Micro-computed tomography of tooth tissue volume changes following endodontic procedures and post space preparation

To compare the volume of hard tooth tissue lost after caries removal, access cavity preparation, root canal preparation, fibre post space and cast post preparation in carious premolar teeth. The null hypothesis tested was that there is no difference between the volumes of hard tooth tissue lost expressed as a percentage of the preoperative hard tooth tissue volume, after each operative procedure.

Twelve extracted human premolars with mesial or distal carious cavities penetrating into the pulp chamber were selected. Teeth were scanned using a microCT scanner. After each operative procedure the loss of hard tooth tissue volume was measured. The data were statistically analysed using one-way analysis of variance and Fisher's PLSD test with statistical significance set at alpha = 0.01.

The percentage of preoperative hard tooth tissue volume lost after caries removal was 8.3 +/- 5.83, after access cavity preparation the loss of volume reached 12.7 +/- 6.7% (increase of 4.4%). After root canal preparation, fibre post space and cast post preparation the hard tissue volume lost reached, 13.7 +/- 6.7 (increase of 1%), 15.1 +/- 6.3 (increase of 1.4%) and 19.2 +/- 7.4 (increase of 4.1%) respectively. Each procedure performed after caries removal significantly increased (P < 0.01) the amount of hard tissue volume lost with the exception of the root canal preparation.

Access cavity and post space preparation are the procedures during root canal treatment which result in the largest loss of hard tooth tissue structure. Cast post space preparation causes a larger loss of tooth structure than fibre post space preparation. This should be taken into account when planning root canal treatment and restoration of root filled teeth that are to be restored with cuspal coverage restorations.