Evaluation of fracture resistance in a single rooted mandibular first premolar following access opening with AReneto^®...

Preservation of pericervical dentin (PCD) during access cavity preparation plays a critical role in maintaining the fracture resistance of endodontically treated teeth. Traditional access techniques, when providing visibility and canal access, often compromise structural integrity. The integration of guided endodontic systems offers a promising minimally invasive alternative.

This study aimed to evaluate the fracture resistance of mandibular first premolar following conventional access cavity preparation and augmented reality (AR)-assisted minimally invasive access cavity preparation using the AReneto^® system, through finite element analysis (FEA).

Three freshly extracted, intact mandibular premolars were chosen for the study. Sample 1 was kept as the control. Sample 2 was prepared using the conventional access cavity technique, while Sample 3 was prepared with AReneto^® system. Pre- and postoperative cone-beam computed tomography scans were converted into three-dimensional finite element models using CS3D^® software. To simulate functional occlusal forces, three loading conditions were applied, each directed along the long axis of the tooth. These models were then subjected to FEA in ANSYS^® software to evaluate stress distribution and displacement.

FEA revealed the highest displacement and stress concentration in Sample 2. Sample 3 demonstrated lower displacement and Sample 1 showed the least displacement.

AR-assisted access preparation using the AReneto^® system offers a conservative, accurate, and clinically feasible approach that preserves PCD and enhances the fracture resistance of endodontically treated teeth. The integration of AR in endodontics represents a significant advancement toward minimally invasive endodontics.