An in vitro study of the effect endodontic access preparation and amalgam restoration have upon incisor crown retention

Endodontic access preparation leads to a significant reduction in crown retention. This study sought to determine whether this retention can be regained after access. Eighteen extracted human maxillary incisors had PFM crowns fabricated. Crowns were cemented, retention measured, recemented, access preparations cut, and retention once again measured. Then, crowns were recemented and accesses restored with dental amalgam and new retention measured. This format allowed each crown to be used as a control of itself. For crowns cemented with zinc phosphate cement and restored with amalgam, a 126% increase over original retention was measured. For crowns cemented with polycarboxylate cement and restored with amalgam, a 237% increase over original retention was measured. For crowns cemented with polycarboxylate cement and restored with amalgam, a 237% increase over original retention was measured. These results suggest that recementing crowns secondary to endodontic access and restoring the access with amalgam regains and even surpasses the original retention.