Copyright © 2026 Authors retain the copyright of this article. This article is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

@article{203275,
        author = {Dr. Akash lakshmanan and Dr. Sumita Bhagwat and Dr. LalitaGauri Mandke and Dr. Mansi Vandekar and Dr. Aishwarya Pawar and Dr. Mansi Patel},
        title = {Effect of Endodontic Access Cavity Designs on Fracture Resistance of Mandibular Molars: A Systematic Review},
        journal = {International Journal of Innovative Research in Technology},
        year = {2026},
        volume = {12},
        number = {12},
        pages = {10821-10831},
        issn = {2349-6002},
        url = {https://ijirt.org/article?manuscript=203275},
        abstract = {Background
The design of endodontic access cavities plays a pivotal role in determining the structural integrity and fracture resistance of endodontically treated teeth. With the growing emphasis on minimally invasive dentistry, newer access cavity designs have been introduced with the objective of preserving maximum tooth structure, particularly dentin, while still ensuring adequate canal debridement and disinfection.

Aim
The present systematic review aimed to evaluate the effect of different endodontic access cavity designs on the fracture resistance of mandibular molars.

Materials and Methods
A systematic review of both in vitro studies and finite element analysis models was conducted, focusing specifically on mandibular molars prepared using different access cavity designs, including traditional endodontic cavities, conservative endodontic cavities, truss access cavities, ninja access cavities, and ultraconservative designs. Fracture resistance was assessed using universal testing machines, while stress distribution patterns were analysed through finite element models.

Results
The findings across the included studies consistently demonstrated that preservation of coronal and pericervical dentin significantly enhances fracture resistance. Traditional access cavities, which involve extensive removal of tooth structure, exhibited comparatively lower fracture strength. In contrast, conservative and truss access cavity designs showed significantly improved fracture resistance, with truss access cavities demonstrating the highest resistance and superior fatigue performance. However, ninja and ultraconservative designs showed variable outcomes, suggesting that excessive restriction of access does not necessarily improve structural strength and may compromise clinical effectiveness. Finite element analysis further revealed that conservative designs distribute stresses in a manner more closely resembling intact teeth, whereas traditional designs tend to concentrate stresses, thereby increasing fracture susceptibility. Additionally, the use of restorative materials such as short fiber-reinforced composites was found to further enhance fracture resistance.

Conclusion
Preservation of dentin, particularly in the pericervical region, plays a critical role in improving the fracture resistance of mandibular molars. Conservative and truss access cavity designs offer a favourable balance between structural preservation and functional efficacy. However, further long-term clinical studies are required to validate these findings and establish definitive clinical guidelines.},
        keywords = {},
        month = {May},
        }