Ideal Endodontic Access In Mandibular Incisors

By Mauger M, Waite R, Alexander J, Schindler W

Date: 03/1999
Journal: Journal of Endodontics

Purpose:

To determine the ideal access location for mandibular incisors to get straight line access to the apical third and to determine if a correlation exists between the degree of incisal edge wear and location of access opening.

Materials/Methods:

  • 279 extracted mandibular incisors were radio-graphed (bucco-lingual and proximal views obtained for each tooth).
  • Using proximal images, each tooth was divided into coronal, middle and apical thirds.
  • At the 2 junctions (coronal-middle thirds junction and middle-apical thirds junction), the canal width was measured and the midpoint between the buccal and lingual walls was determined.
  • A line was drawn connecting the 2 midpoints and extending through the crowns to determine the ideal access location.
  • The degree of teeth wear was recorded (slight or non, moderate, extensive) and chi-square test was used to assess the relationship between the incisal wear and the ideal access location

Results:

  • 27.6% of the teeth had their ideal access facial to the incisal edges and 72.4% had straight line access on the incisal edges.
  • The ideal access opening moved from the facial to the inciasl edges as the amount of the incisal wear increases
  • Non of the teeth had straight line access on the lingual surface.

Clinical Significance:

The straight line access for mandibular incisors is always located incisally or facially . For mandibular teeth requiring crown with a post and core, the access is best prepared through the incisal or facial surfaces.