Maxillary Molar Endodontic Access

[Althingsdentist]

How many times have you started an endo access and not really felt confident as to what is going on at the end of the bur?

Until I started using a microscope (or super high power loupes), I really didn't know what what going on until I either saw red, or felt the bur drop through the roof of the chamber.

What unique instrumentation do you use for endodontic access?

Cheers

Ashley

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[tinman831]

If you ever have the slightest doubt, take a radiograph.

 

[Althingsdentist]

Excellent Point.

Additionally, there are a number of articles that have been written regarding basic chamber morphology, including:

Deutsch/Musikant JOE 2004 - Measuring key external landmarks relating pulp chamber morphology in molars. They found that (in general) cusp tip to pulp chamber roof was 6mm. The pulp chamber ceiling is found at the level of the CEJ 97% of the time.

Krasner P, Rankow HJ. Anatomy of the pulp chamber floor. J Endodon 2004; 30(1):5

These guys studied a whole bunch of teeth and figured out a few laws - the law of color change, concentricity, symmetry and whole bunch of others.

It's worth taking a look at the AAE's Access Opening PDF.

http://www.aae.org/uploadedFiles/Publications_and_Research/Endodontics_Colleagues_for_Excellence_Newsletter/ECFESpring2010_Final.pdf

Cheers

Ashley

 

[DrJeff]

If you ever have the slightest doubt, take a radiograph.

Or even take it 1 step further. If you ever have the slighest doubt, refer it out!

 

[psiyung]

Or even take it 1 step further. If you ever have the slighest doubt, refer it out!