Cone Beam Computed Tomographic Evaluation of Two Access Cavity Designs and Instrumentation on Pericervical Dentin Thickness in Mandibular Incisors-An Invitro Study

Introduction: Access cavity preparation plays a crucial role in successful root canal treatment. Traditionally, the endodontic access cavity for mandibular central and lateral incisors extends in a labiolingual direction, forming an oval shape just above the cingulum. To enhance fracture resistance in mandibular anterior teeth, it is essential to consider a modified access design that conserves pericervical dentin. Methods: Sixty extracted human permanent mandibular incisors were randomly allocated into two groups of thirty based on the access cavity design. Group A received a conventional access cavity, while Group B was treated with a modified access cavity. Cervical dentin thickness was measured using cone-beam computed tomography (CBCT) on the facial, lingual, mesial, and distal surfaces at the level of the cementoenamel junction (CEJ) before, during, and after instrumentation. Results: A statistically significant difference in pericervical dentin loss was observed at the facial surface following access preparation with the modified cavity design (P<0.05). However, this loss was not statistically significant (P>0.05) after instrumentation in both the groups. Conclusion: CBCT evaluation demonstrated that the modified access cavity design in mandibular anterior teeth resulted in less pericervical dentin loss at the facial surface.