The Influence of Minimally Invasive Access Cavities on the Cleaning Ability of Primary Infected Root Canals: An in-Vitro Study

Abstract

Introduction: A successful outcome of an endodontic treatment depends on proper cleaning and shaping, efficient irrigation and disinfection. A new concept of endodontic access cavity has been proposed for dentin preservation. Therefore, the current study might be of value. Aim: This study was carried out to evaluate the influence of minimally invasive endodontic access cavities (truss, pointed) versus conventional ones on cleaning ability of primary infected root canals. Materials and Methods: This study was carried on 36 molars. The teeth were initially infected with Fusobacterium nucleatum, and Streptococcus Intermedius then were divided into three groups (n=12) according to the access cavity: Group (A0): conventional access cavities, Group (A1): truss access cavities, and Group (A2): pointed access cavities. Cleaning and shaping of the root canals was performed and irrigated with NaOCl 2.5% + EDTA 17% and ChloraEXtra + EDTA 17%. Confocal Laser Scanning was performed. Results: Conservative access with ChloroExtra showed the statistically significantly lowest mean Bacterial reduction. While Conventional access cavity either using NaOCl or ChloroExtra irrigation showed the highest bacterial reduction, followed by Truss access cavity with NaOCl, Truss access cavity with ChloroExtra, and Conservative access cavity with NaOCl. Conclusion: Within the limitations of the current study, the following can be concluded: 1. Using both NaOCl and ChloroExtra lead to reduction in bacterial count. 2. Conventional endodontic access cavities are still considered the gold standard in root canal treatment. Keywords: Conventional endodontic access cavities, Minimal endodontic access cavities, Sodium hypochlorite irrigation, ChloroExtra, Confocal Laser Scanning Microscope.