Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth

Introduction: The purpose of this study was to assess the impact of access cavity preparation and the remaining tooth substance on the fracture strength of endodontically treated teeth. Methods: One hundred sound mandibular first and second molar teeth were selected and divided into 1 control and 9 test groups (n = 10/group) as follows: control group, intact teeth; group 1, teeth prepared with traditional endodontic access cavity (TEC); group 2, teeth prepared with conservative endodontic access cavity (CEC); group 3, teeth prepared with truss endodontic access cavity (TREC); group 4, TEC + 3 residual walls; group 5, CEC + 3 residual walls; group 6, TREC + 3 residual walls; group 7, TEC + 2 residual walls; group 8, CEC + 2 residual walls; and group 9, TREC + 2 residual walls. After access cavity preparation, all test teeth were endodontically treated and restored. The specimens were then loaded to fracture in a universal loading machine (Triaxial Tester T400 Digital; Controls srl, Cernusco, Italy), and fracture values were recorded in newtons. The data were analyzed with 2-way analysis of variance and Tukey post hoc analysis for multiple comparisons (P < .05). Results: Intact teeth were more resistant to fracture than the teeth in all the test groups. No statistically significant differences were found between the 3 tested access cavities (P > .05). Significant differences were observed between the different number of residual walls (P < .05). Conclusions: TRECs do not increase the fracture strength of endodontically treated teeth in comparison with CECs and TECs. Moreover, the loss of mesial and distal ridges reduced the fracture strength of teeth significantly.