Impact of Minimally Invasive Endodontic Procedures on the Development of Dentinal Microcracks

Introduction: To evaluate the impact of root canal preparation in teeth with ultraconservative access cavities (UltraAC) on the development of dentinal microcracks using a nondestructive longitudinal micro-computed tomography (micro-CT) imaging experimental model. Root canal preparation in teeth with traditional access cavities (TradAC) was used as control. Methods: Forty mandibular molars were scanned in a micro-CT device, anatomically matched, and distributed into 4 groups according to the type of access cavity and instru-mentation system: traditional/Reciproc (TradAC/RC), traditional/XP-endo Shaper (TradAC/ XP), ultraconservative/Reciproc (UltraAC/RC), and ultraconservative/XP-endo Shaper (UltraAC/XP). After root canal preparation, the teeth were rescanned. After reconstruction and co-registration procedures, the images were screened from the furcation level to the apex to identify the presence of dentinal microcracks. Results: From a total of 15,340 cross-section images, 19.65% (3014 slices) had some dentinal microcracks. The qualitative analysis demonstrated the presence of some dentinal microcracks in 11%, 33%, 19%, and 15% of the images of cross-sections in TradAC/RC, TradAC/XP, UltraAC/RC, and UltraAC/XP groups, respectively. All dentinal microcracks observed after root canal preparation were already present in the corresponding images before canal instrumentation. Therefore, no new microcracks were detected, regardless of the access cavity and root canal instrumentation system. Conclusions: Root canal preparation with Reciproc or XP-endo Shaper under traditional or ultraconservative access cavities did not create dentinal microcracks in extracted mandibular molars. (J Endod 2022;48:1146-1151.)

Automated summary

This study evaluated the impact of root canal preparation in teeth with ultraconservative access cavities on the development of dentinal microcracks using nondestructive longitudinal micro-CT imaging. The results showed that regardless of the access cavity and instrumentation system, root canal preparation did not create new dentinal microcracks.