Department of Operative Dentistry and Endodontics, Liaquat College of Medicine and Dentistry, Karachi, Pakistan.
Department of Operative Dentistry and Endodontics, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan.
J Endod. 2021 Aug;47(8):1229-1244. doi: 10.1016/j.joen.2021.05.007. Epub 2021 May 28.
Several endodontic access cavity designs have been proposed in the past decade to access the root canal space in a minimally invasive manner. The rationale for this approach was derived from the assumption that preserving more tooth structure during access preparation will improve the tooth's resistance to fracture and its long-term survivability. However, is this assumption valid? Also, can this approach compromise other treatment-related aspects?
We conducted a literature review using 4 online databases and classified the access cavity designs presented in each article according to our proposed classification.
Through the literature search, we identified 49 articles that evaluated the effect of the access cavity design on 11 different treatment parameters. The majority of the studies failed to demonstrate clear benefits of the minimally invasive access designs, whereas others raised concerns regarding the ability to adequately disinfect, fill, and restore teeth with a minimally invasive access cavity design.
Minimally invasive access cavity designs present more risk than benefit on the outcome of endodontic treatment. Clinicians should reconsider the application of a minimally invasive access cavity for routine endodontics and cautiously apply it in selected cases when the proper armamentarium is available.
在过去的十年中，已经提出了几种牙髓腔入口设计方案，以微创的方式进入根管空间。这种方法的基本原理是假设在入口制备过程中保留更多的牙齿结构将提高牙齿的抗裂性和长期存活率。然而，这种假设是否合理？此外，这种方法是否会影响其他与治疗相关的方面？
我们使用 4 个在线数据库进行了文献回顾，并根据我们提出的分类对每篇文章中提出的牙髓腔入口设计进行了分类。
通过文献检索，我们确定了 49 篇评估入口设计对 11 个不同治疗参数影响的文章。大多数研究未能证明微创入口设计的明显益处，而其他研究则对微创入口设计能否充分消毒、填充和修复牙齿的能力提出了担忧。
微创入口设计对牙髓治疗的结果弊大于利。临床医生应重新考虑将微创入口设计应用于常规牙髓治疗，并在适当的器械可用时谨慎地将其应用于选定的病例。
