Endodontic Access: Straight-Line Access for Anterior Incisors
THE NEXT DDS
As a result of watching this video, the viewer should:
what a clinician must do to gain endodontic access to a maxillary central
the steps, precautions, and instrumentation that need to be used to gain
endodontic access to a tooth
The primary goal of access preparation is to allow instruments to be
introduced into the canal without bending. This is referred to as straight-line
access. Proper straight-line access is essential to successful endodontic
treatment. By correctly accessing the root canal system, the clinician can
reduce the possibility of instrument fracture and facilitate obturation.
After the outline form has been established, access should be initiated
using high speed rotary instruments to remove the roof of the chamber. Once the
roof of the chamber is removed, it is advisable to switch to slow speed rotary
instruments. It is essential to avoid damage to the floor of the pulp chamber.
Since measurement control has not yet been established, this is an
opportune time to determine if there is a need to reduce the occlusion as part
of a pain preventative strategy. There are specific indicators that will help a
clinician determine if occlusal reduction is necessary.
Appropriate occlusal reduction is an important component of a
pain-preventive strategy which also includes: addressing the patient’s anxiety
and preoperative Non-steroidal medication.
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