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Influence of access cavity preparation on the dentine thickness of mesial canals of mandibular molars prepared with reciprocating instruments

Int Endod J. 2021 Oct 3. doi: 10.1111/iej.13642. Online ahead of print.

ABSTRACT

AIM: To evaluate the influence of traditional and conservative access cavity preparations on the remaining dentine thickness in the coronal third of mesial canals of extracted mandibular molars prepared with reciprocating instruments, using micro-computed tomography as the analytical tool.

METHODOLOGY: Seventy extracted mandibular molars were scanned at a pixel size of 19 μm. From this initial sample, twenty teeth were selected, pair-matched, and distributed into 2 groups (n=10) according to the access cavity preparation: traditional (TradAC) or conservative (ConsAC). The root canals were sequentially enlarged with Reciproc Blue R25 (size 25, 0.08v taper) and R40 (size 40, 0.06v taper) instruments. A new scan was performed and the postoperative stacks were co-registered with their respective preoperative datasets. A colour-coded cross-sections of the roots were created and used to identify and measure the smallest dentine thickness related to both MB and ML canals at 1.0-mm intervals from the furcation level up to 5 mm in the apical direction, in both mesial and distal aspects of the roots, before and after preparation. The statistical analyses were performed with paired-samples t-test, independent-samples Student T, and Chi-Square test with a significance level of 5%.

RESULTS: In all levels of both groups, dentine thickness before preparation was greater than after preparation (p < 0.05). No difference in the percentage of dentine reduction were observed between TradAC and ConsAC groups (p > 0.05), but a significantly greater reduction was observed to the distal aspect of the roots (p < 0.05). After root canal preparation, dentine thickness thinner than 0.5 mm was observed mostly at the distal aspect of the root (10% to 15%) of the MB and ML canals, with no influence of the access cavity type on its incidence to either mesial (X2 =1.66; p=0.2) or distal (X2 =0.40; p=0.5) directions. In the TradAC group, dentine thickness in most slices was greater than 1.0 mm after preparation (n=124) while, in the ConsAC, it ranged from 0.5 to 1.0 mm (n=136).

CONCLUSION: Traditional or conservative access cavity preparation in extracted mandibular molars did not influence the remaining dentine thickness in the coronal third of mesial canals enlarged with thermomechanically-treated nickel-titanium reciprocating instruments.

PMID:34601728 | DOI:10.1111/iej.13642

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