Open AccessThe maxillary molar endodontic access opening: A microscope-based approach
Author(s) -
John Mamoun
Publication year - 2016
Publication title -
the european journal of dentistry/the european journal of dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.625
H-Index - 31
eISSN - 1305-7464
pISSN - 1305-7456
DOI - 10.4103/1305-7456.184153
Subject(s) - molar , dentistry , root canal , magnification , pulp (tooth) , operating microscope , materials science , maxillary molar , microscope , orthodontics , medicine , computer science , surgery , computer vision , pathology
This article reviews the basic clinical techniques of performing a maxillary molar endodontic access opening, starting from the initial access opening into the pulp chamber, to the point where a size #10 file has been advanced to the apices of all three or four (or more) canals. The article explains how the use of the dental surgical operating microscope or microscope-level loupes magnification of ×6–8 or greater, combined with head-mounted or coaxial illumination, improve the ability of a dentist to identify microscopic root canal orifices, which facilitates the efficient creation of conservative access openings with adequate straight-line access in maxillary molars. Magnified photos illustrate various microscopic anatomical structures or landmarks of the initial access opening. Techniques are explored for implementing an access opening for teeth with vital versus necrotic pulpal tissues. The article also explores the use of piezoelectric or ultrasonic instruments for revealing root canal orifices and for removing pulp stones or calcified pulpal tissue inside the pulp chamber.