In the last decade, several access cavity designs involveing minimal removal of tooth tissue have been described for gaining entry to pulp chambers during root canal treatment. The premise behind this concept assumes that maximum preservation of as much of the pulp chamber roof as possible during access preparation would maintain the fracture resistance of teeth following root canal treatment. However, the smaller the access cavity, the more difficult it may be to visualize and debride the pulp chamber as well as locate, shape, clean and fill the canals. At the same time, a small access cavity may increase the risk of iatrogenic complications as a result of poor visibility, which may have an impact on treatment outcome. This study aimed to critically analyse the literature on minimal access cavity preparations, propose new nomenclature based on self-explanatory abbreviations and highlight the areas in which more research is required. The search was conducted without restrictions using specifics terms and descriptors in four databases. A complementary screening of the references within the selected studies, as well as a manual search in the highest impact journals in endodontics, namely International Endodontic Journal and Journal of Endodontics, was also performed. The initial search retrieved 1831 publications. The titles and abstracts of these papers were reviewed, and the full text of 94 studies was assessed. Finally, a total of 28 studies were identified as evaluating the influence of minimally invasive access cavity designs on the fracture resistance of teeth and on the different stages of root canal treatment (orifice location, canal shaping, canal cleaning, canal filling and retreatment). Overall, the studies had major methodological drawbacks and reported inadequate and/or inconclusive results on the utility of minimally invasive access preparations. Furthermore, they offered limited scientific evidence to support the use of minimally invasive access cavities to improve the outcome of root canal treatment and retreatment; they also provided little evidence that they preserved the fracture resistance of root filled teeth to a greater extent than traditional access cavity preparations. It was concluded that at present, there is a lack of supporting evidence for the introduction of minimally invasive access cavity preparation into routine clinical practice and/or training of undergraduate and postgraduate students.

中文翻译：

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最小通道腔准备的现状：一项关键分析和一项通用命名建议。

在过去的十年中，已经描述了几种涉及最小程度地去除牙齿组织的进入腔设计，以在牙根管治疗期间进入牙髓腔。该概念背后的前提是，假设在牙根入路准备期间最大程度地保留尽可能多的牙髓腔顶将维持牙根管治疗后牙齿的抗断裂性。然而，进入腔越小，可视化和清创浆腔以及定位，定型，清洁和填充根管的难度就越大。同时，由于视野不佳，进入腔较小可能会增加医源性并发症的风险，这可能对治疗结果产生影响。这项研究旨在批判性地分析有关最小通道腔准备的文献，根据自我解释的缩写提出新的术语，并强调需要更多研究的领域。使用四个数据库中的特定术语和描述符不受限制地进行了搜索。还对所选研究中的参考文献进行了补充筛选，并在影响最大的牙髓学期刊（即《国际牙髓期刊》和《牙髓学期刊》）中进行了手动搜索。最初的搜索检索了1831种出版物。审查了这些论文的标题和摘要，并评估了94篇研究的全文。最后，总共进行了28项研究，这些研究评估了微创进入腔设计对牙齿的抗断裂性以及根管治疗不同阶段（孔口位置，根管成形，渠的清洁，渠的填充和再处理）。总体而言，这些研究在方法学上存在重大缺陷，并报道了微创通路制剂的实用性不足和/或不确定的结果。此外，他们提供的科学证据有限，无法支持使用微创通路改善根管治疗和再治疗的效果。他们还提供了很少的证据表明，与传统的出牙腔准备相比，它们在更大程度上保留了根充牙齿的抗骨折能力。结论是，目前缺乏将微创入路腔准备引入常规临床实践和/或对大学生和研究生进行培训的支持证据。这项研究具有主要的方法学缺陷，并报道了微创通路制剂的实用性不足和/或不确定的结果。此外，他们提供的科学证据有限，无法支持使用微创通路改善根管治疗和再治疗的效果。他们还提供了很少的证据表明，与传统的出牙腔准备相比，它们在更大程度上保留了根充牙齿的抗骨折能力。结论是，目前缺乏将微创入路腔准备引入常规临床实践和/或对大学生和研究生进行培训的支持证据。这项研究具有主要的方法学缺陷，并报道了微创通路制剂的实用性不足和/或不确定的结果。此外，他们提供的科学证据有限，无法支持使用微创通路改善根管治疗和再治疗的效果。他们还提供了很少的证据表明，与传统的出牙腔准备相比，它们在更大程度上保留了根充牙齿的抗骨折能力。结论是，目前缺乏将微创入路腔准备引入常规临床实践和/或对大学生和研究生进行培训的支持证据。