definition
clinical pictures
how to check access cavity
access cavity through a crown
access cavity in a crooked tooth
modification in access cavity
problems in access cavity
pulp stones
calcified canals
primary teeth access cavity
magnification in access cavity
bleeding during access cavity
perforation in access cavity
correction in access cavity
caries and access cavity
restoration and access cavity
bleeding points
pulpal triangle
3. AIM OF ACCESS CAVITY
TO CREATE A STRAIGHT LINE PATH TO
THE CANAL ORIFICES AND THUS THE
APEX
4. ADVANTAGES
Ease of removal all the pulp or necrotic
tissue (asepsis + discoloration)
Facilitation in canal location (vision,
hemorrhagic points, canal location)
Facilitation in irrigation and shaping
Successful root canal is important than a
conservative approach
5. PROCEDURE
A good preop radiograph is extremely
imp ( orientation + depth)
Remove all the carious lesion first
A round or tapering fissure carbide bur
Round diamond bur is used to cut
through the Porcelain crown or carbide
bur through metal crown
In sclerosed chamber, calculate the
depth of the chamber
7. PROCEDURE
PENETRATION PHASE: Feel the dip
with a round tungsten carbide bur in high
speed hand piece
ENLARGEMENT PHASE: Round bur in
slow hand piece is used next with a
pulling out action
FINISHING AND FLARING PHASE:
tapering fissure bur may be used in
lateral cut / Endo Z burr has non cutting
8. PROCEDURE
Check with probe,
the complete
deroofing
Coronal pulp is
removed using a
long shank excavator
or a round burr in a
slow hand piece
9.
10. WHAT IS THE IDEAL
SHAPE?
Completely deroofed
pulp chamber and
having divergent
walls
U will be able to
appreciate the
dentinal map on the
floor joining the
orifices
11. MAXILLARY ANTERIOR
Rarely two canals / roots
Ovoid or round triangular in shape on the
lingual surface
It is placed slightly above the cingulum in
the centre
A buccal approach if grossly carious tooth
A straight approach in case of horizontal
fracture
Max canine has more ovoidal shape
17. MAXILLARY PREMOLARS
4 has two canals and 5 may have one or
two
preparation is ovoid (bucco lingually) and
directed through the middle of the
occlusal surface
Cervical circumference is 2/3 rd the
coronal circumference
Mesial concavity in max first premolar be
kept in mind
18.
19. MAXILLARY MOLARS
Three roots and three canals
Usually a triangular cavity on the occlusal
surface
Bur is placed in the centre directed
towards the palatal canal
Mesio buccal, disto buccal and palatal
canals.
Presence of fourth canal (MB 2) may
require a trapezoidal shape. Usually under
a ridge / shelf.
20.
21. MANDIBULAR ANTERIOR
Usually a single root and
canal. An oval cavity or
an hour glass shape
cavity.
Mesio distal width is very
less
More than 40% have two
roots
Burr is placed in the
centre just above the
cingulum
Buccal approach in
crowding or tooth loss
Incisal approach in
fracture
24. MANDIBULAR
PREMOLARS
Rarely two canals are
present
Round or oval cavity
Lingual inclination of the
occlusal table
Burr not be
perpendicular to the
table
If there is abrupt loss of
translucency than there
is a bifurcation
26. MANDIBULAR MOLARS
Two roots and three canals. Mesio
buccal, mesio lingual and distal.
Triangular cavity on the occlusal surface
Burr is kept slightly to the mesial of the
centre and directed towards the biggest
canal
Trapezoidal cavity if there are two distal
canals
30. INCOMPLETE DEROOFING
Inability to locate the canals
Coronal pulp or necrotic tissue left behind
Improper irrigation
Improper cleaning and shaping
31. PERFORATION
Supra gingival Crown Perforation : if
supra gingival restore it first.
Sub gingival Crown Perforation :
gingivectomy to avoid impinging on the
biological width
If perforation in the bifurcation area – GIC
or Floor raising with amalgam ( MTA may
be used)