The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 25 , ISSUE 4 ( April, 2024 ) > List of Articles

REVIEW ARTICLE

Impact of Pericervical Dentin on Fracture Resistance of Endodontically Treated Posterior Permanent Teeth: A Systematic Review and Meta-analysis

Selvakumar Haridoss, Mathanranjan Rajendran, Kavitha Swaminathan, Anbarasi, Aruna Sharma, Vijayaragavan Elumalai

Keywords : Fracture resistance, Minimal invasive endodontics, Pericervical dentin, Pericervical dentin thickness, Permanent molars

Citation Information : Haridoss S, Rajendran M, Swaminathan K, Anbarasi, Sharma A, Elumalai V. Impact of Pericervical Dentin on Fracture Resistance of Endodontically Treated Posterior Permanent Teeth: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2024; 25 (4):372-385.

DOI: 10.5005/jp-journals-10024-3671

License: CC BY-NC 4.0

Published Online: 14-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Objective: The main aim of this present systematic review is to evaluate if the preservation of pericervical dentin (PCD) increases the fracture resistance of endodontically treated permanent posterior teeth. Materials and methods: Two independent reviewers conducted a comprehensive review of all published studies from 2007 (1/1/2007) to 2023 (31/5/23) since the concept of PCD first appeared in the literature in 2007. Searches were conducted in multiple electronic database engines: PubMed, Scopus, EBSCO (Dentistry and oral health sciences), Web of Sciences (WOS), Cochrane, Google Scholar and Open Grey, Ovid and Shodhganga, in addition to cross-references and hand search. Articles were chosen according to a certain inclusion and exclusion criteria, which, in brief, are laboratory-based studies published in English that assess the impact of PCD on fracture resistance of endodontically treated permanent posterior teeth. Using domains, such as sample size, sample dimensions, and control group as quality assessment criteria, evaluated the selected articles and classified them according to their risk of bias into low, moderate, and high. A meta-analysis was conducted using random effects modeling at a significance level of p < 0.05. Results: A total of studies 6,043 were retrieved from 10 different electronic search databases and hand searches, but only 12 laboratory-based studies were selected after removing duplicates and applying the eligibility criteria. Of the included 12 studies, nine studies showed low risk of bias and three studies showed moderate risk of bias. Two studies showed related data for meta-analysis, the difference observed between the two studies is statistically non-significant. Conclusion: Based on the results of the study, there is evidence to support that PCD preservation offers fracture resistance to the endodontically treated posterior teeth. Clinical significance: The practice of conservative cavity preparation and avoiding the usage of instruments with high taper increases the fracture resistance of the tooth by retaining the PCD.


PDF Share
  1. Acharya N, Hasan MR, Kafle D, et al. Effect of hand and rotary instruments on the fracture resistance of teeth: An in vitro study. Dent J (Basel) 2020; 8(2):38. DOI: 10.3390/dj8020038.
  2. Reeh ES, Messer HH, Douglas WH. Reduction in tooth stiffness as a result of endodontic and restorative procedures. J Endod 1989;15(11):512–516. DOI: 10.1016/S0099-2399(89)80191-8.
  3. Bürklein S, Schäfer E. Minimally invasive endodontics. Quintessence Int 2015;46(2):119–124. DOI: 10.3290/j.qi. a33047.
  4. Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in endodontically treated teeth. J Endod 2010;36(4):609–617. DOI: 10.1016/j.joen.2009.12.002.
  5. Clark D, Khademi J. Modern molar endodontic access and directed dentin conservation. Dent Clin North Am 2010;54(2):249–273. DOI: 10.1016/j.cden.2010.01.001.
  6. Clark D, Khademi JA. Case studies in modern molar endodontic access and directed dentin conservation. Dent Clin North Am 2010;54(2):275–289. DOI: 10.1016/j.cden.2010.01.003.
  7. Clark D, Khademi J, Herbranson E. The new science of strong endo teeth. Dent Today 2013;32(4):112, 114, 116–117. PMID: 23659101.
  8. Lenchner NH. Considering the “ferrule effect”. Pract Proced Aesthet Dent 2001;13(2):102. PMID: 11315426.
  9. Mukherjee P, Patel A, Chandak M, et al. Minimally Invasive Endodontics a Promising Future Concept: A Review Article. Int J Sci Stud 2017;5(1):245–251. DOI: 10.17354/ijss/2017/199.
  10. Arora V, Yadav M, Singh S. Peri-cervical dentin (pcd): A new paradigm for endodontic success. Global J Res Anal 2016;4: 490–493.
  11. Sedgley CM, Messer HH. Are endodontically treated teeth more brittle? J Endod 1992;18(7):332–335. DOI: 10.1016/S0099-2399(06)80483-8.
  12. Dietschi D, Duc O, Krejci I, et al. Biomechanical considerations for the restoration of endodontically treated teeth: A systematic review of the literature. Part II. Evaluation of fatigue behavior, interfaces, and in vivo studies. Quintessence Int 2008;39(2):117–129.
  13. Dietschi D, Duc O, Krejci I, et al. Biomechanical considerations for the restoration of endodontically treated teeth: A systematic review of the literature. Part 1. Composition and micro- and macrostructure alterations. Quintessence Int 2007;38(9):733–743.
  14. Magne P, Belser U. Bonded porcelain restorations in the anterior dentition: A biomimetic approach. Batavia, Ill: Quintessence; 2003. Understanding the intact tooth and the biomimetic principle. pp. 23–55.
  15. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021;372: n71. DOI: 10.1136/bmj. n71.
  16. Silva EJNL, Rover G, Belladonna FG, et al. Impact of contracted endodontic cavities on fracture resistance of endodontically treated teeth: A systematic review of in vitro studies. Clin Oral Investig 2018;22(1):109–118. DOI: 10.1007/s00784-017-2268-y.
  17. Sarkis-Onofre R, Skupien JA, Cenci MS, et al. The role of resin cement on bond strength of glass-fiber posts luted into root canals: Asystematic review and meta-analysis of in vitro studies. Oper Dent 2014;39(1):E31–44. DOI: 10.2341/13-070-LIT.
  18. Rosa WL, Piva E, Silva AF. Bond strength of universal adhesives: A systematic review and meta-analysis. J Dent 2015;43(7):765–776. DOI: 10.1016/j.jdent.2015.04.003.
  19. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. 2008. Wiley-Blackwell; p. 673.
  20. Clark D, Khademi J. Modern endodontic access and dentin conservation, Part I. Dent Today 2009;28(10):86, 88, 90 passim. PMID: 19845305.
  21. Clark D, Khademi J. Modern endodontic access and dentin conservation, Part 2. Dent Today 2009;28(11):86, 88, 90 passim. PMID: 19994824.
  22. Issac C, Valli SK, Pasha S. CBCT evaluation of pericervical dentin thickness after completion of biomechanical preparation with fifth generation rotary files. Int J Med Sci Diagn Res 2020;4(8):44–49. DOI: 10.32553/ijmsdr.v4i8.644.
  23. Zinge PR, Patil J. Comparative evaluation of effect of rotary and reciprocating single-file systems on pericervical dentin: A cone-beam computed tomography study. J Conserv Dent 2017;20(6):424–428. DOI: 10.4103/JCD.JCD_201_17.
  24. Sarvaiya UP, Rudagi K, Joseph J. A comparative evaluation of the effect of different access cavity designs on root canal instrumentation efficacy and resistance to fracture assessed on maxillary central incisors: An in vitro study. J Conserv Dent 2020;23(6):609–614. DOI: 10.4103/JCD.JCD_600_20.
  25. Varghese VS, George JV, Mathew S, et al. Cone beam computed tomographic evaluation of two access cavity designs and instrumentation on the thickness of peri-cervical dentin in mandibular anterior teeth. J Conserv Dent 2016;19(5):450–454. DOI: 10.4103/0972-0707.190018.
  26. Huynh N, Li FC, Friedman S, et al. Biomechanical Effects of Bonding Pericervical Dentin in Maxillary Premolars. J Endod 2018;44(4): 659–664. DOI: 10.1016/j.joen.2018.01.002.
  27. Arora V, Yadav MP, Singh SP, et al. Comparative evaluation of post obturation materials on reinforcement of pericervical dentin (PCD)–An in vitro study. IJTEEE 2015;39–43.
  28. Arora V, Yadav MP, Singh SP, et al. Effect of adhesive obturation and post obturation monoblock systems on reinforcement of peri-cervical dentin (PCD). Int J Br Trend Technol 2015;1–6.
  29. Smoljan M, Hussein MO, Guentsch A, et al. Influence of progressive versus minimal canal preparations on the fracture resistance of mandibular molars: A 3-dimensional finite element analysis. J Endod 2021;47(6):932–938. DOI: 10.1016/j.joen.2021.03.008.
  30. Lin CY, Lin D, He WH. Impacts of 3 different endodontic access cavity designs on dentin removal and point of entry in 3-dimensional digital models. J Endod 2020;46(4):524–530. DOI: 10.1016/j.joen.2020.01.002.
  31. Krishan R, Paqué F, Ossareh A, et al. Impacts of conservative endodontic cavity on root canal instrumentation efficacy and resistance to fracture assessed in incisors, premolars, and molars. J Endod 2014;40(8):1160–1166. DOI: 10.1016/j.joen.2013.12.012.
  32. Yuan K, Niu C, Xie Q, et al. Comparative evaluation of the impact of minimally invasive preparation vs conventional straight-line preparation on tooth biomechanics: A finite element analysis. Eur J Oral Sci 2016;124(6):591–596. DOI: 10.1111/eos.12303.
  33. Osman IA, Ahmed HA. The effect of access cavity design on fracture resistance of endodontically treated first molars: In vitro study. Sch J Dent Sci 2018;5(9):443–451.
  34. Makati D, Shah NC, Brave D, et al. Evaluation of remaining dentin thickness and fracture resistance of conventional and conservative access and biomechanical preparation in molars using cone-beam computed tomography: An in vitro study. J Conserv Dent 2018;21(3):324–327. DOI: 10.4103/JCD.JCD_311_17.
  35. Jiang Q, Huang Y, Tu X, et al. Biomechanical Properties of First Maxillary Molars with Different Endodontic Cavities: A Finite Element Analysis. J Endod 2018;44(8):1283–1288. DOI: 10.1016/j.joen.2018.04.004.
  36. Zhang Y, Liu Y, She Y, et al. The effect of endodontic access cavities on fracture resistance of first maxillary molar using the extended finite element method. J Endod 2019;45(3):316–321. DOI: 10.1016/j.joen.2018.12.006.
  37. Wang Q, Liu Y, Wang Z, et al. Effect of access cavities and canal enlargement on biomechanics of endodontically treated teeth: A finite element analysis. J Endod 2020;46(10):1501–1507. DOI: 10.1016/j.joen.2020.06.013.
  38. Silva AA, Belladonna FG, Rover G, et al. Does ultraconservative access affect the efficacy of root canal treatment and the fracture resistance of two-rooted maxillary premolars? Int Endod J 2020;53(2):265–275. DOI: 10.1111/iej.13219.
  39. Saber SM, Hayaty DM, Nawar NN, et al. The effect of access cavity designs and sizes of root canal preparations on the biomechanical behavior of an endodontically treated mandibular first molar: A finite element analysis. J Endod 2020;46(11):1675–1681. DOI: 10.1016/j.joen.2020.06.040.
  40. Elkholy MMA, Nawar NN, Ha WN, et al. Impact of canal taper and access cavity design on the life span of an endodontically treated mandibular molar: A finite element analysis. J Endod 2021;47(9): 1472–1480. DOI: 10.1016/j.joen.2021.06.009.
  41. Nawar NN, Kataia M, Omar N, et al. Biomechanical behavior and life span of maxillary molar according to the access preparation and pericervical dentin preservation: Finite element analysis. J Endod 2022;48(7):902–908. DOI: 10.1016/j.joen.2022.03.013.
  42. Juloski J, Radovic I, Goracci C, et al. Ferrule effect: A literature review. J Endod 2012;38(1):11–19. DOI: 10.1016/j.joen.2011.09.024.
  43. Magne P, Lazari PC, Carvalho MA, et al. Ferrule-effect dominates over use of a fiber post when restoring endodontically treated incisors: An in vitro study. Oper Dent 2017;42(4):396–406. DOI: 10.2341/16-243-L.
  44. Soares PV, Santos-Filho PCF, Queiroz EC, et al. Fracture resistance and stress distribution in endodontically treated maxillary premolars restored with composite resin. J Prosthodont 2008;17(2):114–119. DOI: 10.1111/j.1532-849X.2007.00258. x.
  45. Bóveda C, Kishen A. Contracted endodontic cavities: The foundation for less invasive alternatives in the management of apical periodontitis. Endod Top 2015;33:169–186. DOI: 10.1111/ETP.12088.
  46. Clark D, Khademi J, Herbranson E. Fracture resistant endodontic and restorative preparations. Dent Today 2013;32(2):118, 120–123. PMID: 23431876.
  47. Nagendrababu V, Murray PE, Ordinola-Zapata R, et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: Explanation and elaboration. Int Endod J 2021;54(9):1491–1515. DOI: 10.1111/iej.13565.
  48. Silva EJNL, Attademo RS, da Silva MCD, et al. Does the type of endodontic access influence in the cyclic fatigue resistance of reciprocating instruments? Clin Oral Investig 2021;25(6):3691–3698. DOI: 10.1007/s00784-020-03694-7.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.