracts of these papers were reviewed, and the full text of 94 studies was assessed. Finally, a total of 28 studies were identified as evaluating the influence of minimally invasive access cavity designs on the fracture resistance of teeth and on the different stages of root canal treatment (orifice location, canal shaping, canal cleaning, canal filling and retreatment). Overall, the studies had major methodological drawbacks and reported inadequate and/or inconclusive results on the utility of minimally invasive access preparations. Furthermore, they offered limited scientific evidence to support the use of minimally invasive access cavities to improve the outcome of root canal treatment and retreatment; they also provided little evidence that they preserved the fracture resistance of root filled teeth to a greater extent than traditional access cavity preparations. It was concluded that at present, there is a lack of supporting evidence for the introduction of minimally invasive access cavity preparation into routine clinical practice and/or training of undergraduate and postgraduate students.

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Section: Chemomechanical Canal Preparationmentioning

confidence: 90%

Section: Reviewmentioning

confidence: 97%

Section: Reviewmentioning

confidence: 99%

Section: Chemomechanical Canal Preparationmentioning

confidence: 99%

See 2 more Smart Citations

Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature

et al. 2020

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“…The goal of this concept was the maintenance of the pulp chamber roof and pericervical dentin to preserve the fracture resistance of root canal treated teeth [ 14 ]. Ever since, other designs of access cavities were described, such as ultraconservative access cavities and truss access cavities, and several studies were performed to assess the fracture resistance of root canal treated teeth with these minimally invasive access cavities [ 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 ], as well as their influence on the location of canals, shaping, cleaning and disinfection, filling, restoration, and retreatment procedures [ 17 21 28 29 30 31 32 33 34 35 36 37 38 39 40 ]. Therefore, this field has received great attention from researchers and clinicians, leading to a significant rise in the volume of publications during these 10 years.…”

Section: Introductionmentioning

confidence: 99%

Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies

et al. 2021

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Objectives This study aimed to analyze the main features of the 25 most-cited articles in minimally invasive access cavities. Materials and Methods An electronic search was conducted on the Clarivate Analytics' Web of Science ‘All Databases’ to identify the most-cited articles related to this topic. Citation counts were cross-matched with data from Elsevier's Scopus and Google Scholar. Information about authors, contributing institutions and countries, year and journal of publication, study design and topic, access cavity, and keywords were analyzed. Results The top 25 most-cited articles received a total of 572 (Web of Science), 1,160 (Google Scholar) and 631 (Scopus) citations. It was observed a positive significant association between the number of citations and age of publication ( r = 0.6907, p < 0.0001); however, there was no significant association regarding citation density and age of publication ( r = −0.2631, p = 0.2038). The Journal of Endodontics made the highest contribution ( n = 15, 60%). The United States had the largest number of publications ( n = 7) followed by Brazil ( n = 4), with the most contributions from the University of Tennessee and Grande Rio University ( n = 3), respectively. The highest number of most-cited articles were ex vivo studies ( n = 16), and ‘fracture resistance’ was the major topic studied ( n = 10). Conclusions This study revealed a growing interest for researchers in the field of minimally invasive access cavities. Future trends are focused on the expansion of collaborative networks and the conduction of laboratory studies on under-investigated parameters.

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Current strategies for conservative endodontic access cavity preparation techniques—systematic review, meta-analysis, and decision-making protocol

et al. 2021

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Objectives To assess related studies and discuss the clinical implications of endodontic access cavity (AC) designs. Materials and methods A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05). Results A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P < 0.05), (ii) there is no significant effect of the type of AC on the fracture resistance of teeth when one or two marginal ridges are lost (P > 0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P < 0.05). Conclusions Decreasing the AC extent does not necessarily present mechanical and biological advantages especially when one or more surfaces of the tooth structure are lost. To date, the evidence available does not support the application of Trus-sAC. UltraAC might be applied in limited occasions. Clinical relevance Maintaining the extent of AC design as small as practical without jeopardizing the root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.

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Influence of endodontic cavity access on curved root canal preparation with ProDesign Logic rotary instruments

Cited by 18 publications

References 38 publications

Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature

Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature

Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies

Current strategies for conservative endodontic access cavity preparation techniques—systematic review, meta-analysis, and decision-making protocol

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