Minimally Invasive Endodontic Treatment through the Labial/Buccal Cervical Approach - Protocol and Case Series

Traditional access cavity preparation involves removing the roof of the pulp chamber and smoothing the dentin bulges at the root canal orifice, thereby creating straight-line access. However, this may damage more healthy dental tissue and reduce the tooth's fracture resistance. This case series presents a novel minimally invasive endodontic protocol for 1 maxillary canine and 4 mandibular premolars, which required root canal therapy, due to labial/buccal cervical decay that caused pulpitis or periapical periodontitis.

Our treatment protocol includes the following steps: preoperative assessment, removing decay in the labial/buccal cervical region, preparing an endodontic access cavity utilizing the affected region, establishing a working-length reference line using resin, cleansing the pulp horn with ultrasonic retro-preparation tip, root canal preparation, disinfection, obturation through the labial/buccal cervical access, and final resin restoration.

Ideal root canal obturation outcomes were achieved in all cases, while avoiding the abrasion of tooth tissue at the pulp chamber roof, caused by traditional endodontic access cavity methods.

Minimally invasive endodontic treatment through the labial/buccal cervical approach offers clinicians new insights and options for endodontic access design.