Access Is the Key

Amy Dukoff, D.M.D.
Access Is the Key

Amy Dukoff

CCESS IS CRITICAL in achieving the ultimate goal of a consistent outcome for root canal therapy. If the visual access to the pulp chamber and the canal system is good, the ultimate outcome for the endodontist will be more predictable.
    Instrumenting each canal properly requires straight-line access. If the access path is not a straight line, the instrument will bend when it is placed in the canal. Straight-line access eliminates an unnecessary curve on the instrument, and that in turn eliminates unnecessary stress on the intrument. Stress on an instrument in a curved access path can be a cause of instrument separation. Straight-line access facilitates instrumentation whether it is performed by hand or by using the reciprocating handpiece.
    Additionally, tooth flattening is important in gaining access. Flattening of the tooth makes straight-line access easier, for it eliminates unneeded tooth structure. Flattening allows for a predictable reference point. In addition, it helps the practitioner relieve the occlusion to aid in decreasing the post-operative symptoms. Tooth flattening is a useful procedure to incorporate into the treatment procedure. It is important to remember to use the PulpOut Bur® first before employing the tooth-flattening technique.
    Full access is needed to help eliminate pulp chamber overhangs, which may harbor pulp tissue. One can be surprised at the amount of calcified tissue that clings to the pulpal floor, which with good access the practitioner can locate and eliminate. Furthermore, good access facilitates the use of the microscope. One needs an unobstructed field of vision in order to see aberrations in the pulp chamber.
    Access is essential for good results in endodontic procedures. One cannot skip this step or underestimate its importance. With a good beginning, the rest of the procedure will progress easily.

November - December 2006

With a good beginning, the rest of the procedure will progress easily.

For a very effective antibacterial irrigation liquid, use 2 percent chlorhexidine, NOT Peridex, which is only 0.12 percent.

FEEDBACK?

We welcome your responses and questions.
Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail.