Abstract
Background:A perfect balance needs to be maintained between various types of endodontic access cavity preparation designs like - Traditional and conservative designed preparation to have access to the root canal system for proper cleaning and shaping of root canals without compromising the fracture resistance of the tooth structure.Aims and Objectives:We aimed to assess as well as draw comparisons of resistance against fracture of remaining tooth structure post the endodontic treatment after preparing access cavity through a variety of techniques so that we can estimate which type of cavity design technique will help endodontically treated teeth to withstand excessive load without fracture.Methods:Forty-two intact teeth (mandibular molars) were randomly selected and then were assigned to 07 different groups, inclusive of control and test groups. Various designs of access cavity preparation were done on sample teeth. The groups were divided based on different access cavity preparation designs as well as residual walls. The samples were then mounted on a composite cylinder, which was loaded under a mechanical testing machine at 0.5mm/min speed till the tooth structure fractured. This measurement of force was denoted in newton. The later analysis was carried out with the help of two-way Analysis of Variance (ANOVA) as well as Tukey’s post-hoc statistical tests.Results:There was negligible statistically relevant variance in strength towards fracture between traditional and conservative designs in teeth having three remaining walls. However, teeth with only two remaining walls fractured easily.Conclusion:Fracture resistance of teeth with remaining 03 residual walls did not show any significant difference among Traditional (TEC) and Conservative Cavity (CEC) design groups, but increased fracture strength was reported in CEC with 02 residual walls.
Highlights
Vital teeth are much stronger in terms of fracture resistance, especially when bearing occlusal forces compared to root canal treated teeth [1]
Fracture resistance of teeth with remaining 03 residual walls did not show any significant difference among Traditional (TEC) and Conservative Cavity (CEC) design groups, but increased fracture strength was reported in CEC with 02 residual walls
Mean as well as standard deviations were measured for various groups, which were later considered for pairwise comparison with the help of Analysis of Variance (ANOVA) as well as post-hoc Tukey test (Table 2) For comparing various pairs in the study Tukey post hoc analysis was conducted, in which alteration was seen statistically in terms of resistance to fracture of the tooth structure between both traditional as well as conservative designs in teeth where only three walls were remaining, though conservative design still fared better before reaching their breaking point
Summary
Vital teeth are much stronger in terms of fracture resistance, especially when bearing occlusal forces compared to root canal treated teeth [1]. A lot of factors cause the breakage of tooth structure and, in turn, weakening of the same [2]. Endodontic teeth are fracture prone sue to caries, any traumatic event, or a combination of both, which leads to breakage of tooth structure [5]. Periodontal structure is important to maintain the steadiness of the tooth as a whole, so if there is associated. A perfect balance needs to be maintained between various types of endodontic access cavity preparation designs like - Traditional and conservative designed preparation to have access to the root canal system for proper cleaning and shaping of root canals without compromising the fracture resistance of the tooth structure
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