Access Cavity Preparation

Access preparation is the most important phase

of the technical aspects of root canal treatment!
Access is the key that opens the door to maximize
cleaning, shaping, and obturation.

Obtur.

Clean-shap
Tooth length

Access Cavity

The three major objectives of access preparation

are :
(1) attainment of straight-line access,
(2) conservation of tooth structure, and
(3) unroofing of thechamber to expose orifices
and to remove pulp horns in anterior teeth.

The direction and extent of drilling

endodontic access cavity
preparation

should be guided by knowledge of
anatomy

and radiographic information

To achieve optimal preparation , three factors of

internal anatomy must be considered:
- Size of pulp chamber
- Shape of pulp chamber
- The number of individual root canals ,their curvature, and their
position.

For initial entrance through the enamel surface or

restoration :

The ideal cutting instrument is the round end
carbide fissure bur or

Endo-access diamond stone mounted in a
contra-angle hand-piece operating at accelerated
speed.

Instruments
to
be
used
for





access preparation
Endo access bur:
(Martin) diamond
round and fissure
bur for penetration
and smoothening

Long shank bur for access cavity

preparation

Non-cutting tip fissure burs to

prevent perforation of the pulp
chamber

Entrance is always gained through lingual surface

of all anterior teeth.
Initial preparation is made in the exact center of the
lingual surface of tooth. Only the enamel is
penetrated creating a central cavity.

Maintain the point of the bur in the

central cavity and rotate the hand-piece
towards the incisal surface so the bur is
parallel the long axis of the tooth.

Working from inside of the pulp

chamber to the outside , the
round bur is used to :
remove the lingual and labial
walls of the pulp chamber and
the lingual shoulder is removed
to give a continuous , smooth
flowing preparation

Access outline
Anterior teeth

Working from inside to outside , the lingual shoulder is

removed to give a continuous smooth flowing
preparation , allowing approach to the apical third of the
root canal.

Anterior teeth opened from

the lingual aspect.
The cavity is triangular.

Steps
Access Cavity Preparation In
Upper Anterior Teeth
1- Outline Form through Enamel & Dentine

II- Location and Exposure of the Pulp Chamber

III- Complete removal of the roof of pulp chamber

IV- Removal of lingual shoulder

V- Removal of pulp chamber contents &

Location of the root canal

In canine is oval shaped

Maxillary Premolars

Mandibular Premolars

Access outline in
posterior teeth.

Entrance is always gained

through the occlusal surface of
all posterior teeth. Initial
preparation is made in the exact
center of the mesial fossa .

A regular length number 4 or 6 round bur

is used to open into the pulp chamber.
In maxillary molar should be directed
toward the palatal canal. It will be felt to
drop when the pulp chamber is reached .

The floor of the pulp chamber is dark

and has a convex form which leads into
orifices of root canals.

Location of the canals is facilitated

by direction and extent of the
access cavity .

Opening in lower molar should be

trapezoidal, usually wider mesially

than distally .

Access in maxillary molar

rhomboidal in shape or
trapezoidal, with a second MB2

Explore
and locate
canal orifices :
Orifice shapers and orifice wideners

Orifice shapers
Gates-Glidden drills ,
sizes indicated by no.
of rings

Access related ERRORS

Access cavity perforations

Cervical canal perforations

Bifurcation perforation