Access cavity preparation

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Access cavity preparation

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Access cavity preparation

  1. 1. Endodontic Access Cavity PreparationPREPARED BY:DR. HAMED AL-HADDAD 1
  2. 2. Access Cavity Preparation MAJOR OBJECTIVESStraight-Line Access - 1Conservation of Tooth Structure - 2Unroofing of Chamber and Exposure of Pulp Horns - 3 2
  3. 3. Endodontic Preparation ofMaxillary and mandibular Anterior Teeth 3
  4. 4. Maxillary CentralIncisor All upper anterior teeth have one root and one canal. Central incisor are large and on an average of 23 mm. It has a single canal and a single apical foramen. The canal form is usually Type I. The pulp in young patients normally has 3 pulp horns. The pulp chambers is noticeably wider in thefaciolingual direction than in the mesiodistal. 4
  5. 5. Maxillary Lateral Incisor It is shorter than central incisor. Average length of 21- 22 mm. It has a single canal and a single apical foramen.The canal form is usually Type I.In young patients have two only pulp horn and iswider in labiopalatal dimension.The canal is tapered and the apex is often curved generally in distal direction. 5
  6. 6. Maxillary Canine It is the longest tooth (26.5 mm) Seldom has more than one canalThe pulp chamber is quite narrow M- D, and there is one pulp horn pointed to the incisal angle.The pulp space is much wider labiopalatally and the pulp space follows this outline.Oval Type I root canal.The root apex is often tapered and very thin.The canal is usually straight but may show a distal apical 6
  7. 7. Mandibular Central and LateralIncisors Average length is 21 mm, but the central incisor may be shorter than the lateral. The root canal morphology may be place into 1 or 3 configurations. Type I canal form is most prevalent, Types II and IIICENTRAL are less prevalent. The pulp chamber is smaller replica of the upper incisors. When the tooth has a single root canal it is normally straight but may curve to the distal.LATERAL 7
  8. 8. Mandibular Canine Smaller than the maxillary canine. The average length is 22.5 mm. Type I canal form is most prevalent.Rarely has 2 roots, but fewer of mandibular canine displaythe Type IV canal form with 2 separates apical formina. 8
  9. 9. Access cavity preparation 9
  10. 10. Endodontic Preparation of Maxillary Anterior Teeth 10
  11. 11. Endodontic Preparation of Maxillary Anterior Teeth Adult tooth 11
  12. 12. Cavity Access. CanineExtensive ovoid, funnel-shaped coronal preparation 12
  13. 13. Maxillary Anterior Teeth ERRORS in Cavity Preparation 13
  14. 14. Maxillary Anterior Teeth ERRORS in Cavity Preparation 14
  15. 15. Endodontic Preparation of Mandibular Anterior Teeth 15
  16. 16. Mandibular Anterior TeethERRORS in Cavity Preparation 16
  17. 17. Mandibular Anterior TeethERRORS in Cavity Preparation 17
  18. 18. 18
  19. 19. 19
  20. 20. Endodontic Preparation ofMaxillary and mandibular Premolar Teeth 20
  21. 21. Maxillary First Generally has 2 root with 2 Premolar canals, but in the case of 1 root has 2 canals which open in a common apical .foramen Many types of canal  .configurations .Average length 21.5 mm  The pulp chamber is wide B-P  .with 2 distinct pulp horn M-D, the pulp chamber  .is much narrower
  22. 22. Endodontic Preparation ofMaxillary First premolar Teeth Young tooth Adult tooth 22
  23. 23. Maxillary Second Premolar The typical second premolar has one root and one canal and sometimes.has an apical distal curvature The Type I canal form is prevalent with  a frequency of 48%, approximately the same.as types II and IV-VII combinedThe pulp chamber is wider B-P and narrower M- .D and has 2 well define pulp hornsThe canal orifice is directly in the centre of the .tooth.Average length: 21 mm 
  24. 24. Endodontic Preparation ofMaxillary Second premolar TeethYoung tooth Adult tooth 24
  25. 25. Endodontic Preparation of Maxillary Premolar Teeth 25
  26. 26. Maxillary Premolar Teeth ERRORS in Cavity Preparation 26
  27. 27. Maxillary Premolar Teeth ERRORS in Cavity Preparation 27
  28. 28. Mandibular Premolars delicate root Usually has a single with a mesial concavity, but occasionally present a division of .the root in the apical half.As a rule, both teeth have a single canal  The coronal pulp is wide B-L with a large .buccal horn and a small lingual hornThe shape of the canal is similar in first and second . premolarsIts buccolingual extension is broad until the  middle third of the canal, but is very narrow in.the apical third Average Length: 22mm
  29. 29. Cavity AccessBecause of the inclination of the crowns of •mandibular teeth and the smaller lingualcusp, the access opening should be. placed buccal to the central fissureThe preparation is made • oval , corresponding to the.shape of the root and canal
  30. 30. Endodontic Preparation ofMandibular premolar TeethYoung tooth Adult tooth 30
  31. 31. Endodontic Preparation of Mandibular Premolar Teeth 31
  32. 32. Mandibular Premolar Teeth ERRORS in Cavity Preparation 32
  33. 33. Mandibular Premolar Teeth ERRORS in Cavity Preparation 33
  34. 34. Endodontic Preparation ofMaxillary and mandibular Molar Teeth 34
  35. 35. Maxillary First MolarsGenerally three rooted with 3 canals. Additional . canal is located in the MB rootLarge pulp chamber, triangular in shape , with the base toward the buccal and the apex.toward the lingual surface.Slightly curved buccal roots .DP curvature of the MB root Apical-buccal curvature of the (palatal root (55%:Average Length MB: 20mmDB: 19.5mmP: 20.5mm
  36. 36. Maxillary First Molars.It has 3 or 4 pulp horn, the MB is the longest  The floor of the pulp chamber is normally just apical to .the cervix and is rounded and convex to the occlusal The MB canal opening is closer to the buccal .wall than is the DB orificeThe DB canal is closer to the middle of the tooth than to the distal wall, and isthe shorter and finest. of the 3 canals
  37. 37. Endodontic Preparation ofMaxillary First molar TeethYoung tooth Adult tooth 37
  38. 38. Maxillary Second Molar :It is similar of the first molar .Large pulp chamber  Mesiobuccal, distobuccal, and palatal  .roots, each with one canal .Gradual curvature of all three canals  .Flattened” triangular outline form“  The DB canal orifice is  nearer the centre of the .cavity floor
  39. 39. Endodontic Preparation ofMaxillary Second Molar Teeth Young tooth Adult tooth 39
  40. 40. Endodontic Preparation of Maxillary Molar Teeth 40
  41. 41. Locate canal orifices & obtain Straight-Line AccessProbing the Canal Entrances After the roof of the pulp chamber has been penetrated and the access cavity prepared, the entrances to the .pulp canals must be probed A hooked explorer can be used to determine if enough dentin has been removed ,The canal entrances are found by feeling with a thin stiff explorer. If the explorer sticks in a spot, a size 15 Hedstr6m file is used to verify that the spot is indeed the entrance to a root canal and not a perforation. Only then is the opening gently enlarged. Narrow root canals must first be enlarged coronally with a Hedstr6m file .before the deep preparation with Gates-Glidden burs can be started 
  42. 42. 42
  43. 43. Maxillary Molar Teeth ERRORS in Cavity Preparation 43
  44. 44. Maxillary Molar Teeth ERRORS in Cavity Preparation 44
  45. 45. Mandibular FirstMolar has 2 roots one mesial Usually.and one distalThe Distal root is smoller and .verticalDistal curvature of the mesial root (84% of the time) which has two.canalsThe distal canal is larger and more .ovalThe MB is the most difficult canal to instrument because its tortuous
  46. 46. Average Length: 21 mm The cavity is primarily within the mesial half of the tooth but is extensive enough to allow positioning of instruments and .filling materials Triangular outline form reflects the anatomy of the pulp chamber, with the base toward mesial and the apex toward the .distal surface
  47. 47. Mandibular Second MolarIt is smaller version of the first molar •.with an average length of 20mmThe mesial root has 2 canals and the •.distal oneThe mesial canals tend to fuse in the •apical third to give rise to one main.apical foramen
  48. 48. Endodontic Preparation of Mandibular Molar TeethYoung tooth Adult tooth 48
  49. 49. Endodontic Preparation of Mandibular Molar Teeth 49
  50. 50. Mandibular Molar Teeth ERRORS in Cavity Preparation 50
  51. 51. Mandibular Molar Teeth ERRORS in Cavity Preparation 51
  52. 52. Thank you 52

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