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1. Anatomy of pulp
canal and its access
opening
DEPARMENT OF
CONSERVATIVE AND
ENDODONTICS
Prepared by:
Pratibha sharma
final-yr

2. IMPORTANT TERMS
Pulp chamber
(coronal
portion )
Root canal
(radicular
portion )
Pulp
cavity

3. Coronal pulp
Radicular pulp
Pulp horn
Pulpchamber
Orifice
Lateralcanal
Root canal
Apical foramen
Pulp spacemorphology

5. Accessory
canals
Lateral canals
Accessory
foramina
Apical
foramina
Root canal
(radicular
portion )

6. Coronal pulp
Radicular pulp
Pulp horn
Pulpchamber
Orifice
Lateralcanal
Root canal
Apical foramen
Pulp spacemorphology

7. CLASSIFICATIONOFCANALMORPHOLOGY
VERTUCCI’S CLASSIFICATION

8. CLASSIFICATIONOFCANALMORPHOLOGY
Weine's Classification of Root Canal

9. CLASSIFICATIONOFCANALMORPHOLOGY
•Based on canal cross section
 Round
 Oval
 Long oval
 Flattened
 Irregular

12. Space between major and minor apical
diameter –funnel shaped ,hyperbolic or
having the shape of a MORNING GLORY

13. ACCESS
CAVITY
PREPARATION

15. Access cavity is defined as endodontic coronal
preparation which is the first and most important
phase of non-surgical root canal treatment that is
essential for a good endodontic result.

16. OBJECTIVES
remove all caries whenpresent.
conserve sound tooth structure.
unroof the pulp chamber completely .
remove all coronal pulp tissue
locate all root canal orifices .
achieve straight- or direct-lineaccess
to the apical foramen

17. Clinical guidelines for access cavity prepartion
• Preoperative considerations
Armamentarium for access cavity preparation
-Front surface miror
-Airotar and slow speed rotary handpieces
-Burs
Round carbide burs no.2,4,6
Diamond burs
Fissure carbide burs and carbide burs
Round diamond burs
Long shank burs
-Endodontic spoon escavator
-Endodontic explorer eg. DG-16
-Additional aids –
Magnification and illumination aids
Ultrasonic tips
Microopeners and microdebriders

18. Instruments
Low speed contra High speed contra

19. Roundbur size2,3,4
Safe-endtapered stone
DG16 endodonticexplorer
Taperedstone with
round end
EndoZburTransmetalbur

20. Endo accessbur
Pulpoutbur
Ultrasonics

21. Surgical operatingmicroscope
Loupes

22. • Assessment Of Occlusal Tooth Anatomy
Indicative Of Unusual Canal Anatomy :
-Presence Of An Additional Cusp
-Abnormality In Size And Shape Of The Tooth
Major Principle Of The Endodontic Cavity Outline Form.It Depends Upon
The Size And Shape Of The Pulp And Chamber.
Complicating Factors
Rotated Teeth /Malpositioned Teeth
Tipping/Mesial Tilting Of The Tooth
Grossly Decayed Teeth
Teeth With Full Coverage Restoration
Abutment Teeth Of Fixed Prosthesis
Teeth With Extensive Calcifications

23. 1.Size of Pulp Chamber

24. 2.Shape of Pulp Chamber

25. Radiographic assessment
The most Important Prerequisite For Successful Accesscavity
Preparation Is Having A Sound Knowledge Of The Root Canal
Anatomy And Its Variations.
Pre-operative Peri-apical Radiographs Can Be Done To Visualise
The Internal Anatomy Of Tooth

26. BASIC STEPS OF ACCESS
OPENING

27. COMPLETE REMOVAL OF CARIOUS
TOOTH STRUCTURE AND OTHER
RESTORATIVE MATERIAL

28. COMPLETE DE-ROOFING AND
REMOVAL OF DENTINAL
SHOULDERS

29. EVALUATION OF CEJ AND ROOT
CANAL ORIFICE

30. SIGNIFICANCE OF STRAIGHT LINE
ACCESS

31. 1-Law of centrality: The floor of the pulp
chamber is always located in the center of the
tooth at the level
of the CEJ.
2-Location of CEJ: The distance from the external surface of the
clinical crown to the wall of the pulp chamber is the same
throughout the circumference of the tooth at the level of the CEJ,
making the CEJ is the most consistent repeatable landmark for
locating the position of the pulp chamber.
Laws of the pulp chamberanatomy

32. 3-First law of symmetry: Except
for the maxillary molars, canal
orifices are equidistant from a
line drawn in a mesiodistal
direction through the center of the
pulp chamber floor.
M
D
4-Second law of symmetry: Except
for the maxillary molars, canal
orifices lie on a line perpendicular to
a line drawn in a mesiodistal
direction across the center of the
pulp chamber floor.

33. 5-Law of color change:
The pulp chamber floor is always darker in color than the walls.

34. 6-First law of orifice location: The
orifices of the root canals are always
located at the junction of the walls and
the floor.
7-second law of orifice location :
The orifices of the root canals are
always located at angles in floor wall
junction

35. 8-Third law of orifice location: The orifices of the root
canals are always located at the terminus of the roots’
developmental fusion lines.

36. Access cavity preparation in anteriorteeth
Outline form of central and lateral incisors are triangular with the base of
the triangle towards the incisal edge and the apextowards the cingulum.
Incisaledge
Cervicalline

37. MAXILLARY CENTRAL INCISOR
• Average tooth length-22.8mm
• Pulp chamber – located in the centre of the crown
Equidistant from dentinal walls
• Root and root canals – one root and one root canal
• Clinical significance –roots are straight (70%)
curve labially or palatally (17%)
• Entrance is gained through
the middle of the middle third of the
palatal surface.

38. Initial entrance Is prepared with a
round bur at a high speed
operated at a right angle to the
long axis of the tooth.
Only enamel is penetrated.

39. The bur is positioned in a 45
degree to the long axis of the
tooth then to penetrate the pulp
chamber.

40. Removal of the pulp chamber
(de-roofing)

41. Removal of lingual shoulder.

42. MAXILLARY LATERAL INCISOR
Average tooth length -
22.5
Pulp chamber –similar to
maxillary central incisor but
smaller
Two pulp horns
Root and root canal-
conical in shape but finer in
diameter than central
incisor
Access opening-similar to
central incisor but its
smaller and usually more
ovoid

43. In canine the outline isoval
Average tooth length -26mm (longest
human teeth )
Pulp chamber –largest of any single
rooted teeth
Labio-palatally –chamber is traingular
with apex towards the single cusp and a
broad base in there cervical third of crown
Cross section –ovoid
One pulp horn
Root and root canal –single root canal
Access opening –its all same as maxillary
central and lateral
In place of circular --------its ovoid

44. Premolars
Upperoval Lowerovoid

45. MAXILLARYPREMOLARS
Buccal canal is located under
the buccal cusptip.
Palatal canal is located at the
baseof the palatal cusp.
First pre-molar
Average tooth length -21.5mm
Pulp chamber –narrow mesiodistally
Has pulp horn beneath each cusp
Buccal pulp horn is more prominent then the
palatal in young teeth .
Root and root canals –two roots (54.6%)
21.9% of double rooted cases –roots are separated
whereas in 32.7% roots are partially fused

46. Initial penetration is made parallel to the long axis of the tooth in
the exact center of the central groove
ACCESS OPENING

47. A round bur is used to open into the pulp chamber. The bur will be
felt to “drop” when the pulp chamber is reached.
2

48. An endodontic explorer is used to locateorifices.

49. Around bur is used to deroof the pulp
chamber.

50. Finishing and flaring of the cavity walls.

51. Upper Lower

52. MAXILLARY SECOND PREMOLAR
• Average Length -21.6 mm
• Pulp chamber –similar to second
premolar like first pre-molar ,has a narrow
chamber mesio-distally.and pulp floor is
deeper if two canals are present.
• Roots and root canals –single root-
90.3%
• 2%- well defined roots
• 7.7%-have two roots fused partially
• Access opening-similar to first
premolar

53. MAXILLARY FIRST MOLAR
• Average tooth length-21.3%
• Pulp chamber –largest in the dental arch with 4
pulp horns
• Pupal roof-rhomboid appearance
• Pulp chamber-triangular form in cross section
• roots and root canals -3 roots with 3 root canals
• MB-divides to form MB2 canal
• Access opening

54. Molars
Upper Lower
B
B
P
L
Trapezoid
M MD D

55. MAXILLARY SECOND MOLAR
• Average tooth length-21.7mm
• Pulp chamber –similar to first molar except it is
narrower mesiodistally.
• Roots and root canals -3 roots which are closely
grouped
• Buccal roots may fuse and ocassionally all three
roots fuse to form single conical root .
• Access opening –same as maxillary first molar

56. MB1
MB2
Palatal
DB
UPPER
Pointof
entry
• MB1 islocatedunderthe buccalcusptip.
• MB2 islocatedmesialandpalatal to MB1 (at the endof a commatail).
• DBislocatedunderthe centralfossa.
• Palatal islocatedat the junctionof mesiopalatal cuspand obliqueridge.
• Pointof entry isthe centerof the occlusaltable.

57. MB
ML
Distal
Point ofentry LOWER
• MB islocatedunderthe mesiobuccalcusptip.
• MLislocatedat the sameline lingual to the centralfissure.
• Distalislocateddistal to the centralfossa.
• Pointof entry isthe central fossa.

58. Mandibular molar

59. MANDIBULAR CENTRAL INCISOR
Average Length 21.5
One canal 70%
Two canals 23%
Straight 60%
Distal Curve 23%
Outline form : triangular in young and ovoid in adult

60. MANDIBULAR LATERAL INCISORS
Average Length 22.5
One canal 57%
Two canals one foramen 14.7%
Two canals two foramina 29.5%
Straight 60%
Distal Curve 23%
Outline form : triangular in young and ovoid in adult

61. MANDIBULAR CANINE
Average Length 25.2mm
One canal 94%
Two canals 6%
Straight 68%
Distal Curve 20%

62. ACCESSCAVITY PREPARATION OF
MANDIBULARPREMOLARS
Because of the lingual tilt of
the mandibular premolars
The access cavity should
have extended on to the
buccal cusp inclines ,in
order to gain straight line
access

63. Mandibular First Premolar
Average Length 22.1mm
One canal 73%
Two canals 19%
Three canals 0.5%
Straight 48%
Distal Curve 35%
Outline form ovoid

64. Mandibular SecondPremolar
.4mmAverage Length 21
One canal 85%
Two canals 11%
Three canals 0.5%
Outline form -
ovoid

65. Axioms of pulpanatomy
1- Thetwo orifices of the maxillaryfirst
premolars are further to thebuccal.
2- Theorifices of the mesio-buccal canalsin
molars are well up under the mesio-buccalcusps
and the outline form should be widely extended
into the cusp.

66. 3- Theorifices of the palatal canal inmaxillary
molars is not too far to the lingual, but is
actually in the center of the mesial half of the
tooth
4- Theorifices of the disto-buccal canal in
maxillary molars is not too far to the disto
buccal, but it is almost buccal to the palatal
orifice.

67. 5- Theorifice of the distal canal in
mandibular molars is not too far to the
distal, but is actually in theexact center of
the tooth
6- Theorifice of the mesio-lingual canalin
mandibular molars is not too far to the
mesio-lingual, but is almost mesial to the
distal orifice.

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