Fracture Resistance of Teeth with Truss Endodontic Access: An In Vitro Study and Literature Review

Abstract Objective This article evaluates the fracture resistance of teeth with different endodontic access cavities and conducts literature review on the effects of truss endodontic cavity. Material and Methods Eighty human mandibular first molars were assigned randomly to four groups (n = 20); group 1: truss access cavity (TrussAC); group 2: conservative access cavity (ConsAC); group 3: traditional access cavity (TradAC); and group 4: served as control (no access). Accesses were prepared in groups 1 to 3, respectively. Endodontic treatment was performed on all accessed teeth and composite restoration placed. Teeth in all groups were loaded until fracture using a mechanical testing machine. The maximum load at fracture and patterns of fracture were recorded. Additionally, a literature search was performed on studies related to TrussAC and its importance. Statistical Analysis Fracture strengths were compared using one-way analysis of variance complemented by Bonferroni test. Fracture patterns were analyzed using chi-square test. Results TradAC showed significantly lower mean load at fracture than TrussAC, ConsAC, and intact teeth. Fracture resistance of teeth with TrussAC and ConsAC was not significantly different. All three test groups showed significantly more frequent unrestorable fractures. The literature review revealed that TrussAC did not improve the fracture strength significantly; however, pulp chamber debridement was significantly impaired. Conclusion TrussAC improved the fracture strength of endodontically treated teeth, but not significantly as compared to ConsAC. Restorable fractures were more in intact teeth compared with all prepared ones.