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Influence of minimally invasive access cavities on load capacity of root-canal-treated teeth: A systematic review and meta-analysis
Authors:Behrad Rahbani Nobar DDS  Omid Dianat DDS  MS  Behnam Rahbani Nobar DDS  MS  Majid Kazem DDS  MS  M. Lamar Hicks DDS  MS
Affiliation:1. Private Practice, Tehran, Iran;2. Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA;3. Department of Endodontics, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran;4. Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:This systematic review (PROSPERO-CRD42020147333) aimed to compare the effects of conservative, ultraconservative and truss access cavities with traditional access cavities on the load capacity of root-canal-treated teeth. Online databases were searched until December 2021, and 25 ex vivo studies in which the effects of different access cavities on load capacity of permanent teeth had been investigated were included. Quality assessment was completed using a modified risk of bias tool for in vitro studies adapted from previous studies. Meta-analysis was performed using the maximum-likelihood-based random-effects model with similar groups. Conservative access cavities significantly improved the load capacity of maxillary premolars (p < 0.01 [−1.32, −0.028]) and molars (p < 0.05 [−0.89, −0.02]) compared to traditional access cavities. Additionally, truss access cavities significantly improved the load capacity of mandibular molars with (p < 0.05, [−1.18, −0.02]) mesio-occluso-distal cavity preparations. Higher levels of evidence are needed to determine the long-term implications of minimal preparations for treatment outcomes.
Keywords:endodontics  load capacity  minimally invasive access cavity  root canal therapy  systematic review
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