Endo access cavity tips ??!

[ysmien]

Im a preclinical student and I'm struggling a bit with my access cavity preparations , and preping the coronal part in general (we are currently practicing anteriors and premolars) .. so any tips are appreciated 🙂

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[THS]

It just takes practice. Do y'all get to use Endo Z burs? (http://zahnsply.com/image/data/Dentsply/361119306_011.jpg)
They are non-end cutting burs that are great for shaping the walls of your access prep. Once you break into the chamber, you can use those burs to shave away the chamber roof and pulp horns without widening the chamber itself or cutting through the floor.

Be sure you start out at the right angle. Look at pre-op radiographs of the extracted teeth to see how the chamber looks. Remember that it will be right at the height of the CEJ. Use the endo explorer to ensure straight line access from the cavosurface margin to the coronal segment of the canal. When you place the endo explorer into the canal(s), the explorer should rest against (but not firmly) the wall of your prep. You want to make sure your file isn't bending to get to the orifice.
Keep in mind that anteriors will have a lingual "bulge" of dentin right at the orifice that you'll need to remove to get proper straight-line access. I use an orifice opening file to do this.

Other than that, just keep studying the shape of the access preps for each tooth (triangular for incisors, oval for canines and premolars). Always look for 2 canals in max premolars, but don't over-extend your prep looking. If you're prepping a max 2nd premolar and you see any groove in the floor of the pulp chamber leading to/from the orifice, follow it to find the other orifice and then widen the prep.

 

[Bis-GMA111]

have an idea of the ideal access shapes-have a diagram right beside you if possible

start off with a 33 1/2 round bur at first to get the general outline-once you get that switch to a round bur and go in at the appropriate angle to access the canals (i.e. for central incisors you need to go in at a 90 degree angle, then 45 degree angle to access the canal). you should feel a drop once you get into the pulp chamber.

after you feel the drop use an endo explorer to feel around for the canal. if you can stick the instrument in, you're in good shape. at this point, you would refine your access to make sure that there is no ledging.

 

[FanOfCostco]

have an idea of the ideal access shapes-have a diagram right beside you if possible

start off with a 33 1/2 round bur at first to get the general outline-once you get that switch to a round bur and go in at the appropriate angle to access the canals (i.e. for central incisors you need to go in at a 90 degree angle, then 45 degree angle to access the canal). you should feel a drop once you get into the pulp chamber.

after you feel the drop use an endo explorer to feel around for the canal. if you can stick the instrument in, you're in good shape. at this point, you would refine your access to make sure that there is no ledging.

totally agree with this, but i would like to add just a little bit of advice. If you are unsure of the angle or proximity, etc ALWAYS TAKE AN X-RAY. Especially for a patient. Taking an x-ray can save you from a perf. (also helps during wreb/nerb just to be safe)

 

[rus dentist]

problem perforation is often high on the upper incisors of the upper jaw, rightly said that it is necessary to choose the angle and leisurely first 90 then 45 degrees. The next group of teeth such problems should not be, if you know a little anatomy and the position of the root canal.
And remember that the lower incisors may be in frequent cases, the root canal 2 !!!!

Im a preclinical student and I'm struggling a bit with my access cavity preparations , and preping the coronal part in general (we are currently practicing anteriors and premolars) .. so any tips are appreciated 🙂

 

[ysmien]

Thanks all 😀 <3