ACCESS CAVITY PREPARATION IN ANTERIOR TEETH

Submitted By: SONAL CHAUDHARY Batch 2007-08

INTRODUCTION  COMPONENTS OF THE ROOT CANAL SYSTEM  OBJECTIVES AND GUIDELINES FOR ACCESS CAVITY PREPARATION  ARMAMENTARIA  PRINCIPLES OF ENDODONTIC CAVITY PREPARATION  ACCESS CAVITY PREPARATION  MORPHOLOGY & ACCESS CAVITY PREPARATIONS FOR INDIVIDUAL TEETH  ERRORS IN ACCESS CAVITY PREPARATION  REFERENCES .

and adequate access to and exploration of the tooth's interior are prerequisites for treatment Components of the Root Canal System  The entire space in the dentin where the pulp is housed is called the “ ROOT CANAL SYSYTEM”.  ROOT CANAL SYSTEM is divided into 2 portions:  PULP CHAMBER – located in the Anatomic Crown of the tooth. Introduction  The hard tissue encompassing the dental pulp can take a variety of configurations and shapes. A thorough knowledge of tooth morphology. .  PULP/ROOT CANAL (S) – located in the Anatomic Root. careful interpretation of angled radiographs.

Law of Color change: The color of the pulp chamber floor is always darker than the walls.OBJECTIVES To Remove All Caries To Conserve Sound Tooth Structure To Completely Unroof The Pulp Chamber To Remove All Coronal Pulp Tissue (Vital Or Necrotic) To Locate All Root Canal Orifices GUIDELINES Visualization of the Likely Internal Anatomy : Diagnostic radiographs. cervical. . Evaluating angled periapical radiographs. and root levels. . Examination of tooth anatomy at the coronal.

 First Law of orifice location : The orifices of the root canals are always located at the junction of the walls and the floor.Preparation Of The Access Cavity Through The Lingual & Occlusal Surfaces : Access cavities of anterior teeth are usually prepared through the lingual tooth surface. . and those on the posterior teeth are prepared through the occlusal surface. 2.

or #10). all canal orifices & the coronal portion of the canals are flared to make instrument placement easier.Removal Of All Defective Restorations And Caries Before Entry Into The Pulp Chamber 4. negotiating constricted.#8.g. And Exploration Of All Root Canal Orifices: A sharp endodontic explorer is used to locate canal orifices .Location. RC-Prep) may be used on instruments & introduced in the Canal. DE-17)  Endodontic Spoon . 6. The canals are then explored with small.3. pre-Curved K-files (#6. A lubricating agent (e. ARMAMENTARIA  Magnification & Illumination  Handpieces  Burs  Endodontic explorer (DG-16.Removal Of Unsupported Tooth Structure 5. Using Magnification And Adequate Illumination: For determining the location of canals. & debriding and removing tissue & calcifications from the pulp chamber. Next. Flaring..Inspection Of The Pulp Chamber. curved & calcified canals.

V. #17 Operative Explorer  Ultrasonic Unit & tips Principles of Endodontic Cavity Preparation  According to Ingle.  IV. Removal of the remaining carious dentin and defective restorations. Toilet of the cavity  V. Convenience Form  III. Outline Form  II. Retention form. VI. Outline form and Convenience form  IV. Endodontics follows the basic principles by G. Resistance form . Toilet of the cavity Endodontic Radicular Cavity Preparation:  I and II. Black with slight modifications to explain principles of endodontic cavity preparation: Endodontic Coronal Cavity Preparation :  I.

Access Cavity Preparation       Removal of caries & permanent restorations Initial external outline form Penetration of the pulp chamber roof Complete roof removal Identification of all canal orifices Removal of the lingual shoulder & orifice & coronal flaring  Straight line access determination  Visual inspection of the access cavity  Refinement & smoothing of restorative margins .

.0mm  Always has one Root & Type I canal configuration. some curve distally (8%).ACCESS PREPARATION FOR ANTERIOR TEETH  MAXILLARY CENTRAL INCISOR  Internal anatomic structure of Pulp chamber dictates Shape & Size of Access opening.  Majority of roots are straight (75%).  Root is bulky with slight distal axial inclination but rarely has Dilacerations. mesially (4%) palatally (4%) or labially (9%).  Average length : 23.  Pulp cavity is wider towards incisal area and then tapers to the apex.

 Initial External Outline Form  (A) For an intact tooth.  A #2 or #4 round bur or a tapered fissure bur in a high-speed handpiece is used to penetrate through the enamel and slightly into the dentin (approximately 1 mm). begin in the center of the lingual surface of the anatomic crown. . it is one half to three fourths the projected final size of the access cavity. similar in geometry to an ideal access shape for the particular anterior tooth.  (B) An outline form is created.

 Penetration of the pulp chamber roof Experienced clinicians . frequently a “drop-in effect” is felt when this occurs. .  All of the pulp chamber roof. including the pulp horns.tactile sensation of a slow-speed handpiece. but less experienced . (C)The bur is directed perpendicular to the lingual surface as the external outline opening is created.change the angle of the bur from perpendicular to the lingual surface to parallel to the long axis of the root . must be removed. feeling.allows the internal pulp anatomy to dictate the external outline form of the access opening.  Complete Roof Removal (E) The remaining roof is removed by catching the end of a round bur under the lip of the dentin roof and cutting on the bur's withdrawal stroke .high-speed handpiece. All internal walls must be flared to the lingual surface of the tooth.  Identification of canal orifices With an endodontic explorer Used for reaching. Penetration into the tooth is accomplished along this root's long axis until the roof of the pulp chamber is penetrated. (D) With the same round or tapered fissure bur . and often digging at the hard tissue using tactile sensation.

. Its removal aids straight-line access and allows for more intimate contact of files with the canals walls for effective shaping and cleaning. Removal of the Lingual Shoulder  This is the lingual shelf of dentin that extends from the cingulum to a point approximately 2 mm apical to the orifice .

e.MAXILLARY LATERAL INCISOR: Similar to that for Maxillary Central Incisor.  Access cavity preparation in maxillary lateral need to be modified in certain cases such as in anomalies such as dens invaginatus. . peg laterals and talon cusps. but is smaller and more ovoid in shape. 2 round bur may be used instead of no. a no.  Technique for entry is same except that a smaller i. 4 as for central.5mm  Always has one Root & type I Canal Configuration  Access is Smaller in all dimensions & More ovoid  Access opening – similar to central.  Average length : 22.

straight 39%. lingual curve 7%  Extensive.  Lateral canals 24%  Roots have a Distal curve 32%. beveled.  Long. incisal extension. ovoid. Labial curve 13%. funnel shaped coronal preparation.0mm. Maxillary Anterior Teeth: Errors in Cavity Preparation  Perforation :-Failure to complete convenience extension toward the incisal  Gouging of the labial wall caused by failure to recognize the 29-degree lingual-axial angulation and LATERAL PERFORATION .Maxillary canine  Average length – 26.

 When Two Canals are present . III.4% cases & type 3 in 6.5mm  One root & Canal configuration can be type I .4 mm  One root & Canal configuration can be type I .  For central incisors: type 1 canal configuration in 70.1% cases.4%). type 2 in 23. with greatest dimension oriented inciso-gingivally.  Average length : 22.II.II.9%).7%) & Type 3 (29.9%). Labial canal is straighter. .5% cases.  Type 1 (56. Type 2 (14.Pear Shaped preparation Discoloration Ledge Formation  MANDIBULAR CENTRAL INCISOR Average length : 21. III.  Lateral Canals (13.  Point of division for divided canals is generally in Cervical third of root  Shape is Long Oval.

.

5%  Distal curve – 20%  Extensive. Mandibular Anterior Teeth: Errors in Cavity Preparation  Gouging at the labio cervical wall  Gouging of labial wall: failure to recognise the 20-degree lingual-axial inclination of tooth  Gouging of distal wall: failure to recognise 17-degree mesial-axial angulation of the tooth  Failure to explore. funnel shaped coronal preparation.  Access cavity is Ovoid & may extend Incisally for access  Lateral canals – 9. Beveled incisal extension. debride or fill the second canal  Discoloration of crown Ledge formation . ovoid.0mm  One root.MANDIBULAR CANINE:  Average length : 24. rare cases : 2 roots  One root may have type I (94%) & III Canal Configurations.

Franklin Weine  Endodontics . COHEN -10th  editionEndodontic therapy.REFERENCES  Pathways of pulp.Ingle 5th edition and 6th edition  Endodontic practice -Louis I. grossman .

Sign up to vote on this title
UsefulNot useful

Master Your Semester with Scribd & The New York Times

Special offer for students: Only $4.99/month.

Master Your Semester with a Special Offer from Scribd & The New York Times

Cancel anytime.