Definition

Branch of Dentistry concerned with

Prevention, Diagnosis, Treatment and
Prognosis of diseased or injuries of the
Pulp and Periapical tissues.
Objectives:

* To render the affected tooth biologically

accepted; esthetic, function, symptoms
free and without a diagnosable pathosis.

In other words:
* Restoration of the Endodontically treated
tooth to its proper form & function in the
masticatory apparatus in a healthy state.
Phases of Endodontic Treatment:

* Diagnosis Phase.
Obturation Diagnosis

* Preparatory Phase.

Preparatory
* Obturation Phase.
Indications of Endodontic Therapy:
* Teeth with Pulp &/or Periapical pathosis.
* Traumatic &/or Pathological pulp exposure.
* Incomplete calcification of pulp chamber
& root canals.
* Internal resorption.
* Over-eruption & mesially drifted abutment
teeth.
* Esthetic requirements.
* Retained teeth to support overly dentures.
* Need of Post & Core to rebuild the missing
coronal portion of the tooth ??.
* Teeth with Pulp &/or Periapical pathosis.
* Traumatic &/or Pathological pulp exposure.
* Incomplete calcification of pulp chamber
& root canals.
* Internal resorption.
* Over-eruption & mesially drifted abutment
teeth.
* Esthetic requirements.
* Retained teeth to support overly dentures.
* Need of Post & Core to rebuild the missing
coronal portion of the tooth ??.
Contra-Indications of Endodontic Therapy:
* Teeth with insufficient periodontal support.
* Teeth with vertical or oblique fracture.
* Teeth with extensive internal or external
resorption.
* Non-restorable teeth.
* Non-strategic teeth.
* Teeth with root canals not suitable for
instrumentation &/or periapical surgery.
* Patients with systemic conditions contra-
indicated for Surgical Endodontics ??.
* Teeth with insufficient periodontal support.
* Teeth with vertical or oblique fracture.
* Teeth with extensive internal or external
resorption.
* Non-restorable teeth.
* Non-strategic teeth.
* Teeth with root canals not suitable for
instrumentation &/or periapical surgery.
* Patients with systemic conditions contra-
indicated for Surgical Endodontics ??.
‫بسم هللا الرحمن الرحيم‬

‫‪2005‬‬
Morphology
of Permanent Teeth
and
Pulp space morphology
 Crown

Alveolar bone Gingival tissue

Root Periodontal membrane

Enamel
Dentin
Pulp chamber

Root canal
Pathology of the Pulp

Inflamed Pulp
ROOT CANAL
TREATMENT

Endodontology

Pulpectomy
 Root pulp morphologies

Root shape

Canal shape

MB root Palatal root

DB root
Pulp space of any tooth consists of
A- Coronal pulp
I- Pulp chamber
(Roof - Floor - Side walls).
II- Pulp horns.
B- Radicular pulp
I- Root canal.
II- Lateral or accessory canals.
Shape and size of the pulp
cavity: pulp chamber and root
canals,
 Number of roots, and
number of root canals,
 Direction of curvature of
root and canals.

The dimensions of the pulp chamber
Pulp chamber size
(physiologic)
reduced by calcification,
which tends to be greater on
the roof of the pulp chamber
and the axial walls than on
the floor of the pulp chamber

Secondary Cementum
 Types of root canals

Mature
Immature
Type I :
Mature straight
canal.
 Type II :
Mature curved canal:

A- Slightly curved canal

 Severely curved
B-
canal
C- Dilacerated
canal .
D - Bayonet
canal .
 Type III:
Immature (open apex) canals
(straight or curved)

A-Tubular
root
apex .
B - Blunderbuss
apex .
 ROOT CANAL SYSTEM

Root canals are specified as:

1. Main canal

2. Secondary canal or extra

canal
3. Lateral or Accessory root
canal
 Location of root canals requires
a knowledge of tooth and pulp
anatomy;

 in young teeth the pulp horn

may be located coronal
to cemento-enamel junction

in older patient may be located at

or below the junction,
 1- Root canal orifices

An imaginary opening between pulp

chamber and root canal commonly
located at cervical part of a tooth.
2- Root Canal Apex :
It is found at the end of root
apex. ( A,B,C)
ِ A-Radiographic Apex: refers to
the external border of the root
tip.
B-Anatomic Apex :It ends at
cemento- dentinal junction
(apical constriction).
C- Apical third of the root
The distance between anatomic apex and
radiographic apex ranges from (0.5 - 1mm).
 Class I :

Single Orifice
Single Canal
Single Apical Foramen .

1---1----1
 Class II :

Two Orifices
Two Canals

Single Apical Foramen

2---2----1
Class III :
Two Orifices
Two Canals
Two Apical Foramen .

2---2---2
 Class IV :

Single orifice
Single canal
Two apical foramina

1---1---2
 Class V :

Single orifice
Two canals
Single apical foramen .

1---2----1
 Class VI :

Two orifices
Single canal
Two apical foramen

2---1---2
Maxillary and
Mandibular
Permanent
Incisors Teeth
 Maxillary Central
Incisors

This tooth is specially suitable for

endodontic treatment because
more than one third of its canal
is directly visible .
A- Lingual view :

1- Pulp chamber is wide

coronal with three pulp
horns, and uniformly
tapering toward apex .
2- Two (2) degree mesial
axial inclination of the
tooth .
3- Apical distal curvature.
B-Mesial view :

1- Pulp chamber is
pointed incisally ,
then Wider
cervically and
uniformly tapering
toward apex.
2- Twenty nine (29)
degree lingual-axial
angulations of the
tooth.
C-Cross-section:

I- Cervical third:
Triangle in shape , the base
toward the palatal surface ,
while the apex toward
lingual surface .
II- Middle third :
Ovoid in shape , wider in
mesio-distal dimension .
III-Apical third:
Narrow round in shape .
 Maxillary
Lateral Incisor
Similar to maxillary
central incisor but
smaller in size and the
root is slightly conical
and tend toward a
slight curvature
toward the distal .
Variations in the number of root canals in incisors.

Central Lateral

Average length: 22.8-mm 23.3mm

Time of eruption: 7-8 years 7-8 years
Time of calcification: 10 years 10 years
One canal one foramen 100% 99.9%


 Maxillary Canine

The longest tooth in the dental

arch , and has formidable shape
desigened to withstand heavy
occlusal stress.
 A - LINGUAL VIEW :

1. Coronal extent of
the pulp .
2. Narrow M D width of the
pulp .
3. Apical-distal curvature
(32%)
4. 6-degree distal-
axial inclination of the tooth
 B - Mesial View :
1. Huge ovoid pulp, larger
labio-lingually.
2. labial “shoulder” just
below the cervical third
3. narrow canal in the
apical third
4. 21-degree lingual-axial angulation
of the tooth
5. narrow labio-lingual width of the
pulp
6. apical Palatal curvature (13%)
 C - Cross-section:
I-Cervical third: Oval –
shape much wider in the
labio-lingual direction.
II-Middle third : the canal
continues ovoid in shape
III-Apical third : Narrow
rounded.
 Maxillary Canine

• Average length 26.0-mm

• One canal one foramen 100%
• Curvature Straight 39%
Distal 32%

• Time of eruption: 10-12 years

• Time of calcification: 13-15 years
 MANDIBULAR
CENTRAL and
LATERAL INCISOR

Central incisor is the smallest

human adult teeth , so they often
appear more accessible than they
really are , and can be a treatment
challenge .
 A-Lingual view:
1. Three pulp horns
2. Mesial-axial
inclination of the
tooth (2 degrees).
3. Slight apical-distal
curvature of the
canal
 B-Mesial view :

1. lingual “shoulder” at
the point where the
chamber and canal
join.
2. Broad labio-lingual.
3. 20-degree lingual-
axial angulations.
 C- Cross-section:
Class I:
A-Cervical third: wider in the
labiolingual.
B-Middle third the canal
continues ovoid.
C-Apical third : the canal,
generally round in shape,
 Class II:
A-Cervical third: the two
canal is slightly ovoid.
B-Middle third : : the
two canals are round.
C-Apical third :
are slightly round
 Class III:
A-Cervical third: two oval
canal
B-Middle third : : the two
canals are round
C-Apical third : the two
canals are narrow round
 Mandibular central and
lateral incisors
Central Lateral
Average length 21.5mm 22.4mm
One canal one foramen 70.1% 56.9%
Two canals two foramen 6.5% 29.4%
Curvature Straight 60%
Time of eruption: 6-8 year
Time of calcification: 9-10 years
MANDIBULAR CANINE
 A-Lingual View :
1. Coronal extent of
the pulp.
2. Narrow mesio-
distal width of the
pulp.
3. 13-degree mesial-
axial inclination.
4. Apical-distal
curvature.
 B-MESIAL VIEW :

1-Broad labio-lingual
extent of the pulp.
2. Narrow canal in the apical third.
3. 15-degree lingual- axial angulation.
4. Apical-labial
curvature .
 C-Cross-section:
Class I: ) 94%(
A-Cervical third: wider in
the labiolingual.
B-Middle third the canal
continues ovoid.
C-Apical third : the canal,
generally round in shape,
 Class III (4%):

A-Cervical third: two oval

canal
B-Middle third : : the two
canals are round
C-Apical third : the two
canals are narrow round
 MANDIBULAR CANINE
• Average length 25.2-mm
• One canal one foramen 91%
• Two foramen 6.5%
Curvature: Straight 65%
Distal curvature 20%

• Time of eruption: 9-10 years

• Time of calcification: 13 years
‫بسم هللا الرحمن الرحيم‬

‫‪2005‬‬
Maxillary First Premolar
 Class III: 72%

A-Buccal view
• Straight canals.
• Presence of two
canals.
• 10 0 distal-axial
inclination
B-Mesial view :

• Broad bucco-lingual
dimension of the Pulp.
• Two separate roots, each
with a single straight
canal.
• 6-degree buccal-axial
angulation of the tooth.
C-Cross-section:
Cervical third:
The two canals are kidney shape
very wide in the bucco-lingual
direction.
Middle third :
The two canals are only lightly
ovoid and may be enlarged to a
round
Apical third :
The two canals are only round
 Class II: 13%

A-Buccal view
• Single root with two
parallel canals and a
single apical foramen
• 10-degree distal-axial
inclination of the tooth.
 B-Mesial view :

•Pulp recession and a

greatly flattened pulp
chamber.
•Buccolingual width
revealing the pulp to be
“ribbon shaped” rather
than “thread-like”.
 C-Cross-
section:
Cervical third:
The chamber is very narrow
ovoid, and canal orifices are
at the buccal and lingual
termination of the floor.
Middle third :
The two canals are only
lightly round
Apical third :
The canal are only round
 Class I: 9%

A- Buccal view :
• Full pulp recession and
thread-like shape.
• Radiographic appearance of
only one canal.
• 10-degree distal-axial
inclination of the tooth
B-Mesial view :

1. Pulp recession and a

greatly flattened pulp
chamber.
2. Bucco-lingual width
revealing the pulp to
be “ribbon shaped”
3. Single root with
single apical foramen.
Cervical third:
Very wide in the bucco-lingual
direction.The orifice is directly
in the center of the tooth. Pulp
chamber is very narrow ovoid.
Middle third:
The canal remains ovoid in
shape .
Apical third:
The canal are only round
Class III: 72%
Class I: 9%
Class II: 13%

1. Time of eruption: 10 - 11 years.

2. Time of calcification: 12 -13 years.
3. Average tooth length : 21.8 mm .
4. One root one foramen 9%
5. Two root two foramina 13%.
6. Two root two canals two foramina:72%
7. Three canals three foramina 6%
MAXILLARY SECOND
PREMOLAR
 Class I: 75%

A - Buccal view:
• Narrow mesiodistal
width of the pulp .
• Apical-distal curvature
(34%).
• 19-degree distal-axial
inclination of the tooth.
 B- Mesial view :
• Broad bucco-lingual
width revealing the
pulp to be “ribbon
shaped”
• Single root with a
large single canal
• 9-degree lingual-axial
angulation of the
tooth
Cervical third:
Very wide in the bucco-lingual
direction. The orifice is
directly in the center of the
tooth. Pulp chamber is very
narrow ovoid.
Middle third :
The canal remains ovoid in
shape .
Apical third :
The canal are only round
 Class III: 24%

A-Buccal view:

•ِِRoentgen
appearance of two
roots (2%).
•Bayonet curve of the
roots (20%).
•19-degree distal-axial
inclination of the tooth.
 B . Mesial view :

• Buccolingual width
revealing the coronal
pulp to be “ribbon
shaped” rather than
“thread-like”.
• High bifurcation and
two separate apical
third roots.
• 9-degree lingual-axial
angulation of the tooth
 C-Cross-section:
Cervical third:
The chamber, very narrow
ovoid extends deeply into
the root .
.
Middle third :
Bayonet curve and round
canal orifices are apparent
Apical third :
The two canals are round.
 Three canals: 1%
Class I: 75% Class III: 24%

Date of irruption: 10-11 years

Date of calcification: 12-13 years
Average length: 21-mm
One canal one foramen: 75%
Two canals two foramina : 24%
Three canals: 1%
Mandibular First Premolar
 Class I: 73.5%
A. Buccal view:

• Presence of one straight

canal.
• Narrow mesio-distal width
of the pulp.
• 14-degree distal-axial
inclination of
 B-Mesial view:

1. Height of the pulp horn.

2. Broad bucco-lingual extent
of the pulp.
3. Apical-buccal curvature
(2%).
4. 10-degree lingual-axial
angulations of the root .
 C-Cross-section:

Cervical third:
Very wide in the
buccolingual dimension,
ovoid shape.
Middle third :
Slightly ovoid.
Apical third : Round.
 Class II: 19.5%

A-Buccal view :

1-Pulp recession and

thread-like appearance
2-Radiographic appearance of
only one canal.
3-14-degree distal-axial
inclination of the root.
 B- Mesial view:

• Buccolingual “ribbon-
shaped” coronal pulp.
• Single-root, bifurcated
canal at the midroot
level and a single
apical foramen.
• 10-degree lingual-axial
angulation of the root
 C-Cross section:

Cervical third:
The chamber is very narrow
ovoid,and canal orifices are
at the buccal and lingual
termination of the floor.
Middle third :
The two canals are only
lightly round.
Apical third :
The canal are only round.
Class I: 73.5% Class II: 19.5%

1.Time of eruption: 10 – 12 years.

2.Time of calcification: 12- 13 years
3.Average tooth length: 22.1 mm .
4. One canal one foramen : 73.5%
5. Two canals one foramen: 6.5%
6. Two canals two foramina: 19.5%
7. Three canals 0.5%
MANDIBULAR SECOND
PREMOLAR
 Class I: 85.5%

A-Buccal view :
1. Pulp recession and
“thread-like” appearance
of the pulp.
2. Sweeping distal curve of
the apical third of the root
of the tooth (40%).
B-Mesial view:

1. Buccolingual “ribbon-
shaped” pulp
2. 34-degree buccal-axial
angulation of the root
 Class II: 14.5%

A-Buccal view :

1. Mesiodistal width
of the pulp.
2. Apical-distal
curvature (40% ).
3. 10-degree distal-axial
inclination of the root.
 B-Mesial view:

1. Buccolingual “ribbon-
shaped” coronal pulp.
2. Single-root, bifurcated
canal at the mid-root
level and a single
apical foramen.
3. 10-degree lingual-axial
angulation's of the root
 C-Cross section:
Cervical third:
The chamber is very narrow
ovoid,and canal orifices are at
the buccal and lingual
termination of the floor.
Middle third :
The two canals are only
lightly round.
Apical third :
The canal are only round.
Class I: 85.5% Class II: 14.5%

1.Time of eruption: 11 – 12 years.

2.Time of calcification: 13- 14 years
3.Average tooth length: 21.4 mm .
4. One canal one foramen: 85.5%
5. Two canals one foramen 1.5%
6. Two canals two foramen 11.5%
7. Tree canals 0.5%
MAXILLARY FIRST MOLAR
Internal anatomy is reflected
on the external anatomy of
the tooth
Internal anatomy is reflected on
the external anatomy of the tooth
• Large pulp chamber with four
prominent pulp horns.

• Three root (Mesio-Buccal,

Disto-Buccal ,and Palatal )

• Each root contain one canal,

except mesial canal it may
contain two canals (MB 1 &
MB 2 ) .
 Mesial Root Three Canals :

: A -Buccal view
1. Pulp recession and
“thread-like” pulp.
2. MB, DB, & P
roots, each with one
canal.
3. Straight P root, MB & DB
curved toward distal.
 Mesial Root 4 Canals MB2

A - Buccal view:
• MB root with two
separate canals, and
two apical foramina.

•Apical-buccal curvature
of the palatal root (55%)
 B. Mesial view:

1. Pulp recession.
2. Relatively straight
palatal root.
3. Buccal inclination
of the buccal roots.
C_Cross section
Cervical third:
A dark cavity floor with
“lines” connecting orifices
is in marked contrast to
white walls.
Middle third:
Three slightly oval canals.
Apical third:
The 3 canals are round.
B. Mesial view :

Mesio –buccal root:

One canal one foramen: 41.1%.
Two canal one foramen: 40%
Two canals two foramen:18.9%
Maxillary first Molar

1. Date of eruption: 6 - 7 years.

2. Date of calcification:9 - 10 years
3. Average tooth length:
MB: 19.9-mm,
DB:19.4-mm.
P: 20.6-mm.
4. Three canals: 41.1%
5. Four canals: 56.5%
6. Five canals: 2.4%
Maxillary Second Molar
 A - Buccal view:

• MB, DB, and P

roots, each with
one canal.
• Gradual curvature
of all three canals.
 B - Mesial view:

• Gradual curvature
in two directions of
all three canals.
• Buccal inclination
of the B roots.
Maxillary Second Molar Mesio-buccal root
One canal one foramen: 63.9%.
Two canals one foramen: 13.9%.
Two canals two foramen: 24.9%

I- Date of eruption:11-13 years.

2- Date of calcification:14-15 years
3- Average tooth length :
MB: 20.2- mm.
DB: 19.4 –mm
P: 20.8-mm
Number of roots: Three: 54%
Fused: 46%
Mandibular First Molar

Mesial root with two root canals (98%)

or one (2%) canals (MB &ML).
Distal root with one(65%) or two(35%)
canals (DB & DL ).

• The mesial roots are curved, greatest

curvature MB than ML canal
 A -Buccal view:

• Large pulp chamber.

• M&D roots, 1 canal.
• D root with a severe
apical curvature.
• D-axial inclination.
 B - Mesial view:

• Single mesial root with

two ROOT canals

Mesial Root canal:

Two canals one foramen: 40.5%
Two canals two foramina: 59.5%
C-Cross-section:

Cervical third:
Pulp, enormous in a young
tooth,
Middle third :
Canals are ovoid.
Apical third :
canals are round and are
shaped tapered prep.
 Four Canals:
A- Buccal view:

• Pulp recession and

“thread-like” pulp.
• M&D roots, each
containing one canal.
• M curvature of the D
root (5%) and D
curvature of the M root
(84%).
Average length: Mesial Distal
20.9-mm 20.9-mm
Number of root canals:
Two canals 6.3%
Three canals 64.4%
Four canals 28.9%
 Canals
Roots Two canals 6.7%
Two roots 97% Three canals 64.4%
Three roots 2.2% Four canals 28.9%

Canals
Mesial Distal
Two canals one foramen: 40.5% 61.9%
Two canals two foramina: 59.5% 38.9%
MANDIBULAR SECOND MOLAR
 B-Mesial view :

• Pulp recession.
• Mesial root,
two canals.
• 58-degree
buccal-axial
inclination of
the roots.
C-Cross-Section:

Cervical third:
Middle third :
Apical third :
 Mandibular Second Molar

1. Time of eruption: 9-11 years.

2. Time of calcification: 11-13 years.
3. Average tooth length:
Mesial: 20.9- mm .
Distal: 20.8-mm.

4. One canal one foramen Mesial Distal

13% 92%
5. Two canals one foramen 49% 5%
6. Two canals two foramina 38% 3%
Access cavity perforations

Cervical canal perforations

Bifurcation perforation
Overextended or underextended outline

Treating the wrong

tooth

Missed canals

Crown fractures

Damage to existing restoration

 Midroot perforations
Apical perforations

Separated instruments and

foreign objects
FOR YOU
Lecture III: Pulp morphology and access cavity
preparation
 ENDODONTIC
CAVITY PREPARATION
 ENDODONTIC
CAVITY PREPARATION
Divided into:

* Intra-Coronal preparation.

* Intra-Radicular preparation.
 ENDODONTIC
ACCESS “Intra-coronal”
CAVITY PREPARATION
 Endodontic
Objectives:
cavity preparation

1) Obtaining direct line access

to both RC orifices & Apical
foramen.

2) Conservation of tooth
structure.

3) Deroofing of the Pulp

chamber.
* Actually, coronal preparation is not only
a means to an end, but also to accurately
prepare & properly fill the radicular space,
i.e.
Intra-Coronal preparation must be correct
in size, shape and inclination.
[John Ingle 2002]
Pulp Anatomy in relation to Cavity
Preparation

* Develop a mental
three dimensional
image of the tooth
internal anatomy
from pulp horn to
apical foramen.
* The radiograph provide only two
dimensions “Blueprint”.
* Suspect the number & anatomy of thex
root canals.
Basic Coronal Instruments
& Instrumentation
* Power driven rotary instrument
with widely divergent rates of
speed.

* Round Diamond Tip.

* Endo-Z Tip.

* Extra-course Dom-ended
cylinder diamond tip mounted
in contra-angle hand piece
operating at accelerated
(High) speed.
*Diamond tips Vs Carbide burs.
[Stokes & Tidmarsh, JOE, 1988]
*Never force the tip during access.
*As soon as the enamel or
restoration penetrated, use
the slow speed (3000-8000
rpm) mounted with round
bur or Endo-Z for deroofing
the pulp camber.
* Regular length (9mm) Vs Surgical length
(14mm) tips.

* Preoperative X-ray trying of the instrument.

* With magnification e.g. Magnifying Glasses
& Lopes.
[Stokes & Tidmarsh, JOE, 1988]

“ Course diamond tapered with rounded

end tip (stone), is used for initial entrance.
However, never be forced, but should
be allowed to cut with their own way with
a light touch by the operator. Unless, forcing
the tip would cause crack or craze the enamel
or porcelain covering of the teeth ”
Endodontic Cavity Preparation:

1) Intra-Coronal Cavity Preparation.

2) Intra-Radicular Cavity Preparation.

Principles of Intra-coronal Cavity
Preparation
* G.V.Black 1936: Deal completely with cavity
preparation limited to the crown of the tooth.
WHILE
* In Endodontics: Cavity preparation deal with
both Coronal & Radicular portions of the tooth.
[Ingle J & Backland L: 2004]
Principles of Intra-Coronal Cavity
Preparation:
(I): Out line Form.

(II): Convenience Form.

(III): Removal of Remaining

Carious Dentin &
Defective Restorations.

(IV): Toilet of the Cavity.

 Principle I: Outline Form:

I.e. Endodontic cavity is correctly

shaped & positioned to establish
complete access for instrumenta-
tion from cavity margin to the
apical foramen.
N.B.
External outline form is established
by mechanically projecting the internal
anatomy of the pulp; the shape of pulp
chamber & location of RCs orifices) into
the external surface of the tooth.
e.g
* Incisor ---} Triangular in shape
based incisally & apex
cervically.
* Canines ---} Oval Inciso-cervically
 Factors affecting Outline Form

1) Size of the pulp chamber.

2) Shape of the pulp chamber.

3) Number, Position &

Curvature or Direction
of each individual RCs.

4) Age of the patient.

 Principle II: Convenience Form:
I.e. Modification of the
Cavity Outline Form to
establish greater conven-
-ience in preparation as
well as obturation of the
RCs.
Benefits of Convenience Form:
1) Unobstructed access to the
canal orifice & searching for
extra canal.

2) Direct access to the apical

foramen.

3) Complete authority over the

enlarging instruments.

4) Cavity expansion to accommodate

filling techniques
Principles III: Removal of the Remaining
Carious Dentin & Defective Restorations:

I.e. All carious & loosed or fractured

restorations must be removed &
the cavity is sealed with hard
restoration before Endodontic
cavity preparation is established.
Benefits of Removal of Carious Dentin
& Defective Restorations:
1) To eliminate mechanically as many micro-organisms
as possible from the interior of the tooth.

2) To eliminate the discolored tooth structure.

3) To eliminate the possibility of micro-organisms coming

with saliva leakage through defective restoration.

4) To avoid detached tooth or restoration particles from

interring & occluding the RCs.
Principle IV: Toilet of the cavity:
(Irrigation of the Cavity)
I.e. All the detached carious dentin, debris & necrotic
material must be removed from the pulp chamber
before the Radicular preparation is begun because
they may:

1) Obstruction of the canal during enlargement.

2) Increase bacterial possibilities in the canal

(RCs infection).

3) Discoloration of the crown.

Toilet of the Cavity
(Irrigation of RCs)
 Access Cavity
Preparation
for Anterior Teeth
(Step by Step)
Maxillary Incisors
Mandibular Incisors
Maxillary Cuspid (Canine)
Mandibular Cuspid (Canine)
 Errors in access preparation for
Upper Anterior Teeth
A) Labio-cervical perforation.

B) Labial Ledge.

C) Disto-cervical perforation.

D) Pear shape (Zipping) of

apical perforation.

E) Coronal discoloration.

F) Apical ledge.

G) Apical perforation
(Transportation).

H) Apical perforation
(Transportation).
 Errors in access preparation for
Lower Anterior Teeth

A) Labio-cervical perforation.

B) Labial Ledge.

C) Mesial ledge.

D) Missing of Root Canal.

E) Coronal discoloration.

F) Incorrect Access