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VOLUME 14 , ISSUE 4 ( July-August, 2021 ) > List of Articles

RESEARCH ARTICLE

Efficacy of Root Canal Instrumentation and Fracture Strength Assessment in Primary Molars after Preparing Two Different Shapes of Access Cavity: An Ex Vivo Histological Study

Yashika Singhal, Vandana Reddy

Keywords : Access cavity, Fracture strength, Pediatric endodontics, Primary tooth, Root canal debridement, Root canal instrumentation

Citation Information : Singhal Y, Reddy V. Efficacy of Root Canal Instrumentation and Fracture Strength Assessment in Primary Molars after Preparing Two Different Shapes of Access Cavity: An Ex Vivo Histological Study. Int J Clin Pediatr Dent 2021; 14 (4):518-524.

DOI: 10.5005/jp-journals-10005-1997

License: CC BY-NC 4.0

Published Online: 29-10-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: To evaluate the efficacy of root canal instrumentation and fracture strength assessment in primary molars after preparing different shapes of access cavity design. Materials and methods: Sixty extracted primary mandibular molars with at least 2/3rd roots were randomly, equally divided into two groups based on shapes of the access cavities; Group I: Traditional access cavity (TAC), Group II: Conservative access cavity (CAC). Each group was further subdivided into two subgroups with 15 samples each. After, root canal debridement, samples in subgroup 1 were sectioned for histological evaluation of root canal instrumentation efficacy, while subgroup 2 were assessed for fracture strength using a Universal Testing Machine. The data were analyzed statistically using Mann–Whitney and post hoc Tukey tests, with a p value <0.05. Results: Traditional access cavity showed statistically significant root canal debridement efficacy (p < 0.05) compared with CAC. Statistically significant differences were obtained between fracture strength values among the two groups (p < 0.05), with considerably higher fracture strength in the CAC group than TAC. Conclusion: Traditional access cavity design resulted in complete root canal debridement but caused weakening of tooth structure due to low fracture strength, necessitating the use of full coverage restoration postendodontic therapy.

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  1. Ahmed HM. Pulpectomy procedures in primary molar teeth. Eur J Dent 2014;3(1):3–6. DOI: 10.4103/2278-9626.126201.
  2. Coll JA, Sadrian R. Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition. Pediatr Dent 1996;18(1):57–63.
  3. Asundi A, Kishen A. Advanced digital photoelastic investigations on the tooth-bone interface. J Biomed Opt 2001;6(1):224–230. DOI: 10.1117/1.1344587.
  4. Hargreaves KM, Berman LH. Cohen's pathways of pulp. 11th ed., U.S.A: Elsevier; 2016.
  5. Dean JA, Jones JE, Vinson LW. McDonald and Avery's dentistry for the child and adolescent. U.S.A: Elsevier; 2016.
  6. Sabeti M, Kazem M, Dianat O, et al. Impact of access cavity design and root canal taper on fracture resistance of endodontically treated teeth: an ex vivo investigation. J Endod 2018;44(9):1402–1406. DOI: 10.1016/j.joen.2018.05.006.
  7. Monga P, Sharma V, Kumar S. Comparison of fracture resistance of endodontically treated teeth using different coronal restorative materials: an in vitro study. J Conserv Dent 2009;12(4):154–158. DOI: 10.4103/0972-0707.58338.
  8. Rezaei DM, Amirian CK, Tavanafar S. Upper central incisors restored with different posts and cores. Restor Dent Endod 2015;40(3):229–235. DOI: 10.5395/rde.2015.40.3.229.
  9. Auswin MK, Ramesh S. Truss access new conservative approach on access opening of a lower molar: A case report. J Adv Pharm 2017;7(3):134–136.
  10. Belladonna FG, De‐Deus G, Dummer PM, et al. Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature. Int Endod J 2020;53(12):1618–1635. DOI: 10.1111/iej.13391.
  11. Plotino G, Grande NM, Isufi A, et al. Fracture strength of endodontically treated teeth with different access cavity designs. J Endod 2017;43(6):995–1000. DOI: 10.1016/j.joen.2017.01.022.
  12. Cheong J, Chiam S, King NM, et al. Pulp chamber analysis of primary molars using micro-computed tomography: Preliminary findings. J Clin Pediatr Dent 2019;43(6):382–387. DOI: 10.17796/1053-4625-43.6.4.
  13. Siqueira JF, Araújo MCP, Garcia PF, et al. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. J Endod 1997;23(1):499–502. DOI: 10.1016/S0099-2399(97)80309-3.
  14. Adams N, Tomson PL. Access cavity preparation. Br Dent J. 2014;216(6):333–339. DOI: 10.1038/sj.bdj.2014.206.
  15. McCabe PS. Avoiding perforations in endodontics. J Ir Dent Assoc 2006;52(3):139–148.
  16. Hibbaed ED. Morphology of the root canals of the primary molar teeth. J Dent Child 1957;24(3):250–257.
  17. Zurcher E. The anatomy of the root canals of the teeth of the deciduous dentition and of the first permanent molars. New York: William Woods & Co.; 1925.
  18. 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. DOI: 10.1016/j.joen.2017.05.006.
  19. Krishan R, Paqué 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. J Endod 2014;40(8):1160–1166. DOI: 10.1016/j.joen.2013.12.012.
  20. Neelakantan P, Khan K, Ng GP, et al. Does the orifice-directed dentin conservation access design debride pulp chamber and mesial root canal systems of mandibular molars similar to a traditional access design. J Endod 2018;44(2):274–279. DOI: 10.1016/j.joen.2017.10.010.
  21. 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. DOI: 10.1016/j.joen.2016.08.028.
  22. Katge F, Wakpanjar MM. Root canal morphology of primary molars by clearing technique: an in vitro study. J Indian Soc Pedod Prev Dent 2018;36(2):151–155. DOI: 10.4103/JISPPD.JISPPD_237_16.
  23. Fumes AC, Sousa-Neto MD, Leoni GB, et al. Root canal morphology of primary molars: a micro-computed tomography study. Eur Arch Paediatr Dent 2014;15(5):317–326. DOI: 10.1007/s40368-014-0117-0.
  24. Paqué F, Balmer M, Attin T, et al. Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study. J Endod 2010;36(2):703–707. DOI: 10.1016/j.joen.2009.12.020.
  25. Alghnay M, Aljuieed H. Conservative access cavity preparations. EC Dent Sci 2020;19(1):1–6.
  26. Aps JK. Cone beam computed tomography in paediatric dentistry: overview of recent literature. Eur Arch Paediatr Dent 2013;14(3):131–140. DOI: 10.1007/s40368-013-0029-4.
  27. Horner K, Barry S, Dave M, et al. Diagnostic efficacy of cone beam computed tomography in paediatric dentistry: a systematic review. Eur Arch Paediatr Dent 2019;19(2):1–20. DOI: 10.1007/s40368-019-00504-x.
  28. Hülsmann M, Peters OA, Dummer PMH. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Topics 2005;10(1):30–76. DOI: 10.1111/j.1601-1546.2005.00152.x.
  29. Versiani MA, Pe´cora JD, Sousa-Neto MD. Flat-oval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod 2011;37(4):1002–1007. DOI: 10.1016/j.joen.2011.03.017.
  30. De-Deus G, Souza EM, Barino B. The self-adjusting file optimizes debridement quality in oval-shaped root canals. J Endod 2011;37(3):701–705. DOI: 10.1016/j.joen.2011.02.001.
  31. Habib AA, Taha MI, Farah EM. Methodologies used in quality assessment of root canal preparation techniques: Review of the literature. J Taibah Univ Med Sci. 2015;10(2):123–131. DOI: 10.1016/j.jtumed.2014.11.002.
  32. Rodrigues RCV, Zandi H, Kristoffersen AK, et al. Influence of the apical preparation size and the irrigant type on bacterial reduction in root canal-treated teeth with apical periodontitis. J Endod 2017;43(7):1058–1063. DOI: 10.1016/j.joen.2017.02.004.
  33. Langeland K, Liao K, Pascon EA. Work-saving devices in endodontics: efficacy of sonic and ultrasonic techniques. J Endod 1985;11(11):499–510. DOI: 10.1016/s0099-2399(85)80223-5.
  34. ElAyouti A, Serry MI, Geis-Gerstorfer J, et al. Influence of cusp coverage on the fracture resistance of premolars with endodontic access cavities. Int Endod J 2011;44(6):543–549. DOI: 10.1111/j.1365-2591.2011.01859.x.
  35. Hamouda IM, Shehata SH. Fracture resistance of posterior teeth restored with modern restorative materials. J Biomed Res 2011;25(6):418–424. DOI: 10.1016/S1674-8301(11)60055-9.
  36. Linn J, Messer HH. Effect of restorative procedures on the strength of endodontically treated molars. J Endod 1994;20(10):479–485. DOI: 10.1016/S0099-2399(06)80043-9.
  37. Makati D, Shah NC, Brave D, et al. Evaluation of remaining dentin thickness and fracture resistance of conventional and conservative access and biomechanical preparation in molars using cone-beam computed tomography: an in vitro study. J Conserv Dent 2018;21(3):324–328. DOI: 10.4103/JCD.JCD_311_17.
  38. 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. Eur J Oral Sci 2016;124(8):591–596. DOI: 10.1111/eos.12303.
  39. Lin CY, Lin D, He WH. Impacts of 3 different endodontic access cavity designs on dentin removal and point of entry in 3-dimensional digital models. J Endod 2020;46(4):524–530. DOI: 10.1016/j.joen.2020.01.002.
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