Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs

Gianluca Plotino, Nicola Maria Grande, Almira Isufi, Pietro Ioppolo, Eugenio Pedullà, Rossella Bedini, Gianluca Gambarini, Luca Testarelli

Research output: Contribution to journalArticlepeer-review


Introduction The purpose of this study was to compare in vitro the fracture strength of root-filled and restored teeth with traditional endodontic cavity (TEC), conservative endodontic cavity (CEC), or ultraconservative “ninja” endodontic cavity (NEC) access. Methods Extracted human intact maxillary and mandibular premolars and molars were selected and assigned to control (intact teeth), TEC, CEC, or NEC groups (n = 10/group/type). Teeth in the TEC group were prepared following the principles of traditional endodontic cavities. Minimal CECs and NECs were plotted on cone-beam computed tomographic images. Then, teeth were endodontically treated and restored. The 160 specimens were then loaded to fracture in a mechanical material testing machine (LR30 K; Lloyd Instruments Ltd, Fareham, UK). The maximum load at fracture and fracture pattern (restorable or unrestorable) were recorded. Fracture loads were compared statistically, and the data were examined with analysis of variance and the Student-Newman-Keuls test for multiple comparisons. Results The mean load at fracture for TEC was significantly lower than the one for the CEC, NEC, and control groups for all types of teeth (P <.05), whereas no difference was observed among CEC, NEC, and intact teeth (P >.05). Unrestorable fractures were significantly more frequent in the TEC, CEC, and NEC groups than in the control group in each tooth type (P <.05). Conclusions Teeth with TEC access showed lower fracture strength than the ones prepared with CEC or NEC. Ultraconservative “ninja” endodontic cavity access did not increase the fracture strength of teeth compared with the ones prepared with CEC. Intact teeth showed more restorable fractures than all the prepared ones.

Original languageEnglish
Pages (from-to)995-1000
Number of pages6
JournalJournal of Endodontics
Issue number6
Publication statusPublished - Jun 1 2017


  • Conservative access cavity
  • endodontic access cavity
  • fracture resistance
  • traditional endodontic cavity
  • “ninja” cavity

ASJC Scopus subject areas

  • Dentistry(all)


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