Endodontic Access Flashcards
What must a tooth be free of before endodontic intervention?
caries
Why must a tooth be caries free before commencing endodontic treatment?
- to assess restorability
- to allow treatment planning for the final restoration
- to expose anatomical landmarks
- to allow for dam isolation
- safe use of irrigants
How can safe use of irrigants be encouraged?
providing an access cavity with four walls
When should dental dam be placed for root canal treatment?
- from the start of the procedure
- once pulp chamber penetrated
- if need to see anatomy to aid access
- cotton wool rolls and saliva ejector before
What clamps can be used for anterior teeth?
- C
- E
What clamps can be used for premolars?
- E
- EW
What clamps can be used for molars?
- A
- AW
- FW
- K
What can be used to aid dam seal?
- Oraseal caulking
- OpalDam
How can the seal of a dental dam be checked?
chlorhexidine solution
What measurements should be made on a pre-operative radiograph?
- estimated working length
- length of each root
- with anatomical reference point
- length of each root
What can be measured to reduce the risk of perforation during access?
- DG16 with rubber stop
- gauge depth of access cavity
- if beyond ACJ stop
Describe the process of accessing an anterior tooth
- open into dentine in centre of lingual surface
- high speed diamond round/fissure
- incisal to cingulum
- shank of bur parallel to long axis of tooth
- ensure straight line access
- long shank latch grip bur can be used
- if regular bur does not access pulp chamber
- opening should be funnelled
- remove ledges on palatal aspect
- remove pulp chamber roof
- remove pulp horn remnants
- avoid hollowing out the natural crown
- retain as much cingulum dentine as possible
What shape should access cavities be for incisors?
- triangualr
- base to incisal edge
What shape should access cavities be for canines?
oval
Describe the process of accessing a posterior tooth
- open into dentine
- high speed diamond bur
- estimate depth of penetration necessary
- aim for largest pulp horn
- open into pulp chamber
- preferably slow speed
- long shank round bur
- do not let bur touch pulp chamber floor
- preferably slow speed
- remove remainder of pulp chamber roof
- endo Z bur
- float bur at roof of the pulp chamber
- do not let bur touch pulp chamber floor
- remove contents of pulp chamber with discoid excavator
- remove any overhanging edges of pulp chamber
- endo Z bur