Bokor Eszter Anna
Title: Effects of endodontic acces cavity preparation techniques on sealing ability of root canal fillings
Introduction: The success of endodontic treatments is determined by the use of appropriate instrumentation, ideal access cavity configuration, root canal exploration and preparation, complete disinfection of the canal, and the construction of a wall-tight and hermetically sealed root canal filling. Traditional endodontic access cavity shaping (TEC) involves the creation of a cavity on the occlusal surface of the tooth, followed by the appropriate opening of the pulp chamber of the tooth to provide access to the canal openings. In the case of the truss endodontic access cavity (TREC) shaping method, part of the pulp chamber roof is retained, providing separate access to each root canal.
Objective: The aim of this research is to compare the adaptation of root canal filling to the wall of the root canal in case of the two access cavity shaping methods (TEC and TREC).
Methods: In our study, 6-6 molar teeth were prepared using TEC and TREC access cavity shaping methods, followed by root filling and obturation of the crown. Using a slicing machine, 3 equal sections were made from the roots of the teeth: the first section was made at the enamel-cement boundary, the second section in the middle third of the root and the third section in the apical third. Photographs of the sections were taken using a macro lens. Each of the three incisions allowed the measurement of the area of the root filling and the resulting gaps on 2 to 2 surfaces. The area of root fillings and gaps were measured using the software “Image-Pro Insight”. The presence of gutta-percha was examined in sections taken in the apical third. The results obtained were subjected to statistical analysis using Mann-Whitney and Chi-square tests.
Results: No significant differences were observed between the coronal, middle and apical thirds in terms of root filling area. For the two access cavity shaping methods (TEC and TREC), the presence or absence of gaps – between the root filling and the wall of the root canal – did not show statistically significant differences in the coronal and middle thirds. However, significantly fewer gaps were observed in the apical third in the TEC-prepared group than in the TREC-prepared group (p=0.01). There was no significant difference between the two groups in the presence of gutta-percha in the apical third (p=0.43).
Conclusion: Our study suggests that, although there is no difference in the edge adaptation of the root filling in the coronal and middle thirds for the two access cavity shaping methods, the TEC method is more accurate in the apical third. Endodontic treatment is more successful, especially for a beginner dentist, when using traditional acces cavity shaping to open up the root canals.