Minimal İnvaziv Giriş Kaviteleri

Yıl 2024, Cilt: 8 Sayı: 2, 82 - 91, 29.08.2024

Bilge Zülal Kaçmaz , Zuhre Hale Cimilli

https://doi.org/10.29228/erd.76

Öz

Kanallara yeterli erişim ve görünürlüğü sağlayan uygun bir giriş kavitesi açmak, başarılı bir kök kanal tedavisi uygulamak için önemlidir. Geleneksel endodontik giriş kavitelerinin önemli miktarda dental doku kaybına neden olması, dişin kırılma direnciyle ilgili endişeler doğurmuştur. Buna karşılık, diş dokusunun korunmasını öneren minimal invaziv yaklaşım ortaya çıkmıştır. Minimal invaziv giriş kaviteleri ve geleneksel giriş kaviteleri arasındaki seçim dikkatli bir değerlendirme gerektirir. Çünkü bu kavitelerin diş üzerindeki etkisi tartışmalıdır. Bu kavitelerin efektif bir şekilde tedavide kullanılabilmesi için CBCT, mikroskop ve ultrasonik uçlar gibi aletlerin kullanılması gerekir. Minimal invaziv giriş kavitelerinin avantaj ve dezavantajlarına, komplikasyon ve malpraktis oluşma riskine, yeterli bir kök kanal temizliği sağlayıp sağlamadığına, dişin kırılma direncine ve genel olarak tedavi başarısına dair kesin sonuçlara ulaşmak için daha fazla ve uzun dönem çalışmaların yapılması gereklidir. Bu derlemede, belirtilen faktörler farklı çalışmalardaki bulgulara göre değerlendirilmiş ve genel bir bakış açısı sunulmuştur.

Anahtar Kelimeler

konservatif giriş kavitesi, geleneksel giriş kavitesi, endodonti, giriş kavitesi, kök kanal morfolojisi

Minimally Invasive Access Cavities

Öz

The preparation of an appropriate access cavity is critical to successful root canal treatment, allowing adequate visibility and access to the canals. Traditional endodontic access cavities often require significant removal of dental tissue, which raises concerns about tooth fracture resistance. In response, a minimally invasive approach has been introduced that emphasizes the preservation of dental tissue. The choice between minimally invasive and traditional access cavities requires careful consideration. The impact of these cavities on teeth remains controversial. To effectively use these access cavities in treatment, tools such as CBCT, microscope, and ultrasonic tips are required. Further and long-term studies are necessary to draw definitive conclusions regarding the advantages and disadvantages of minimally invasive access cavities, the risk of complications and malpractice, whether they provide adequate root canal cleaning, the tooth's fracture resistance, and overall treatment success. In this review, the specified factors have been evaluated based on findings from various studies, and a general perspective has been presented.

Anahtar Kelimeler

conservative access cavity, traditional access cavity, endodontics, access cavity, root canal morphology

Kaynakça

• Allen C, Meyer CA, Yoo E, Vargas JA, Liu Y, Jalali P. Stress distribution in a tooth treated through minimally invasive access compared to one treated through traditional access: A finite element analysis study. J Conserv Dent. 2018;21(5):505-509.
• Alovisi M, Pasqualini D, Musso E, Bobbio E, Giuliano C, Mancino D, et al. Influence of Contracted Endodontic Access on Root Canal Geometry: An In Vitro Study. J Endod. 2018;44(4):614-620.
• Augusto CM, Barbosa AFA, Guimarães CC, Lima CO, Ferreira CM, Sassone LM, et al. A laboratory study of the impact of ultraconservative access cavities and minimal root canal tapers on the ability to shape canals in extracted mandibular molars and their fracture resistance. Int Endod J. 2020;53(11):1516-1529.
• Ballester B, Giraud T, Ahmed HMA, Nabhan MS, Bukiet F, Guivarc'h M. Current strategies for conservative endodontic access cavity preparation techniques-systematic review, meta-analysis, and decision-making protocol. Clin Oral Investig. 2021;25(11):6027-6044.
• Barbosa AFA, Silva EJNL, Coelho BP, Ferreira CMA, Lima CO, Sassone LM. The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling, and fracture resistance in mandibular molars. Int Endod J. 2020;53(12):1666-1679.
• Berman LH, Hartwell GR. The Core Science of Endodontics. Hargreaves KM, Berman LH, editors. Cohen's Pathways of the Pulp. 10th ed. Mosby Elsevier; 2016 .p.14-323
• Chan MYC, Cheung V, Lee AHC, Zhang C. A Literature Review of Minimally Invasive Endodontic Access Cavities - Past, Present and Future. Eur Endod J. 2022;7(1):1-10.
• Cleghorn BM, Christie WH. Anatomy and Morphology of Teeth and Their Root Canal Systems. Ingle J I, Rotstein I, editors. Ingle’s Endodontics, 7th ed. PMPH USA, Ltd; 2019 .p.1-58.
• Corsentino G, Pedullà E, Castelli L, Liguori M, Spicciarelli V, Martignoni M, et al. Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth. J Endod. 2018;44(9):1416-1421.
• Franco ABG, Franco AG, de Carvalho GAP, Ramos EV, Amorim JCF, de Martim AS. Influence of conservative endodontic access and the osteoporotic bone on the restoration material adhesive behavior through finite element analysis. J Mater Sci Mater Med. 2020;31(4):39.
• Freitas GR, Ribeiro TM, Vilella FSG, de Melo TAF. Influence of endodontic cavity access on curved root canal preparation with ProDesign Logic rotary instruments. Clin Oral Investig. 2021;25(2):469-475.
• Jain SD, Saunders MW, Carrico CK, Jadhav A, Deeb JG, Myers GL. Dynamically Navigated versus Freehand Access Cavity Preparation: A Comparative Study on Substance Loss Using Simulated Calcified Canals. J Endod. 2020;46(11):1745-1751.
• Krishan R, Paqué F, Ossareh A, Kishen A, Dao T, Friedman S. 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.
• 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.
• Marchesan MA, James CM, Lloyd A, Morrow BR, García-Godoy F. Effect of access design on intracoronal bleaching of endodontically treated teeth: An ex vivo study. J Esthet Restor Dent. 2018;30(2):E61-E67.
• Mendes EB, Soares AJ, Martins JNR, Silva EJNL, Frozoni MR. Influence of access cavity design and use of operating microscope and ultrasonic troughing to detect middle mesial canals in extracted mandibular first molars. Int Endod J. 2020;53(10):1430-1437.
• Moore B, Verdelis K, Kishen A, Dao T, Friedman S. Impacts of Contracted Endodontic Cavities on Instrumentation Efficacy and Biomechanical Responses in Maxillary Molars. J Endod. 2016;42(12):1779-1783.
• Neelakantan P, Khan K, Hei Ng GP, Yip CY, Zhang C, Pan Cheung GS. 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.
• Özyürek T, Ülker Ö, Demiryürek EÖ, Yılmaz F. The Effects of Endodontic Access Cavity Preparation Design on the Fracture Strength of Endodontically Treated Teeth: Traditional Versus Conservative Preparation. J Endod. 2018;44(5):800-805.
• Plotino G, Grande NM, Isufi A, Ioppolo P, Pedullà E, Gambarini G, et al. Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs. J Endod. 2017;43(6):995-1000.
• Plotino G. Minimally Invasive Approaches in Endodontic Practice. Cham: Springer; 2021.
• Roperto R, Sousa YT, Dias T, et al. Biomechanical behavior of maxillary premolars with conservative and traditional endodontic cavities. Quintessence Int. 2019;50(5):350-356.
• Rover G, Belladonna FG, Bortoluzzi EA, De-Deus G, Silva EJNL, Teixeira CS. 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.
• Rover G, de Lima CO, Belladonna FG, Garcia LFR, Bortoluzzi EA, Silva EJNL, et al. Influence of minimally invasive endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors. Int Endod J. 2020;53(11):1530-1539.
• Saberi EA, Pirhaji A, Zabetiyan F. Effects of Endodontic Access Cavity Design and Thermocycling on Fracture Strength of Endodontically Treated Teeth. Clin Cosmet Investig Dent. 2020;12:149-156.
• Saygili G, Uysal B, Omar B, Ertas ET, Ertas H. Evaluation of relationship between endodontic access cavity types and secondary mesiobuccal canal detection. BMC Oral Health. 2018;18(1):121.
• Shabbir J, Zehra T, Najmi N, Hasan A, Naz M, Piasecki L, et al. Access Cavity Preparations: Classification and Literature Review of Traditional and Minimally Invasive Endodontic Access Cavity Designs. J Endod. 2021;47(8):1229-1244.
• Silva AA, Belladonna FG, Rover G, Lopes RT, Moreira EJL, De-Deus G, et al. Does ultraconservative access affect the efficacy of root canal treatment and the fracture resistance of two-rooted maxillary premolars?. Int Endod J. 2020;53(2):265-275.
• Silva EJNL, Attademo RS, da Silva MCD, Pinto KP, Antunes HDS, Vieira VTL. Does the type of endodontic access influence in the cyclic fatigue resistance of reciprocating instruments?. Clin Oral Investig. 2021;25(6):3691-3698.
• Silva EJNL, Pinto KP, Ferreira CM, Belladonna FG, De-Deus G, Dummer PMH, 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.
• Silva EJNL, Rover G, Belladonna FG, De-Deus G, da Silveira Teixeira C, da Silva Fidalgo TK. Impact of contracted endodontic cavities on fracture resistance of endodontically treated teeth: a systematic review of in vitro studies. Clin Oral Investig. 2018;22(1):109-118.
• Silva EJNL, Oliveira VB, Silva AA, Belladonna FG, Prado M, Antunes HS. Effect of access cavity design on gaps and void formation in resin composite restorations following root canal treatment on extracted teeth. Int Endod J. 2020;53(11):1540-1548.
• Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in endodontically treated teeth. J Endod. 2010;36(4):609-617.
• Torabinejad M, Fouad AF, Shabahang S. Endodontics: Principles and Practice, 6th ed. Elseiver; 2000.
• Tüfenkçi P, Yılmaz K, Adigüzel M. Effects of the endodontic access cavity on apical debris extrusion during root canal preparation using different single-file systems. Restor Dent Endod. 2020;45(3):e33.
• Vieira GCS, Pérez AR, Alves FRF, Alves FRF, Provenzano JC, Mdala I, et al. Impact of Contracted Endodontic Cavities on Root Canal Disinfection and Shaping. J Endod. 2020;46(5):655-661.
• Xia J, Wang W, Li Z, Lin B, Zhang Q, Jiang Q, et al. Impacts of contracted endodontic cavities compared to traditional endodontic cavities in premolars. BMC Oral Health. 2020;20(1):250.
• Zehnder MS, Connert T, Weiger R, Krastl G, Kühl S. Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal location. Int Endod J. 2016;49(10):966-972.