Access - Posterior Teeth Flashcards
What is included in pre-assessment for RCT?
Can teeth be isolated and is tooth restorable following endo Caries and periodontal status Structural durability Rotation/tipping teeth Mobility (grade II+ contraindication) Vitality
What is parallax?
Determine difference between canals which overly each other
SLOB rule
What is prognosis if furcal/ radicular lesion?
Large PA lesion between roots
Guarded prognosis
What is prognosis if has large restoration extending into pulp chamber?
Poor - contraindicated
Likely to have poor seal
What should be included in preliminary tx?
Ensure tooth adequately restored
Dismantle coronal restorations
Suspect indirect restorations removed and replaced
How to remove a crown?
Bur a vertical line down buccal aspect to cement layer
Use flat plastic to remove
If doesn’t come off bur line occlusal and re-try
Ideal access preparation?
No undercut, all canal orifices visible, smooth axial walls
Access form funnel to allow straight line access for instruments
Allow safe irrigation, ease of shaping
What are common mistakes to make during access?
Incorrect orientation = perforation
Incorrect depth gauge = perforation between furcation
How many root canals do upper premolars have?
4’s = 2 roots/ 5’s = 1 root
2 root canals
Other: upper 5’s may have 1, uppers 4’s can have 3
Problem with upper premolar access?
Often have deep pulp chambers (half working length)
Canals don’t divide off till low down
How many roots canals do lower premolars have?
Singular roots
1 canals - 30% have two canals
If 2 canal - lingual canal which can be hard to miss due to access (remove shelf of dentine to aid visualisation)
How many canals does upper first molar have?
3 roots
3 canals - sometimes 4
4th canal - second mesio-buccal canal (usually palato-distal)
Big palatal canal - always widest
How access upper first molar?
Access always shifted mesial -triangular access
How to access upper second molars?
Similar anatomy upper first molar
MB2 less common first molar
How many canals does lower first molar have?
2 roots
3 canals - 2 mesial (ML/MB) and distal canal
Sometimes 4 canals - 2 mesial and 2 distal
