Access Cavity Preparation

By : Omid Dianat
DDS, MS. Assistant Professor,
Shahid Beheshti Dental School
Endodontic Treatment
Access Preparation
Working Length
Canal Preparation
Obturation
Access Cavity
(1) Attainment of straight-line access,
(2) Conservation of tooth structure,
(3) Unroofing of the chamber to expose
orifices and to remove pulp horns in
anterior teeth.




Straight-Line Access

Improved Instrument
Control.
Improved Obturation.
Decreased Procedural
Errors.
Ledge Formation.
Apical Perforation.
Furcal (Stripping) Perforation.
Tooth Structure
Removal.
reduction of the dentin shelf


Conservation of Tooth Structure

Minimal Weakening
of Tooth.
Prevention of
Accidents.

Unroofing of Chamber and
Exposure
of Pulp Horns

Maximal Visibility.
Location of Canals.
I mprove Straight-
Line Access.
Exposure of Pulp
Horns.

ACCESS TECHNIQUES

ACCESS IN SPECIAL
SITUATIONS

Caries
Existing Permanent
Restoration
porcelain
Existing Temporary
Restoration
Difficult-to-Locate
Canals
Delay Isolation
Exploratory Radiographs

Caries
Calcified Canals
Access cavity preparation through a ceramometal crown.
A, Diamond-impregnated, round instrument. B, After access outline is made
with the round diamond, an end-cutting or round-carbide bur cuts through the
metal. C, Access cavity prepared, allowing direct approach to the canals. D,
Test files placed without impingement on the access cavity walls.

Maxillary Central Incisor
100% 1 canal
Maxillary Lateral Incisor
100% 1 canal
Maxillary Canine
100% 1 canal
Endodontic Preparation of
Maxillary Anterior Teeth

A-perforation
B-gouging
C-gouging
D-pear shaped prep.
E-discoloration
F-ledge
G-perforation
H-ledge


5%
15%
Central
lateral
Central 25%
Lateral 30%
70%
10%
20%
Endodontic Preparation of
Mandibular Anterior Teeth

gouging
Errors in ant. Mandibular Teeth
D-Failure to explore
E-discoloration F-ledge
Maxillary first premolar
57%
16%
12%
10%
Maxillary Second Premolar
Pulp Anatomy and Coronal Preparation

53%
22%
13%
11%
Endodontic Preparation of Maxillary
Premolar Teeth

Maxillary Premolar Teeth
ERRORS in Cavity Preparation






Mandibular First Premolar
Pulp Anatomy and Coronal Preparation

70%
4%
25%
Mandibular second premolar
85%
12%
3%
Endodontic Preparation of Mandibular Premolar Teeth
Pulp Anatomy and Coronal Preparation

Errors in Mandibular
Maxillary first molar
2 canal 60%
1 foramen
80%
2
Foramen
20%
Maxillary second Molar
38%
10%
Endodontic Preparation of Maxillary Molar
Teeth

Errors






















Mandibular first Molar
60%
40%
70%
20%
10%
Mandibular second Molar
92%
5%
3%
40%
35%
25%
Endodontic Preparation of Mandibular Molar Teeth

Errors



Mandibular Third Molar


C Shape Canals
Rotary systems(access modification)
Maxillary molars
mesiobuccal canals
Mandibular molars
mesiolingual canals
Any Question??
Thank you for attention!