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Traditional VS Conservative Endodontic Access Impact on Fracture Resistance of Chairside CAD-CAM


Now online in the Journal of Prosthodontics, an in vitro study co-authored by ACP members Carlos A. Jurado DDS, MS and Kelvin I. Afrashtehfar DDS, MSc, Dr, FRCD(C).

This report aimed to evaluate the effect of traditional and conservative endodontic access hole preparation on fracture resistance of chairside CAD-CAM lithium disilicate maxillary right central incisor crowns.

Previous research has suggested that endodontic access initiates catastrophic failure for complete crowns. Newer conservative approaches have been proposed for maxillary central incisors; traditionally, the access was triangular, while the novel access is more ovoidal in shape to remove less of the tooth or crown structure.

For this study, 57 crowns were fabricated and divided into three groups, (1) no endodontic access, (2) traditional triangular endodontic access, and (3) conservative ovoidal endodontic access.

All restorations were subjected to 10,000 cycles of thermal cycling and then samples were exposed to compressive loading force until fracture in a universal testing machine.

The authors conclude that the fracture resistance of chairside CAD-CAM lithium disilicate maxillary anterior crowns is influenced by the type of endodontic access provided. Conservative ovoidal endodontic access provides crowns with higher fracture resistance than traditional triangular endodontic access. Crowns with no endodontic access provided the highest resistance compared to other types of endodontic access.

Jurado CA, Amarillas-Gastelum C, Tonin BSH, Nielson G, Afrashtehfar KI, Fischer, NG. Traditional versus conservative endodontic access impact on fracture resistance of chairside CAD-CAM lithium disilicate anterior crowns: An in vitro study. J. Prosthodont. 2022; 1– 7. https://doi.org/10.1111/jopr.13625


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