Endodontics
Course Review
Enoch Ng, DDS 2014
Access Cavity Prep
Rubber Dam
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Rubber dam required for all endo cases – standard of care
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Protection of patient
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Creates aseptic environment, infection control
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Enhances vision, makes treatment more efficient
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Retracts tissue, soft tissues are protected from laceration chemical agents and medicaments
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Irrigation solutions confined to the operating field
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Protects patient from swallowing aspirating instruments and/or materials
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Generally, medium weight non-latex type
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Rubber Dam Retainers
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Anterior –#9 or #212
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Premolars - # 0 or 2
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Molars - # 14, 14A, 56
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Dam Placement
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Evaluate ability to isolate – oraseal caulking can be used to seal, prevent saliva from getting into access
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Periodontal support
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Restorability, caries, defective restorations/leaking margins
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Crown lengthening
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Cost/tx plan, consent
Access Prep
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Objectives
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Remove all caries, conserve tooth structure
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Completely unroof pulp chamber, remove all coronal pulp tissue
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Local all root canal orifices
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Achieve straight line access to apical constriction or initial curvature of canal
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Establish restorative margins to minimize marginal leakage of restored tooth
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Consider multiple tooth isolation – short clinical crown, retainers not in way of radiographs, etc
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Other Considerations
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Until RD is in place, broaches and files CANNOT be used
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All unsupported tooth/restorative structure must be removed
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Radiographs may include off angle bitewings and Pas
Estimated access length
