Ideal endodontic access in mandibular incisors.

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

Date: 01/1999
Journal: Journal of Endodontics

Summary: 

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.

N=  279 extracted human mandibular incisors. ( central & lateral )

Materials/Methods:

•The teeth were radiographed (bucco-lingual and proximal views for each tooth)

•From 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. (Fig. )

•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

Most highlighted 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 incisal 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 & the amount of incisal wear can provide a guide for proper access location.