The Effect of Restoration of Endodontically Treated Teeth with Different Restorations in Both Modern and Traditional Access Cavity Preparations

Abstract

Restoration of endodontically treated teeth represents a great challenge to the dentist due to several limiting and undermining factors that affect the quality of the final restoration. Aim: This study aimed to compare two different endodontic access preparations concepts-traditional vs modern caries driven access cavity preparation-and their effect on the final restoration of the endodontically treated teeth taking in consideration the material of final restoration, regarding the effect of the access design and the afterwards restoration design and material effect on the fracture resistance of the restoration. Methodology: a total number of 120 human permanent molars were used in this study (in-vitro), all were divided into 2 main groups-60 molar each-classified according to the design of the endodontic access cavity performed in the molars of the first group which were accessed through traditional design of access cavity with subsequent root canal treatment for the teeth. While the second group was accessed through a modern access cavity design called caries/restoration driven access cavity, in which the access was guided by caries where less natural tooth structure is removed. Each group was then restored with a different type of restoration, and all were subject to testing for fracture resistance. Results: Less invasive endodontic therapy seeks to improve traditional endodontic treatment by establishing a highly accurate access cavity (AC) that will subsequently results in increased strength of the endodontically treated tooth through preserving more natural tooth structure and less restoration margins exposed to the occlusal stresses. Conclusion: The involvement in functional activity could be kept promoting fracture resistance. Endodontic new ACs were recently created to decrease tooth structure loss. With the introduction of microscopes and enhanced root canal equipment, the preparation of the conservative access opening has evolved to a new level. The conservation of the cervical dentin is a particularly significant element in sustaining the normal function and durability of the restored tooth. So, this study has shown that minimally invasive endodontics can be considered a challenge to the standard approach.