Evaluation of dentin thickness preservation and the efficiency of instrumentation between traditional and guided endodontic access in mandibular central incisors.

INTRODUCTION

Tooth substance loss during endodontic treatment is a major concern, especially in mandibular incisors due to their minimal tooth volume. Template-guided access cavities help preserve dentin and improve instrument centering. This in vitro study compares remaining dentin thickness (RDT) and centering ability of rotary instruments using both conventional and template-guided approaches in mandibular incisors.

OBJECTIVE

Comparative in vitro CBCT study on remaining dentin thickness and centering ability of rotary instrumentation in mandibular incisors using conventional vs. template-guided access cavity preparation.

METHODOLOGY

Pre-treatment CBCT scans were taken of 80 mandibular incisors, to evaluate the existing dentin thickness and these were then divided into 2 groups of 40 teeth each. Conventional endodontic access cavities were made in Group -1, and guided access openings were done in Group - 2. Post-operative CBCT scans were taken to measure the RDT canal centering ability of each approach.The data was examined using a one-way analysis of variance, followed by Tukey's post-hoc test for multiple pairwise comparisons, with a significance level set at p < 0.05.

RESULTS

The mean RDT was significantly higher in the group where a template-guided access opening was done. The statistical difference for RDT amongst both the experimental groups was highly significant at the Cemento-Enamel Junction and 9 mm from the root apex. Statistically significant results were obtained 6 mm level and insignificant result was obtained at 3 mm level from root apex. No significant differences in the centering ability ratio were observed between the Traditional Endodontic Cavity (TEC) and Guided Endodontic Cavity (GEC) at any level.

CONCLUSION

Pericervical dentin was preserved more in guided access cavity preparation. The design of the access cavity preparation did not impact the centering ratio of the instruments used for shaping the root canals.