A Comparative Clinical Evaluation of Access Cavity Preparation Using Dental Operating Microscope and Conventional Preparation for Conservation of Tooth Structure (original) (raw)
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Guidelines for Access Cavity Preparation in Endodontics
2008
Adequate access is essential for successful endodontic treatment. Knowledge of pulp chamber morphology, along with an examination of preoperative radiographs, should be integrated when designing the access cavity to a tooth for nonsurgical root canal treatment. Once the coronal cavity has been adequately prepared, including the removal of carious dentin and defective restorations, a variety of instruments can be used in the process itself. Great variance in overall tooth size, morphology, and arch position means that no two access openings are identical, although common access guidelines have been established depending on the location of the tooth. This article is a review of the endodontic access and anatomic landmarks relating to the pulp chamber. Access is the most important phase of nonsurgical root canal treatment. A well-designed access preparation is essential for an optimum endodontic result. Without adequate access, instruments and materials become difficult to handle prope...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: The restricted access cavity and the remaining roof of the pulp chamber may change the angle at which the instrument enters the root canal, which could have an impact on the effectiveness of chemo-mechanical canal preparation, potentially leading to endodontic mishaps. Aim: To evaluate the effect of the Traditional Endodontic Cavity (TEC) and Conservative Endodontic Cavity (CEC) on the amount of Root Dentin Removal (RDR) and the related Apical Debris Extrusion (ADE) in the curved root canals prepared with ProTaper Next (PTN) and TruNatomy (TN). Materials and Methods: The in-vitro study included a total of 120 extracted human mandibular molars, separated into four groups (n=30) based on the type of endodontic cavity and file used: TEC-TN, CEC-TN, TEC-PTN, and CEC-PTN. Before biomechanical preparation, Cone Beam Computed Tomography (CBCT) scans were taken. During the preparation, apically extruded debris was collected in Eppendorf tubes. After canal preparation, a post-C...
An in vitro comparison of hand and rotary instruments in preparing root canal system
INTRODUCTION: The purpose of this in vitro study was to evaluate the sealing ability of the readymade temporary filling and hand mixed materials by assessing coronal microleakage. MATERIALS & METHODS: Standardized access cavities were prepared in 80 intact human permanent premolar teeth. They were divided randomly into four experimental groups (n=20). The teeth were restored using one of the temporary materials including Cavisol, Litrak, Zinc phosphate cement, Zinconol (IRM). Thermocycling was applied on the specimens. Methylene blue dye was applied and penetration was evaluated under stereomicroscope. Grading of the microleakage pattern was from 1 to 3, with 3 providing the best seal. Results were analyzed using one-way ANOVA test (P<0.05). RESULTS: Microleakage of Cavisol and Litrak samples achieved grade 3; whereas zinc phosphate cement and Zinconol samples absorbed the dye into the bulk of the materials. Cavisol was found to exhibit the best seal amongst the four tested materials followed by Litrak, zinc phosphate cement, and Zinconol. There was a statistically significant difference in the microleakage scores obtained between the materials (P<0.01). CONCLUSION: Among the four materials tested, readymade temporary filling provided the best sealing ability over hand-mixed. This study emphasizes the importance of correct placement and sufficient thickness of temporary filling materials in endodontic access cavities to ensure a tight seal.
International Journal of Dentistry, 2020
Introduction. The geometry of root canals differs in different parts, especially in the apical region, and it is affected by different preparation techniques. The aim of this study was to evaluate the geometric changes of root canal preparation by general dentists regardless of the endodontic instrumentation systems and to study the quality of endodontic treatment by evaluating the untouched areas after mechanical preparation and the smear layer removal. Materials and Methods. 100 extracted maxillary canines were collected for the in vitro study from 10 dentists, and the dentists were asked to treat the teeth endodontically. The teeth then were separated and examined under an optical microscope to evaluate the root canal final diameter and the untouched areas. Then, the teeth were examined under a scanned electronic microscope to evaluate the smear layer in coronal, middle, and third parts of the canal. Statistical significance was set as P<0.05. Results. The mean diameter of the...
Introduction: The aim of this study was to assess the influence of contracted endodontic cavities (CECs) on root canal detection, instrumentation efficacy, and fracture resistance assessed in maxillary molars. Traditional endodontic cavities (TECs) were used as a reference for comparison. Methods: Thirty extracted intact maxillary first molars were scanned with micro–computed tomo-graphic imaging at a resolution of 21 mm, assigned to the CEC or TEC group (n = 15/group), and accessed accordingly. Root canal detection was performed in 3 stages: (1) no magnification, (2) under an operating microscope (OM), and (3) under an OM and ultrasonic troughing. After root canal preparation with Reciproc instruments (VDW GmbH, Munich, Germany), the specimens were scanned again. The noninstrumented canal area, hard tissue debris accumulation, canal transportation , and centering ratio were analyzed. After root canal filling and cavity restoration, the sample was submitted to the fracture resistance test. Data were analyzed using the Fisher exact, Shapiro-Wilk, and t tests (a = 0.05). Results: It was possible to locate more root canals in the TEC group in stages 1 and 2 (P < .05), whereas no differences were observed after stage 3 (P > .05). The percentage of noninstrumented canal areas did not differ significantly between the CEC (25.8% AE 9.7%) and TEC (27.4% AE 8.5%) groups. No significant differences were observed in the percentage of accumulated hard tissue debris after preparation (CEC: 0.9% AE 0.6% and TEC: 1.3% AE 1.4%). Canal transportation was significantly higher for the CEC group in the palatal canal at 7 mm from the apical end (P < .05). Canal preparation was more centralized in the palatal canal of the TEC group at 5 and 7 mm from the apical end (P < .05) and in the distobuccal canal of the CEC group at 5 mm from the apical end (P < .05). There was no difference regarding fracture resistance among the CEC (996.30 ± 490.78 N) and TEC (937.55 ± 347.25 N) groups (P > .05). Conclusions: The current results did not show benefits associated with CECs. This access modality in maxillary molars resulted in less root canal detection when no ultrasonic troughing associated to an OM was used and did not increase fracture resistance.
Australian Endodontic Journal, 2020
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.
The impact of dental operating microscopes on the success rates of endodontic treatments
International Journal Of Community Medicine And Public Health
Recent advancements in dental technology, such as magnification devices like loupes and surgical microscopes, have greatly improved the accuracy and quality of root canal treatments. Dental operating microscopes (DOMs) have become widely accepted in endodontics, providing enhanced visualization and facilitating precise identification of anatomical landmarks, root canal orifices, and pulp remnants. The increased magnification and illumination offered by DOMs have improved treatment outcomes by enabling more efficient removal of bacteria, debris, and obturation materials from the root canal system. Studies have shown that the use of DOMs can significantly increase the success rates of endodontic treatments, allowing for the identification and treatment of even the smallest canals and anatomical variations. Additionally, DOMs enhance ergonomics, patient communication, and documentation in dental practice. However, challenges such as cost and limited office space hinder their widespread...
Alexandria Dental Journal, 2020
INTRODUCTION: Effective irrigant delivery and agitation protocols with recent advances in magnification, endodontic instruments, and obturation systems can lead to more conservative access opening designs. OBJECTIVES: The purpose of this in vitro study was to compare the cleaning of the root canal system with 2 different designs of access opening, traditional versus conservative. METHADOLOGY: 100 extracted upper premolars were divided into four groups according to the access opening performed: Gp I and Gp III Conservative endodontic access, GpII, and IV traditional access opening. Then all teeth were autoclaved, inoculated with Enterococcus faecalis, and incubated for 30 days. Gp I and Gp II were then prepared with Wave One Gold and irrigated with Passive ultrasonic irrigation while Gp III and Gp IV were not instrumented and served as negative control. Finally, all samples were decalcified and submitted to staining by Brown and Brenn stain. RESULTS: The traditional access opening design showed better cleaning than conservative access. The obtained results showed statistical significance between the two access opening designs regarding the chemical cleaning. CONCLUSIONS: Conservative and conventional access cavities exhibited different cleaning outcomes. Endodontic microscope assisted conservative access could not be done as a valuable alternative for conventional access without hindering cleaning.