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012. access cavity preparation

access cavity preparation

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012. access cavity preparation

  1. 1. EndodonticsEndodontics:: Access CavityAccess Cavity PreparationPreparation 11
  2. 2. Access Cavity PreparationAccess Cavity Preparation MAJOR OBJECTIVESMAJOR OBJECTIVES 11--Straight-Line AccessStraight-Line Access 22--Conservation of Tooth StructureConservation of Tooth Structure 33--Unroofing of Chamber and ExposureUnroofing of Chamber and Exposure of Pulp Hornsof Pulp Horns 22
  3. 3. Endodontic Preparation ofEndodontic Preparation of Maxillary and mandibularMaxillary and mandibular Anterior TeethAnterior Teeth 33
  4. 4. 44
  5. 5. 55
  6. 6. 66
  7. 7. 77
  8. 8. 88
  9. 9. 99
  10. 10. 1010 Maxillary Central Incisor  Central incisor are large and on an average of 23 mm.  It has a single canal and a single apical foramen.  The pulp in young patients normally has 3 pulp horns.  The pulp chambers is noticeably wider in the faciolingual direction than in the mesiodistal. All upper anterior teeth have one root and one canal.
  11. 11. 1111 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. 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.
  12. 12. 1212 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 root canal. The root apex is often tapered and very thin. The canal is usually straight but may show a distal apical
  13. 13. 1313 Mandibular Central and Lateral Incisors CENTRAL LATERAL Average length is 21 mm, but the central incisor may be shorter than the lateral. 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.
  14. 14. 1414 Mandibular Canine Smaller than the maxillary canine. The average length is 22.5 mm. . Rarely has 2 roots, but fewer of mandibular canine display the canal form with 2 separates apical formina.
  15. 15. Access cavity preparationAccess cavity preparation 1515
  16. 16. Endodontic Preparation ofEndodontic Preparation of Maxillary Anterior TeethMaxillary Anterior Teeth 1616
  17. 17. Endodontic Preparation ofEndodontic Preparation of Maxillary Anterior TeethMaxillary Anterior Teeth 1717 Adult toothAdult tooth
  18. 18. 1818 Cavity Access. Canine Extensive ovoid, funnel-shaped coronal preparation
  19. 19. Maxillary Anterior TeethMaxillary Anterior Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 1919
  20. 20. Maxillary Anterior TeethMaxillary Anterior Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 2020
  21. 21. Endodontic Preparation of MandibularEndodontic Preparation of Mandibular Anterior TeethAnterior Teeth 2121
  22. 22. Mandibular Anterior TeethMandibular Anterior Teeth ERRORS in Cavity PreparationERRORS in Cavity Preparation 2222
  23. 23. Mandibular Anterior TeethMandibular Anterior Teeth ERRORS in Cavity PreparationERRORS in Cavity Preparation 2323
  24. 24. 2424
  25. 25. 2525
  26. 26. Endodontic Preparation ofEndodontic Preparation of Maxillary and mandibularMaxillary and mandibular Premolar TeethPremolar Teeth 2626
  27. 27. Maxillary FirstMaxillary First PremolarPremolar Generally has 2 root with 2 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.
  28. 28. Endodontic Preparation ofEndodontic Preparation of Maxillary First premolar TeethMaxillary First premolar Teeth 2828 Young tooth Adult toothYoung tooth Adult tooth
  29. 29. Maxillary Second PremolarMaxillary Second Premolar The typicalThe typical secondsecond premolar has onepremolar has one root and one canal and sometimesroot and one canal and sometimes has an apical distal curvaturehas an apical distal curvature.. The pulp chamber is wider B-P and narrower M-The pulp chamber is wider B-P and narrower M- D and has 2 well define pulp hornsD and has 2 well define pulp horns.. The canal orifice is directly in the centre of theThe canal orifice is directly in the centre of the toothtooth.. Average length: 21 mmAverage length: 21 mm..
  30. 30. Endodontic Preparation ofEndodontic Preparation of Maxillary Second premolarMaxillary Second premolar TeethTeeth 3030 Young tooth Adult toothYoung tooth Adult tooth
  31. 31. Endodontic Preparation of MaxillaryEndodontic Preparation of Maxillary Premolar TeethPremolar Teeth 3131
  32. 32. Maxillary Premolar TeethMaxillary Premolar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 3232
  33. 33. Maxillary Premolar TeethMaxillary Premolar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 3333
  34. 34. MandibularMandibular PremolarsPremolarsUsually has a single delicate root 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
  35. 35. Cavity AccessCavity Access •Because of the inclination of the crowns ofBecause of the inclination of the crowns of mandibular teeth and the smaller lingualmandibular teeth and the smaller lingual cusp, the access opening should becusp, the access opening should be placed buccal to the central fissureplaced buccal to the central fissure.. •The preparation is madeThe preparation is made ovaloval, corresponding to the, corresponding to the shape of the root and canalshape of the root and canal..
  36. 36. Endodontic Preparation ofEndodontic Preparation of Mandibular premolar TeethMandibular premolar Teeth 3636 Young tooth Adult toothYoung tooth Adult tooth
  37. 37. Endodontic Preparation of MandibularEndodontic Preparation of Mandibular Premolar TeethPremolar Teeth 3737
  38. 38. Mandibular Premolar TeethMandibular Premolar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 3838
  39. 39. Mandibular Premolar TeethMandibular Premolar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 3939
  40. 40. Endodontic Preparation ofEndodontic Preparation of Maxillary and mandibularMaxillary and mandibular Molar TeethMolar Teeth 4040
  41. 41. Maxillary First MolarsMaxillary First Molars Generally three rooted with 3 canals. AdditionalGenerally three rooted with 3 canals. Additional canal is located in the MB rootcanal is located in the MB root.. Large pulp chamber,Large pulp chamber, triangular in shapetriangular in shape ,, with the base toward the buccal and the apexwith the base toward the buccal and the apex toward the lingual surfacetoward the lingual surface.. Slightly curved buccal rootsSlightly curved buccal roots.. DP curvature of the MB rootDP curvature of the MB root.. Apical-buccal curvature of theApical-buccal curvature of the palatal root (55%palatal root (55%(( Average LengthAverage Length:: MB: 20mmMB: 20mm DB: 19.5mmDB: 19.5mm P: 20.5mmP: 20.5mm
  42. 42. 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. Maxillary First Molars
  43. 43. Endodontic Preparation ofEndodontic Preparation of Maxillary First molar TeethMaxillary First molar Teeth 4343 Young tooth Adult toothYoung tooth Adult tooth
  44. 44. Maxillary Second MolarMaxillary 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.
  45. 45. Endodontic Preparation ofEndodontic Preparation of Maxillary Second Molar TeethMaxillary Second Molar Teeth 4545 Young tooth Adult toothYoung tooth Adult tooth
  46. 46. Endodontic Preparation of Maxillary MolarEndodontic Preparation of Maxillary Molar TeethTeeth 4646
  47. 47. Locate canal orifices & obtainLocate canal orifices & obtain Straight-Line AccessStraight-Line Access Probing the Canal EntrancesProbing the Canal Entrances After the roof of the pulp chamber has been penetratedAfter the roof of the pulp chamber has been penetrated and the access cavity prepared, the entrances to theand the access cavity prepared, the entrances to the pulp canals must be probedpulp canals must be probed.. A hooked explorer can be used to determine ifA hooked explorer can be used to determine if enough dentin has been removedenough dentin has been removed The canal entrances are found by feeling with a thinThe canal entrances are found by feeling with a thin,, stiff explorer. If the explorer sticks in a spot, a size 15stiff explorer. If the explorer sticks in a spot, a size 15 Hedstrom file is used to verify that the spot is indeedHedstrom file is used to verify that the spot is indeed the entrance to a root canal and not a perforation. Onlythe entrance to a root canal and not a perforation. Only then is the opening gently enlarged. Narrow root canalsthen is the opening gently enlarged. Narrow root canals must first be enlarged coronally with a Hedstrom filemust first be enlarged coronally with a Hedstrom file before the deep preparation withbefore the deep preparation with Gates-Glidden bursGates-Glidden burs cacan be startedn be started..
  48. 48. 4848
  49. 49. Maxillary Molar TeethMaxillary Molar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 4949
  50. 50. Maxillary Molar TeethMaxillary Molar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 5050
  51. 51. Mandibular FirstMandibular First MolarMolar Usually has 2 roots one mesialUsually has 2 roots one mesial and one distaland one distal.. The Distal root is smoller andThe Distal root is smoller and verticalvertical.. Distal curvature of the mesial rootDistal curvature of the mesial root (84% of the time) which has two(84% of the time) which has two canalscanals.. The distal canal is larger and moreThe distal canal is larger and more ovaloval.. The MB is the most difficult canalThe MB is the most difficult canal to instrument because its tortuousto instrument because its tortuous
  52. 52. Average Length: 21 mmAverage Length: 21 mm Triangular outline form reflects the anatomy of the pulp chamber, with the base toward mesial and the apex toward the distal surface. The cavity is primarily within the mesial half of the tooth but is extensive enough to allow positioning of instruments and filling materials.
  53. 53. Mandibular Second MolarMandibular Second Molar •It is smaller version of the first molarIt is smaller version of the first molar with an average length of 20mmwith an average length of 20mm.. •The mesial root has 2 canals and theThe mesial root has 2 canals and the distal onedistal one.. •The mesial canals tend to fuse in theThe mesial canals tend to fuse in the apical third to give rise to one mainapical third to give rise to one main apical foramenapical foramen..
  54. 54. Endodontic Preparation ofEndodontic Preparation of Mandibular Molar TeethMandibular Molar Teeth 5454 Young tooth Adult toothYoung tooth Adult tooth
  55. 55. Endodontic Preparation of MandibularEndodontic Preparation of Mandibular Molar TeethMolar Teeth 5555
  56. 56. Mandibular Molar TeethMandibular Molar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 5656
  57. 57. Mandibular Molar TeethMandibular Molar Teeth ERRORS in CavityERRORS in Cavity PreparationPreparation 5757
  58. 58. Thank you 5858

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