Chandolu Vedamani, Mandava Jyothi, Borugadda Roopesh, Sirisha Kantheti, Kumar Konagala Ravi, Goteti Sameera, Nallamilli Lalitha Sri Roja
Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India.
J Conserv Dent Endod. 2024 Mar;27(3):268-273. doi: 10.4103/JCDE.JCDE_272_23. Epub 2024 Mar 6.
Several designs of access cavity have been evolved in the recent past with the concept of minimal tooth tissue removal which would improve the root canal treated teeth fracture resistance.
To investigate the effect of conservative design access cavity during the instrumentation of maxillary molar root canals.
Eighty noncarious maxillary molars were assigned to the traditional and conservative access groups ( = 40 each). After designated access preparations, the teeth were immersed in Lugols's solution for staining the pulp tissue. Root canal instrumentation was performed with TruNatomy file system. Pre- and postinstrumentation nano-computed tomography (CT) images were taken and reconstructed using CT-An software. Root canals volumetric analysis was done with CT-Vol software. The analysis of the data was dealt with Shapiro-Wilk test and independent -test.
The volume of pulp canal space before and after instrumentation changed significantly between the traditional and conservative access design groups, according to an independent -test. In comparison, the mean volume of dentin removed was much larger in the TAC group ( = 0.0016). The independent -test manifests difference significantly between traditional endodontic access cavity (TAC) and conservative access cavity (CAC) with percentage of unprepared canal walls. The mean percentage of unprepared area was significantly lesser in TAC group as compared to CAC group ( = 0.0022).
The volume of dentin removed was greater in TAC than with the CAC design. The amount of untouched canal wall area was significantly higher in conservative access design than with the traditional access design group.
近年来，随着微创去牙体组织理念的出现，几种开髓洞形设计应运而生，这有望提高根管治疗后牙齿的抗折性。
研究上颌磨牙根管预备过程中保守设计开髓洞形的效果。
将80颗无龋上颌磨牙分为传统开髓组和保守开髓组（每组40颗）。完成指定的开髓预备后，将牙齿浸入卢戈氏溶液中以染色牙髓组织。使用TruNatomy锉系统进行根管预备。在预备前后拍摄纳米计算机断层扫描（CT）图像，并使用CT-An软件进行重建。使用CT-Vol软件进行根管容积分析。数据采用Shapiro-Wilk检验和独立样本t检验进行分析。
根据独立样本t检验，传统开髓设计组和保守开髓设计组在根管预备前后的髓腔空间体积有显著变化。相比之下，传统开髓组去除的牙本质平均体积要大得多（P = 0.0016）。独立样本t检验表明，传统牙髓开髓洞形（TAC）和保守开髓洞形（CAC）在未预备根管壁百分比方面存在显著差异。与CAC组相比，TAC组未预备区域的平均百分比显著更低（P = 0.0022）。
传统开髓设计去除的牙本质体积比保守开髓设计大。保守开髓设计中未触及的根管壁面积明显高于传统开髓设计组。
