Exploring access cavity through non-carious cervical lesions: Impacts on instrumentation, obturation, and fracture resistance in mandibular incisors

IF 5.4 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

International endodontic journal Pub Date : 2024-07-10 DOI:10.1111/iej.14123

Emmanuel J. N. L. Silva, Patrícia S. Vianna, Carolina O. Lima, Ana Flávia A. Barbosa, Victor T. L. Vieira, Marco A. Versiani

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Abstract

Aim

To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors.

Methodology

Twenty recently extracted and intact mandibular incisors were initially scanned using a micro-CT device. The specimens were anatomically matched to create two groups (n = 10). A wedge-shaped non-carious cervical lesion (NCCL) was created on the buccal aspect of all teeth using a double-faced segmented diamond disc. In group 1, a TradAC was prepared, whilst in group 2, access was created through the simulated NCCL using a round diamond bur 1012. After root canal preparation with Rotate instruments sizes 15/0.04, 20/0.04, and 25/0.04, the teeth were scanned again and evaluated for root canal volume and surface area, static voxels, volume of removed dental tissue, and dentine thickness. After that, the root canals were filled using the single-cone technique, teeth were restored with composite resin, and subsequently rescanned to calculate the volume of filling materials and voids. Then, the restored teeth were subjected to fracture resistance tests using a universal testing machine. Statistical comparisons between groups were performed with the Mann–Whitney test or the Student's t-test, with a statistical significance level of 5%.

Results

Statistical comparisons indicated no significant differences between groups in terms of root canal volume, surface area, static voxels, removed root dentine, root canal filling volume, percentage of voids, or fracture resistance load (p > .05). Conversely, teeth prepared with TradAC showed a significantly higher percentage of dental tissue removed from the crown (p = .001) and a greater volume of filling material remnants in the pulp chamber (p < .001) compared to the CervAC group. A significantly lower percentage reduction in dentine thickness was observed only on the mesial aspect of root at Level 1 in TradAC group (p = .008).

Conclusions

CervAC can be considered a viable alternative approach in the presence of NCCL in mandibular incisors.

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通过非龋性颈椎病变探查入路腔：对下颌切牙的器械、封闭和抗骨折性的影响。

目的：比较颈部入路腔（CervAC）和传统入路腔（TradAC）对下颌切牙根管预备、根管充填和抗折性的影响：使用微型计算机断层扫描（micro-CT）设备对 20 颗新近拔出且完好无损的下颌门牙进行初步扫描。这些标本在解剖学上是匹配的，分为两组（n = 10）。使用双面分段钻石盘在所有牙齿的颊侧创建楔形非龋颈病变（NCCL）。在第一组中，制备 TradAC，而在第二组中，使用圆形金刚石钻头 1012 通过模拟的 NCCL 创建通路。使用 15/0.04、20/0.04 和 25/0.04 号旋转器械进行根管预备后，再次对牙齿进行扫描，评估根管体积和表面积、静态体素、去除的牙组织体积和牙本质厚度。然后，使用单锥技术填充根管，用复合树脂修复牙齿，随后重新扫描以计算填充材料的体积和空隙。然后，使用万能试验机对修复后的牙齿进行抗折试验。组间统计比较采用曼-惠特尼检验或学生 t 检验，统计显著性水平为 5%：统计比较结果表明，各组之间在根管体积、表面积、静态体素、去除的根部牙本质、根管充填量、空隙百分比或抗折载荷方面均无显著差异（P > .05）。相反，使用 TradAC 制备的牙齿显示，从牙冠上去除的牙组织百分比明显更高（p = .001），牙髓腔中残留的填充材料体积更大（p 结论：CervAC 可被认为是一种可行的根管治疗方法：在下颌切牙存在NCCL的情况下，CervAC可被视为一种可行的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International endodontic journal 医学-牙科与口腔外科

CiteScore

10.20

自引率

28.00%

发文量

195

审稿时长

4-8 weeks

期刊介绍： The International Endodontic Journal is published monthly and strives to publish original articles of the highest quality to disseminate scientific and clinical knowledge; all manuscripts are subjected to peer review. Original scientific articles are published in the areas of biomedical science, applied materials science, bioengineering, epidemiology and social science relevant to endodontic disease and its management, and to the restoration of root-treated teeth. In addition, review articles, reports of clinical cases, book reviews, summaries and abstracts of scientific meetings and news items are accepted. The International Endodontic Journal is essential reading for general dental practitioners, specialist endodontists, research, scientists and dental teachers.