Effect of access cavity design on gaps and void formation in resin composite restorations following root canal treatment on extracted teeth.

Abstract

To evaluate the influence of ultraconservative endodontic access cavities (UEC) on gaps and void formation in resin composite restorations in extracted two-rooted maxillary premolars after root canal treatment. Traditional endodontic access cavities (TEC) were used as a reference for comparison. Two-rooted maxillary premolars were scanned in a micro-computed tomographic (micro-CT) device, matched based on similar anatomical features and allocated into two groups (n=10) according to the design of the access cavity: TEC or UEC. Teeth were mounted on a mannequin head and a single operator performed the treatment, including endodontic access cavity preparation, root canal detection, preparation, filling and restoration procedures, under magnification. For restorative procedure, a bulk fill flowable layer was applied initially followed by an overlaying of regular composite. After restoration procedures, a new micro-CT scan was performed to check the quality of the coronal restoration by analysing the percentage volume of empty spaces present in the tooth-restoration interface (gaps) and inside the restoration (voids). Data were analysed statistically using Shapiro-Wilk and Student's t tests with a significance level of 5%. All specimens had gaps and voids. There were significant differences between the access cavity designs regarding the formation of voids with significantly more voids associated with the UEC (P<0.05). Gap formation did not differ between groups (P>0.05). The access cavity design used during root canal treatment interfered with the adaptation of the restorative material. The minimally invasive access cavity design was associated with a significantly greater number of voids within restorations.