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Present status and future directions - Minimal endodontic access cavities.

Emmanuel João Nogueira Leal Silva1,2, Gustavo De-Deus1, Erick Miranda Souza3

  • 1Department of Endodontics, Fluminense Federal University, Niterói, Brazil.

International Endodontic Journal
|January 31, 2022
PubMed
Summary

Minimal endodontic access cavities aim to preserve tooth structure but may compromise cleaning and show conflicting results on fracture resistance. Further research is needed to clarify their long-term effectiveness.

Keywords:
conservative endodontic cavityendodonticsfracture resistanceminimal access cavity preparationminimally invasive access cavityroot canal treatment

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Area of Science:

  • Endodontics
  • Dental Materials Science
  • Minimally Invasive Dentistry

Background:

  • The trend towards minimally invasive treatments in medicine is also evident in endodontics.
  • Minimal access preparation in endodontics aims to preserve dentine tissue and reduce post-treatment tooth fracture.
  • Existing evidence presents challenges including nomenclature, specialized equipment needs, and variable outcomes.

Purpose of the Study:

  • To review the scientific and clinical status of minimally invasive endodontic access cavities.
  • To provide an unbiased view on the rationale, flaws, and future directions for this technique.
  • To address the conflicting data and guide clinical decision-making.

Main Methods:

  • Systematic review and critical assessment of existing scientific literature on minimal access endodontic cavities.
  • Analysis of studies focusing on dentine preservation, instrument requirements, canal preparation, disinfection, obturation, and fracture resistance.
  • Evaluation of methodological limitations in current research.

Main Results:

  • Minimal access cavities may not affect orifice location or mechanical preparation with proper armamentarium.
  • Concerns exist regarding adequate canal cleaning, disinfection, and filling procedures.
  • Contradictory findings on the ability to increase tooth strength compared to traditional access cavities.
  • Methodological flaws in benchtop studies contribute to conflicting results.

Conclusions:

  • The current evidence base for minimal access endodontic cavities is weak and incomplete.
  • Standardization of nomenclature and development of specialized tools are necessary.
  • Further high-quality research, including in situ models or large clinical trials, is required.
  • The educational impact and cost-benefit of routine implementation need careful consideration.