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Endodontic Access
 Cavity Preparation



PREPARED BY:
DR. HAMED AL-HADDAD

                      1
Access Cavity Preparation
     MAJOR OBJECTIVES
Straight-Line Access - 1

Conservation of Tooth Structure - 2


Unroofing of Chamber and Exposure of Pulp Horns - 3




                                                2
Endodontic Preparation of
Maxillary and mandibular
     Anterior Teeth




                            3
Maxillary Central
Incisor
                               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 the
faciolingual direction than in the mesiodistal.          4
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 is
wider
 in labiopalatal dimension.

The canal is tapered and the apex is often
 curved generally in distal direction.                   5
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
Mandibular Central and Lateral
Incisors
            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 III
CENTRAL       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
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 display
the Type IV canal form with 2 separates apical formina.



                                                       8
Access cavity preparation




                            9
Endodontic Preparation of
 Maxillary Anterior Teeth




                            10
Endodontic Preparation of
 Maxillary Anterior Teeth
                   Adult tooth




                           11
Cavity Access. Canine
Extensive ovoid, funnel-shaped coronal preparation
                                              12
Maxillary Anterior Teeth
  ERRORS in Cavity
      Preparation




                           13
Maxillary Anterior Teeth
  ERRORS in Cavity
      Preparation




                           14
Endodontic Preparation of Mandibular
           Anterior Teeth




                                   15
Mandibular Anterior Teeth
ERRORS in Cavity Preparation




                               16
Mandibular Anterior Teeth
ERRORS in Cavity Preparation




                               17
18
19
Endodontic Preparation of
Maxillary and mandibular
    Premolar Teeth




                            20
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
Endodontic Preparation of
Maxillary First premolar Teeth
 Young tooth             Adult tooth




                                 22
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 combined

The pulp chamber is wider B-P and narrower M-        
.D and has 2 well define pulp horns



The canal orifice is directly in the centre of the   
.tooth
.Average length: 21 mm 
Endodontic Preparation of
Maxillary Second premolar
           Teeth
Young tooth           Adult tooth




                             24
Endodontic Preparation of Maxillary
         Premolar Teeth




                                      25
Maxillary Premolar Teeth
  ERRORS in Cavity
       Preparation




                           26
Maxillary Premolar Teeth
  ERRORS in Cavity
       Preparation




                           27
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 horn
The shape of the canal is similar in first and second 
. premolars
Its buccolingual extension is broad until the 
    middle third of the canal, but is very narrow in
.the apical third             Average Length: 22mm
Cavity Access
Because of the inclination of the crowns of •
mandibular teeth and the smaller lingual
cusp, the access opening should be
. placed buccal to the central fissure

The preparation is made •
 oval , corresponding to the
.shape of the root and canal
Endodontic Preparation of
Mandibular premolar Teeth
Young tooth          Adult tooth




                            30
Endodontic Preparation of Mandibular
          Premolar Teeth




                                   31
Mandibular Premolar Teeth
   ERRORS in Cavity
      Preparation




                            32
Mandibular Premolar Teeth
   ERRORS in Cavity
      Preparation




                            33
Endodontic Preparation of
Maxillary and mandibular
       Molar Teeth




                            34
Maxillary First Molars
Generally three rooted with 3 canals. Additional   
. canal is located in the MB root
Large 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: 20mm
DB: 19.5mm
P: 20.5mm
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 orifice

The DB canal is closer to 
the middle of the tooth than
 to the distal wall, and is
the shorter and finest
. of the 3 canals
Endodontic Preparation of
Maxillary First molar Teeth
Young tooth            Adult tooth




                              37
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
Endodontic Preparation of
Maxillary Second Molar Teeth
 Young tooth           Adult tooth




                               39
Endodontic Preparation of Maxillary Molar
                 Teeth




                                      40
Locate canal orifices & obtain
 Straight-Line Access
Probing 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
Maxillary Molar Teeth
 ERRORS in Cavity
     Preparation




                        43
Maxillary Molar Teeth
 ERRORS in Cavity
     Preparation




                        44
Mandibular First
Molar has 2 roots one mesial 
Usually
.and one distal
The Distal root is smoller and 
.vertical
Distal curvature of the mesial root 
(84% of the time) which has two
.canals
The distal canal is larger and more 
.oval
The MB is the most difficult canal 
to instrument because its tortuous
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
Mandibular Second Molar
It is smaller version of the first molar   •
.with an average length of 20mm


The mesial root has 2 canals and the       •
.distal one


The mesial canals tend to fuse in the      •
apical third to give rise to one main
.apical foramen
Endodontic Preparation of
 Mandibular Molar Teeth
Young tooth           Adult tooth




                             48
Endodontic Preparation of Mandibular
            Molar Teeth




                                   49
Mandibular Molar Teeth
  ERRORS in Cavity
     Preparation




                         50
Mandibular Molar Teeth
  ERRORS in Cavity
     Preparation




                         51
Thank you

            52

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Access cavity preparation

  • 1. Endodontic Access Cavity Preparation PREPARED BY: DR. HAMED AL-HADDAD 1
  • 2. Access Cavity Preparation MAJOR OBJECTIVES Straight-Line Access - 1 Conservation of Tooth Structure - 2 Unroofing of Chamber and Exposure of Pulp Horns - 3 2
  • 3. Endodontic Preparation of Maxillary and mandibular Anterior Teeth 3
  • 4. Maxillary Central Incisor 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 the faciolingual direction than in the mesiodistal. 4
  • 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 is wider in labiopalatal dimension. The canal is tapered and the apex is often curved generally in distal direction. 5
  • 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. Mandibular Central and Lateral Incisors 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 III CENTRAL 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. 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 display the Type IV canal form with 2 separates apical formina. 8
  • 10. Endodontic Preparation of Maxillary Anterior Teeth 10
  • 11. Endodontic Preparation of Maxillary Anterior Teeth Adult tooth 11
  • 12. Cavity Access. Canine Extensive ovoid, funnel-shaped coronal preparation 12
  • 13. Maxillary Anterior Teeth ERRORS in Cavity Preparation 13
  • 14. Maxillary Anterior Teeth ERRORS in Cavity Preparation 14
  • 15. Endodontic Preparation of Mandibular Anterior Teeth 15
  • 16. Mandibular Anterior Teeth ERRORS in Cavity Preparation 16
  • 17. Mandibular Anterior Teeth ERRORS in Cavity Preparation 17
  • 18. 18
  • 19. 19
  • 20. Endodontic Preparation of Maxillary and mandibular Premolar Teeth 20
  • 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. Endodontic Preparation of Maxillary First premolar Teeth Young tooth Adult tooth 22
  • 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 combined The pulp chamber is wider B-P and narrower M-  .D and has 2 well define pulp horns The canal orifice is directly in the centre of the  .tooth .Average length: 21 mm 
  • 24. Endodontic Preparation of Maxillary Second premolar Teeth Young tooth Adult tooth 24
  • 25. Endodontic Preparation of Maxillary Premolar Teeth 25
  • 26. Maxillary Premolar Teeth ERRORS in Cavity Preparation 26
  • 27. Maxillary Premolar Teeth ERRORS in Cavity Preparation 27
  • 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 horn The shape of the canal is similar in first and second  . premolars Its buccolingual extension is broad until the  middle third of the canal, but is very narrow in .the apical third Average Length: 22mm
  • 29. Cavity Access Because of the inclination of the crowns of • mandibular teeth and the smaller lingual cusp, the access opening should be . placed buccal to the central fissure The preparation is made • oval , corresponding to the .shape of the root and canal
  • 30. Endodontic Preparation of Mandibular premolar Teeth Young tooth Adult tooth 30
  • 31. Endodontic Preparation of Mandibular Premolar Teeth 31
  • 32. Mandibular Premolar Teeth ERRORS in Cavity Preparation 32
  • 33. Mandibular Premolar Teeth ERRORS in Cavity Preparation 33
  • 34. Endodontic Preparation of Maxillary and mandibular Molar Teeth 34
  • 35. Maxillary First Molars Generally three rooted with 3 canals. Additional  . canal is located in the MB root Large 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: 20mm DB: 19.5mm P: 20.5mm
  • 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 orifice The DB canal is closer to  the middle of the tooth than to the distal wall, and is the shorter and finest . of the 3 canals
  • 37. Endodontic Preparation of Maxillary First molar Teeth Young tooth Adult tooth 37
  • 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. Endodontic Preparation of Maxillary Second Molar Teeth Young tooth Adult tooth 39
  • 40. Endodontic Preparation of Maxillary Molar Teeth 40
  • 41. Locate canal orifices & obtain Straight-Line Access Probing 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
  • 43. Maxillary Molar Teeth ERRORS in Cavity Preparation 43
  • 44. Maxillary Molar Teeth ERRORS in Cavity Preparation 44
  • 45. Mandibular First Molar has 2 roots one mesial  Usually .and one distal The Distal root is smoller and  .vertical Distal curvature of the mesial root  (84% of the time) which has two .canals The distal canal is larger and more  .oval The MB is the most difficult canal  to instrument because its tortuous
  • 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. Mandibular Second Molar It is smaller version of the first molar • .with an average length of 20mm The mesial root has 2 canals and the • .distal one The mesial canals tend to fuse in the • apical third to give rise to one main .apical foramen
  • 48. Endodontic Preparation of Mandibular Molar Teeth Young tooth Adult tooth 48
  • 49. Endodontic Preparation of Mandibular Molar Teeth 49
  • 50. Mandibular Molar Teeth ERRORS in Cavity Preparation 50
  • 51. Mandibular Molar Teeth ERRORS in Cavity Preparation 51
  • 52. Thank you 52