PREPARED BY:

DR. HAMED AL-HADDAD

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

2- Conservation of Tooth Structure


3- Unroofing of Chamber and Exposure of Pulp Horns
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Endodontic Preparation of
Maxillary and mandibular
Anterior Teeth

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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 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.


All upper anterior teeth have
one root and one canal.

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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.

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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
curvature.
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Mandibular Central and Lateral
Incisors
CENTRAL
LATERAL
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
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.
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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.
Access cavity preparation
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Endodontic Preparation of
Maxillary Anterior Teeth
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Endodontic Preparation of
Maxillary Anterior Teeth
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Adult tooth
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Cavity Access. Canine
Extensive ovoid, funnel-shaped coronal preparation
Maxillary Anterior Teeth
ERRORS in Cavity
Preparation
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Maxillary Anterior Teeth
ERRORS in Cavity
Preparation
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Endodontic Preparation of Mandibular
Anterior Teeth
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Mandibular Anterior Teeth
ERRORS in Cavity Preparation
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Mandibular Anterior Teeth
ERRORS in Cavity Preparation
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Endodontic Preparation of
Maxillary and mandibular
Premolar Teeth

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Maxillary First
Premolar
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.
Endodontic Preparation of
Maxillary First premolar Teeth
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Young tooth Adult tooth

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
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Young tooth Adult tooth

Endodontic Preparation of Maxillary
Premolar Teeth

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Maxillary Premolar Teeth
ERRORS in Cavity Preparation
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Maxillary Premolar Teeth
ERRORS in Cavity Preparation
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Mandibular Premolars

Usually 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
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
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Young tooth Adult tooth

Endodontic Preparation of Mandibular
Premolar Teeth

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Mandibular Premolar Teeth
ERRORS in Cavity Preparation
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Mandibular Premolar Teeth
ERRORS in Cavity Preparation
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Endodontic Preparation of
Maxillary and mandibular
Molar Teeth

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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


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

Endodontic Preparation of
Maxillary First molar Teeth
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Young tooth Adult tooth

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
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Young tooth Adult tooth

Endodontic Preparation of Maxillary Molar
Teeth

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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.


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Maxillary Molar Teeth
ERRORS in Cavity Preparation
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Maxillary Molar Teeth
ERRORS in Cavity Preparation
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Mandibular First Molar
Usually has 2 roots one mesial
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 path.


Average 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.
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.

Commonly has fused roots.
Endodontic Preparation of
Mandibular Molar Teeth
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Young tooth Adult tooth

Endodontic Preparation of Mandibular
Molar Teeth

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Mandibular Molar Teeth
ERRORS in Cavity Preparation
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Mandibular Molar Teeth
ERRORS in Cavity Preparation
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Thank you
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