Truss Access Cavity Design: Limitations and Management: A Case Report

Abstract

Missed root canal is the major cause of failure in the endodontic treatment. Recently,
conservative access cavity designs are advocated to conserve tooth structure specially
pericervical dentin. Although several researchers have shown them to have better mechanical
and biological features, the technique has its own limitations. This case report discusses the
limitation in success of Truss Access Cavity Design and their management. Magnification and 3-
D imaging is effective in resolving the limitations and should be considered treatment of choice
when Truss cavity is used as an access cavity design.
This case report describes a clinical case of chronic irreversible pulpits in left mandibular first
molar undergoing root canal treatment with emphasis on a new conservative approach employed
in the access opening.
A 32-year-old male patient suffered severe sensitivity of the left lower first molar with attrition
involving enamel and dentin as well as pulp with the mesio-occlusal proximal restoration.
Endodontic treatment was performed with Truss Design a new conservative approach on access
opening of lower molar but there was a missed canal as analyzed on Dentascan later and re-
treated for locating the missed canal. Though Truss technique preserved most of the healthy