Influence of minimally invasive access cavities on load capacity of root-canal-treated teeth: A systematic review and meta-analysis

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.

Automated summary

This systematic review compared the effects of conservative, ultraconservative, and truss access cavities with traditional access cavities on the load capacity of root-canal-treated teeth. The results indicated that conservative and truss access cavities significantly improved the load capacity of the teeth compared to traditional access cavities. However, further high-quality evidence is needed to determine the long-term implications of minimal preparations for treatment outcomes.