styleitaliano style italiano research group digital dentistry

Traditional vs Truss Access

Recently, a great effort has been placed in saving as much tooth structure as possible. Truss access cavity have been introduced with he claim of increasing the fracture resistance. This study investigated the difference, in terms of fracture resistance, between a conservative access cavity and a truss access cavity.

styleitaliano style italiano research group digital dentistry

Fig.1

60 lower molars were measured and divided into 6 groups.

styleitaliano style italiano research group digital dentistry

Fig.2

Groups 1, 3 and 5 featured a conservative access cavity with, respectively, 4, 3 and 2 remaining walls.
Groups 2, 4 and 6 featured a conservative access cavity with, respectively, 4, 3 and 2 remaining walls.

styleitaliano style italiano research group digital dentistry

Fig.3

After the endodontic treatment, direct restorations were performed according to the bulk and body technique from Style Italiano.

styleitaliano style italiano research group digital dentistry

Fig.4

Teeth were then subjected to load until fracture.

styleitaliano style italiano research group digital dentistry

Fig.5

And fracture patterns were measured to understand the type (restorable VS non restorable) of fracture.

styleitaliano style italiano research group digital dentistry

Fig.6

An example of the measurements.

styleitaliano style italiano research group digital dentistry

Fig.7

The results clearly show that there is no difference between truss and conservative. Considered the higher risk and difficulty of the truss access, it is advisable to prefer the conservative access. It is also notable that the resistance to fracture decreases strongly for groups 5 and 6, indicating that a cusp coverage is mandatory whenever the two residual walls are missing.

Bibliography

1- Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth. – Corsentino G, Pedullà E, Castelli L, Liguori M, Spicciarelli V, Martignoni M, Ferrari M, Grandini S. J Endod. 2018 Sep;44(9):1416-1421

2- Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs. -Plotino G, Grande NM, Isufi A, Ioppolo P, Pedullà E, Bedini R, Gambarini G, Testarelli L. J Endod. 2017 Jun;43(6):995-1000