Do Conservative Access Cavity Designs Increase The Etiological Complications Incidence Rate? (in Vitro Study)

Introduction & Aim: The aim of this study was to evaluate the effect of two conservative access cavity designs on etiological complications of root canal treatment for molar with severe root canal curvature (according to Schneider's classification). And comparing these differentdesigns to traditional endodontic access cavity. Materials & Methods: Thirty human intact freshly extractedmaxillary and mandibular molars with completely formed apices were used and then randomly divided into three groups. Group A (TEC) was accessed as (Traditional Endodontic Access Cavity) design completely following the principles of conventional endodontic access design that have well described in the literature. Group B (CEC) was accessed as (Conservative Endodontic Access Cavity) design described by David Clark & John Khademi. Group C (Ultra-CEC) was accessed as small as possible and called an (Ultra-Conservative Endodontic Access Cavity) design and also known as “Ninja or Pointed” access. All stages were performed by the same operator and the same manual k-File #8 #10 and rotary files type, Pro-Glider, WOG-Primary for all groups. All steps were performed under microscope magnification. Results: There was no statistical significant deference between groups for (handling glide path canal, ledges, perforations or separating instrument) by using Chi-Square Test for the triple compared among the groups and Fisher's Exact Test for the dual comparisons (P > 0.05). However, the third group Ultra-CEC showed statistical significant possibility for incidence etiological complications in total more than TEC, CEC Groups (p<0.014). Conclusions: CEC access cavity is a reasonable way to be less invasive than TEC in preparing endodontic access cavity without increasing incidence rate an etiological complication which may affect the biological aims of RCT. Ultra-CEC is a short way to make RCT more complicated and more likely to increase incidence rate of etiological complications.