Minimally Invasive Access Cavities: A Benefit/Risk Analysis

Background/Objectives: Contemporary dentistry aims to preserve healthy tissues and perform minimally invasive procedures. The availability of ever-improving equipment allows practitioners to follow this conceptual innovation. This approach is also used in endodontics, as new types of access cavities seem to be gaining popularity, allegedly reducing tissue destruction and loss of mechanical resistance of the treated teeth. Methods: We performed a comprehensive review of the available literature on the subject, focusing on in vitro studies accessible through major search engines and limiting the search to English-language articles published between 2010 and 2024. Results: Our analysis showed that the realization of reduced access cavities seems to preserve the mechanical resistance of the treated teeth, may compromise disinfection, and respects the original root canal path and the quality of obturation. In addition, these procedures appear to increase instrument deformation, fracture susceptibility, and treatment time: Mini-invasive cavities have many limitations and should only be used in situations where there is a high likelihood of success, where there are few difficulties and where sufficient material is available. However, with appropriate case selection, these new approaches can be used and should improve the prognosis of endodontically treated teeth.