Comparative evaluation of Fracture strength of Endodontically treated Maxillary Molars with three different Access Cavity designs and correlating it to Volume percentage of enamel and dentin removed measured using CBCT: An In Vitro study

INTRODUCTION: Access cavity is defined as ‘The opening prepared in a tooth to gain entrance to the root canal system for the purpose of cleaning, shaping and obturation. The endodontic triad consists of biomechanical preparation, microbial control and complete obturation of the canal space. However, access to the canal orifices and the apical foramina are not done properly, achieving the goals of triad will be difficult and time consuming. The ultimate goal of endodontic treatment is to create an environment in which the body can heal itself. Adequate access is the key to achieving endodontic success. AIM OF THE STUDY: To evaluate the fracture strength of endodontically treated extracted maxillary molars with three different access cavity designs– Traditional Endodontic Cavity (TEC), Conservative- “TRUSS” Endodontic Cavity (CEC) and Ultra conservative “NINJA” Endodontic Cavity (NEC)access preparations and to correlate it to the volume percentage of enamel and dentin removed which was measured using CBCT. MATERIALS AND METHODS Sixty intact human maxillary molars extracted for periodontal reasons were selected and the samples were randomly grouped (n= 20) into Group I – Traditional (TEC), Group II – Conservative(CEC) and Ninja (NEC) endodontic access cavities. All the tooth samples were subjected to a Pre- operative CBCT imaging (NEWTOM cone beam computer tomography) with the samples mounted in a custom- made wax rim. Using Digital Imaging and Communications in Medicine data (DICOM) software the total enamel and dentin crown volume for each tooth were calculated. Then, TEC, CEC and NEC cavities access of all teeth were prepared in respected groups. The teeth samples of TEC, CEC and NEC groups were then subjected to a post-operative CBCT imaging. The volume percentage of coronal enamel and dentin removed by TEC, CEC and NEC access cavity preparations were calculated using DICOM software again. The volume percentage of coronal enamel and dentin removed in TEC, CEC, NEC were calculated using formula:(Reduction of ...