Endodontic Access 1 Flashcards
What 3 things does a tooth need to be to do RCT on it?
Restorable
Periodontally Sound
Strategic
are triangular with the base of the triangle toward the incisal
Maxillary central incisors
follow the same form (triangular) but are narrower and less flared incisally
-more oval
Maxillary lateral incisors
also have the same general form (triangular) but are closer to an oval
Maxillary canines
How often do mand incisors have 2 canals?
40%
What shapes are the mand anteriors?
triangular but mostly oval
are very narrow and have 2 canals 40%of the time so
the access is very narrow M-D and extends further incisally
Mandibular central & lateral incisors
are oval and similar to maxillary canine access
Mandibular canines
How deep should your access but go into tooth?
7 mm
What 2 burs can be used for access in endo?
2 round
330
Total straight-line access on anteriors would involve access from the facial and create a weakening of the incisal edge and an esthetic issue.***
“Incisal compromise”
What is used for shaping the access for anterior teeth to provide straight line access without incisal compromise?
Diamond bur
What is used for shaping the access for posterior teeth to provide straight line access without incisal compromise?
Endo EZE bur
What is used for find the canals of accessed teeth?
Endo explorer
- Triangular/Oval Access
- Thinner root than central (narrower access M-D narrower pulp horns)
- Root often curves to distal; Can be VERY DIFFICULT to maintain curve especially in youth
- Apex tips to palatal
- “Incisal Compromise” on all anterior teeth
Max lateral incisor
• Triangular/Oval access • Canal narrower M-D than F-L • One root (larger and longer than lateral) • USUALLY SINGLE CANAL (most max. anteriors)
Max canine
• Oval access (use #2 round bur)
• Root wider F-L than M-D
• Very narrow M-D (easy to perforate to side of root)
• One canal 60% Two canals 40%
• When two canals-mostly Type II (See Weine)
• Benjamin and Dowson study
• Must extend access toward incisal to locate
lingual canal) LOOK at XR-also adjacent teeth.
Mand incisors
Which of the 2 canals is most commonly missed in mand incisors?
Buccal canal
What type of canal
one canal from
pulp chamber to apex
•Type I:
What type of canal
2 canals from
pulp chamber, join
prior to apex
•Type II:
What type of canal
2 canals from
pulp chamber to apex
•Type III:
What type of canal one canal from pulp chamber divides prior to apex (most difficult to treat)
•Type IV:
What type of canal configuration is a fast break?
type 4
The premolars are all what shape?
Oval
________ contain a B. & a L. canal in at least 85% of cases. M-D width of the access
is no wider than a #4 round bur and the opening usually extends from near the tip of the buccal cusp lingually as a
narrow oval
Maxillary first premolars
_______ contain a second canal in at least 35% of cases and the access form is
very similar to the first PM. If there is a single canal, it is centrally located and wide from B to L.
Maxillary second premolars
_________ also have a very narrow M-D width and access
extends from near the tip of the buccal cusp lingually.
2 canals are somewhat rare and very difficult.
Mandibular PMs
• Thin Oval Access (width of #4) • thin M-D root • Two canals most prevalent • 85% two canals • 9% one canal • 6% three canals • Canal orifices lie under respective cusp tips
Max PM
How can you tell between the roof and root on an access with 2 canals?
Endo explorer chips roof
Color of dentin
• Access: Thin oval (width of #4) • Slightly less F-L extension than 1st • Most often Type I 1 root 1 canal (75- 85%); Type II, III & IV less frequently • 2 roots (15 -25%) - Vertucci Study • 3 roots very rarely • If one canal found but not in center F-L, there are probably 2 canals • Beware Type IV, very hard to shape, clean and fill
Max 2nd PM
• Access: thin oval • Usually one root, 1 canal (type I), 73.5 % • Type III, 19.5 %*** • Three canals less than 1% • Vertucci study
Mand 1st PM
-The walls of the pulp chamber are concentric to the
external outline of the tooth at the level of the CEJ
- If the tooth is narrow M-D, the pulp chamber will
be narrow M-D, etc.
“The Law of Concentricity”
