The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
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First step of root canal therapy-access cavity preparation

근관치료의 시작 - 치수강 개방

  • Song, Minju (Department of Conservative Dentistry, College of Dentistry, Dankook university)
  • 송민주 (단국대학교 치과대학 치과보존학교실)
  • Published : 2018.09.30
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Abstract

Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.

Keywords

References

  1. Endodontists AAo. Glossary of Endodontic Terms. In: Endodontists AAo, ed. American Association of Endodontists. American Association of Endodontists, 2015.
  2. Karabucak B, Bunes A, Chehoud C, et al. Prevalence of Apical Periodontitis in Endodontically Treated Premolars and Molars with Untreated Canal: A Cone-beam Computed Tomography Study. J Endod 2016;42(4):538-541 https://doi.org/10.1016/j.joen.2015.12.026
  3. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod 2006;32(9):813-821 https://doi.org/10.1016/j.joen.2006.04.014
  4. Adams N, Tomson PL. Access cavity preparation. Br Dent J 2014;216(6):333-339 https://doi.org/10.1038/sj.bdj.2014.206
  5. Hiebert BM, Abramovitch K, Rice D, Torabinejad M. Prevalence of Second Mesiobuccal Canals in Maxillary First Molars Detected Using Cone-beam Computed Tomography, Direct Occlusal Access, and Coronal Plane Grinding. J Endod 2017;43(10):1711-1715 https://doi.org/10.1016/j.joen.2017.05.011
  6. Deutsch AS, Musikant BL. Morphological measurements of anatomic landmarks in human maxillary and mandibular molar pulp chambers. J Endod 2004;30(6):388-390 https://doi.org/10.1097/00004770-200406000-00003
  7. Nattress BR, Martin DM. Predictability of radiographic diagnosis of variations in root canal anatomy in mandibular incisor and premolar teeth. Int Endod J 1991;24(2):58-62 https://doi.org/10.1111/j.1365-2591.1991.tb00808.x
  8. Abbott PV. Assessing restored teeth with pulp and periapical diseases for the presence of cracks, caries and marginal breakdown. Aust Dent J 2004;49(1):33-39; quiz 45 https://doi.org/10.1111/j.1834-7819.2004.tb00047.x
  9. Krasner P, Rankow HJ. Anatomy of the pulpchamber floor. J Endod 2004;30(1):5-16 https://doi.org/10.1097/00004770-200401000-00002
  10. Gluskin AH, Peters CI, Peters OA. Minimally invasive endodontics: challenging prevailing paradigms. Br Dent J 2014;216(6):347-353 https://doi.org/10.1038/sj.bdj.2014.201
  11. Clark D, Khademi J. Modern Molar Endodontic Access and Directed Dentin Conservation. Dental Clinics of North America 2010;54(2):249-273 https://doi.org/10.1016/j.cden.2010.01.001
  12. Sedgley CM, Messer HH. Are endodontically treated teeth more brittle? J Endod 1992;18(7):332-335 https://doi.org/10.1016/S0099-2399(06)80483-8
  13. Al-Omiri MK, Rayyan MR, Abu-Hammad O. Stress analysis of endodontically treated teeth restored with post-retained crowns: A finite element analysis study. J Am Dent Assoc 2011;142(3):289-300 https://doi.org/10.14219/jada.archive.2011.0168
  14. Lang H, Korkmaz Y, Schneider K, Raab WH. Impact of endodontic treatments on the rigidity of the root. J Dent Res 2006;85(4):364-368 https://doi.org/10.1177/154405910608500416
  15. Asundi A, Kishen A. A strain gauge and photoelastic analysis of in vivo strain and in vitro stress distribution in human dental supporting structures. Arch Oral Biol 2000;45(7):543-550 https://doi.org/10.1016/S0003-9969(00)00031-5
  16. Carlos B, Anil K. Contracted endodontic cavities: the foundation for less invasive alternatives in the management of apical periodontitis. Endodontic Topics 2015;33(1):169-186 https://doi.org/10.1111/etp.12088
  17. Krishan R, Paque F, Ossareh A, et al. Impacts of Conservative Endodontic Cavity on Root Canal Instrumentation Efficacy and Resistance to Fracture Assessed in Incisors, Premolars, and Molars. Journal of Endodontics 2014;40(8):1160-1166 https://doi.org/10.1016/j.joen.2013.12.012
  18. Yuan K, Niu C, Xie Q, et al. Comparative evaluation of the impact of minimally invasive preparation vs. conventional straight‐line preparation on tooth biomechanics: a finite element analysis. European Journal of Oral Sciences 2016;124(6):591-596 https://doi.org/10.1111/eos.12303
  19. Moore B, Verdelis K, Kishen A, et al. Impacts of Contracted Endodontic Cavities on Instrumentation Efficacy and Biomechanical Responses in Maxillary Molars. J Endod 2016;42(12):1779-1783 https://doi.org/10.1016/j.joen.2016.08.028
  20. Rover G, Belladonna FG, Bortoluzzi EA, et al. Influence of Access Cavity Design on Root Canal Detection, Instrumentation Efficacy, and Fracture Resistance Assessed in Maxillary Molars. J Endod 2017;43(10):1657-1662 https://doi.org/10.1016/j.joen.2017.05.006
  21. Eaton JA, Clement DJ, Lloyd A, Marchesan MA. Micro-Computed Tomographic Evaluation of the Influence of Root Canal System Landmarks on Access Outline Forms and Canal Curvatures in Mandibular Molars. Journal of Endodontics 2015;41(11):1888-1891 https://doi.org/10.1016/j.joen.2015.08.013
  22. Clark D, Khademi JA. Case studies in modern molar endodontic access and directed dentin conservation. Dent Clin North Am 2010;54(2):275-289. https://doi.org/10.1016/j.cden.2010.01.003