While traditional access techniques prioritize visibility and operability, the evolving paradigm of minimally invasive endodontics has introduced a new wave of conservative approaches that aim to preserve as much tooth structure as possible.
In the recent article "Endodontic access cavity preparation: challenges and recent advancements", Elmatary et al. (2025) provide a comprehensive review of the current techniques, clinical challenges, and technological innovations that are reshaping the way access cavities are planned and executed.
The authors critically examine various access designs — including traditional, conservative, truss, and ninja accesses — and evaluate their benefits and limitations in terms of mechanical efficacy, canal disinfection, fracture resistance, and long-term prognosis.
One of the key highlights of this article is the exploration of how digital advancements, such as cone-beam computed tomography (CBCT), magnification, and guided endodontics, are enabling clinicians to navigate complex anatomies with greater precision and reduced iatrogenic risks.
However, the authors caution that overly conservative access may compromise disinfection and complicate canal location, particularly in anatomically challenging cases or when used without sufficient operator expertise.
Ultimately, this publication emphasizes the importance of case-by-case decision-making, where access cavity design should be tailored to the tooth's anatomy, available technology, and the clinician's skillset.
The integration of advanced tools must be guided by sound clinical judgment to ensure optimal treatment outcomes
We invite all dental professionals and endodontists worldwide to read the Full article in PDF via the British Dental Journal.
