Endodontic treatment of the single rooted tooth. Part 2 Access cavity preparation
In the second installment of endodontics treatment for a single-rooted tooth, we will focus on the access cavity preparation, specifically on an upper central incisor. Before starting this process, it is crucial to confirm that the tooth is free of caries and has been temporarily restored. Anesthesia should also be achieved before commencing root canal treatment.
To confirm anesthesia, a cold test is recommended rather than probing. Once anesthesia is verified, the access cavity preparation can begin. For this procedure, you will need three high-speed burs: a round diamond bur, a long diamond fissure bur, and an on-end cutting tapered diamond bur. Additionally, a long shank Rose head slow-speed bur is required.
Note that the access cavity is cut without a rubber dam in place. This is intentional to enable correct orientation and angulation of the burs, helping to prevent perforation. The round diamond bur should be held at a 45-degree angle to the palatal surface to cut the initial outline to a depth of 1 millimeter.
Next, use the long diamond high-speed fissure bur to deepen the access cavity to the pulp roof. Hold this bur parallel to the long axis of the tooth. The roof of the pulp chamber is removed using a slow-speed long shank Rose head bur. This step also involves removing any plate or shelf to ensure straight-line access for endodontic rotary files.
To establish axial walls, use an on-end cutting high-speed tapered diamond bur, ensuring they are flared, flattened, and finished. Ultrasonics can also be employed for this purpose. Once the access cavity has been properly cut, place a rubber dam around the tooth, and instruments from the endodontic kit can be utilized.
In the next installment of this series, the focus will shift to discussing the components involved in forming the glide path.