Professional Documents
Culture Documents
Good visibility and accessibility are necessary to carry out an endodontic treatment satisfactorily. To
achieve this, the access preparation must be made so that it is possible to inspect the coronal part of the
pulp cavity visually and with instruments after completion of the opening of the pulp chamber. In many
instances (probably most) when patients have been referred to an endodontist because a started
endodontic treatment has "gone wrong", the cause is poor access preparation.
Underextended access preparations may cause canals to be overlooked, anatomical divergences will not
be detected, and infected material will be left in the root canal and that necrotic tissue remaining in the pulp
chamber will cause discoloration of the crown. Furthermore, a narrow access preparation may direct a bur
or root canal instrument and increase the risk of perforation. It is more important to have good access than
to save a cusp, because a good root filling is necessary to keep an endodontically involved tooth.
Procedure
Remove all caries and fillings that stand in the way of view or that can cause leakage. Undermined enamel
shall also be removed together with parts of the crown that make accessability to the canal(s) difficult e.g.,
mesiobuccal cusps of molars.
Average Length: 22 mm
Number of canals: 1
Root development completed at 10 years of age.
The access preparation of the lateral incisor is also begun from the palatal surface. The root canal is wide
in proportion to the root and also there is usually a distopalatal curve in the apical third of the canal.
Therefore, the canal must be instrumented carefully to avoid perforation.
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Maxillary Canine
Mesially, there is a concavity of the root surface and there is an increased risk of mesio-cervical perforation
during access preparation because of this.
The roots of the first maxillary premolar are often slender and curved; contours are sometimes difficult to
see on the radiograph.
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Mandibular Incisors
Mandibular Canine